Take action to appropriately reduce the number of children in care and improve the lives of those in care
Over 90% of children are in England’s care system because of parental neglect, abuse, illness and acute stress[i]. Children in the care system are four times more likely to have mental health difficulties and are at greater risk of self-harm, suicide attempts and suicide[ii]. The needs arising from such difficulties are often not supported in the most effective ways increasing the risk of adverse outcomes to the child in adulthood. Many millions of pounds could be saved every year if children’s mental health needs were sufficiently met and children remained in stable placements[iii].
Action for central government
1. Increase funding to councils, particularly those in the most deprived areas
Coventry University’s The Child Welfare Inequalities Project [iv] found that children in the UK’s poorest communities are over 10 times more likely to enter the care system than those from the wealthiest areas.
Roughly one in every 60 children in the most deprived communities was in care compared to one in every 660 in the least deprived. Each 10% increase in deprivation rates saw a 30% rise in a child’s chances of entering care.
The researchers, led by Professor Paul Bywaters at Coventry University, said the most likely explanation is that, relative to demand, more deprived councils have less funding to allocate to children’s services.
The study found ‘high deprivation’ councils in England saw children’s services expenditure per child cut by an average of 21% between 2010 and 2015, compared to 7% in low deprivation authorities. By 2015 high deprivation councils were spending a larger proportion of their budgets on looked-after children and a smaller proportion on preventive and early help services.
Action for Local Authorities
1. Support high quality family planning
According to the World Health Organisation[v] family planning, facilitating access to safe, reliable contraception and sexual health services, reduces the number of children entering care systems and leads to better lifetime health outcomes including reducing risk of ACEs, mental ill health and suicide.
Excellent family planning services supports opportunities for women to pursue additional education and participate in public life, including paid employment. By enabling smaller families, family planning allows parents to invest more in each child and better manage a supportive home environment reducing the risk of neglect, abuse and care proceedings.
Since 2013 family planning and all sexual health services have been commissioned by local authority based public health functions. Central government has cut local public health budgets by about 25% since then, reducing the ability to provide high quality family planning and other sexual health services. The King’s Fund described cuts to public health services as the ‘falsest of false economies.’[vi]
2. Ensure NICE compliant services
Ensure you are commissioning NICE guideline compliant sexual health services and ensure family planning provision reaches the most vulnerable like those in care, care leavers and people with substance misuse, mental ill health and domestic violence vulnerabilities.
Pause is an organisation that has developed an effective intervention to prevent the damaging consequences of children being taken into care. Pause does this by working with vulnerable women to give them the chance to take control over their lives by encouraging them to voluntarily use a long acting reversible contraceptive whilst they work on improving the circumstances that led them to be unable to care for children.
The key to success is the relationships Pause workers build with women at risk of becoming pregnant and having a child taken into care. Pause works in partnership with the woman and other agencies finding new ways to overcome the problems of the past and meet the challenges of the present so that together, a better future can be created - potentially including being a parent. It has been shown to significantly reduce the removal of children into care reducing trauma and lifetime cost.
3. Adopt the National Society for the Prevention of Cruelty to Children (NSPCC) ‘five priorities’ for looked after children
The NSPCC worked with councils and children looked after to draw up guidelines on supporting the mental wellbeing of children in care. Health and social care commissioners should consider how they can make more cost-effective local spending decisions that support improved placement stability and better mental health outcomes for children looked after. This report highlights that too often the emotional wellbeing and mental health of looked after children is thought of as something that is the responsibility of specialist mental health services alone. This must not be the case; we need a whole system that prioritises the emotional wellbeing of children in care, across social care and health. Based on the fieldwork and research for this project, the NSPCC and its local authority partners identified five priorities for change, which would improve support for the emotional wellbeing of children in care.
- Embed an emphasis on emotional wellbeing throughout the system
- Take a proactive and preventative approach
- Give children and young people voice and influence
- Support and sustain children’s relationships
- Support care leavers’ emotional needs