Transcript - Open Research Online

How was it for me? A review of
Every Child Matters through the
lens of the marginalised child
Professor Mary Kellett
[email protected]
Director, Children’s Research Centre, Open University UK
http://childrens-research-centre.open.ac.uk
Introduction
• ECM aimed to put the child at the centre of provision –
‘team around the child’ – attend to children’s holistic
needs and emphasize wellbeing as a human right
• This presentation explores ECM wellbeing indicators
through the lens of marginalized children and reviews
the extent to which their views are being accommodated
• focuses on issues of disadvantage, diversity and
marginalisation from a rights’ perspective
• a few snap shots of children’s lived experiences to
stimulate discussion and debate
5 ECM outcomes
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Be healthy
Be safe
Enjoy and achieve
Make a positive contribution
Achieve economic wellbeing
– ? How achievable are these for marginalised children
Disabled children – wheelchair
provision
• Mobility is a vital part of childhood on any wellbeing indicator - yet
• - wheelchair provision still remains problematic for many children
• 70,000 children currently waiting for the right wheelchair (whizzkids.org.uk, 2011)
• Many LAs will not provide a wheelchair until age 30 months (<
pushchair). This denies children the right to engage in activities
commensurate with development needs such as independent
exploration.
• ? What happened to ‘team around the child’ ?
• ? What happened to ‘attending to children’s holistic needs and
emphasizing wellbeing as a human right’ ?
Children’s perspectives
• Sam is a 4-year old with cerebral palsy. The NHS only provided
him with a basic manual wheelchair for indoor use which
prevented him being independent. He had to rely on a charity to
acquire an appropriately adapted indoor/outdoor motorised chair
equipped with a riser enabling him to maximize his independence,
exploratory play and social interaction with peers.
• ‘My new powered wheelchair means that I can go in the
playground and not get so tired – it is fantastic! I can go
shopping without someone having to push me all the time
and I can play basketball at my Saturday Club all by
myself.’ (10-year-old with cerebral palsy).
• (Source Sharma and Morrison 2006; 2008)
Children’s mental health
• ‘Child and adolescent mental health services in this
country are a disgrace. There are many places where
the waiting list is 18 months or more. If that were an
adult service there would be a public outcry’. (David Hall,
president of Royal College of Paediatrics and Child Health, 2002)
• Innocenti Report (UNICEF, 2007) UK was ranked bottom
in children’s own subjective sense of wellbeing.
• It wasn’t until 2007 that Gov agreed to phase out all
admissions of children to adult psychiatric wards by
2010
•
Children’s perspectives
• Shaun said most of his time on the [adult] ward was
spent in his room listening to music and staring at his
wall, walking the corridors, eating sleeping and
drinking tea. He was not offered the opportunity to
take part in any activities, even though there were
many on offer for [adult] patients. Shaun believes
that not having anything to do contributed massively
to how low he felt while being a patient.
• ‘I need treatment to get over my treatment’ (Hattie,
young person on adult psychiatric ward)
•
Source 11 Million, 2007
Barnardo’s perspectives on
children’s mental health provision
• Barriers:
• Opaque commissioning processes and the difficulties that come
with separate commissioning budgets across integrated children’s
services;
• Dominance of the medical model in access, diagnosis and
treatment;
• Overlooking the participation of children and young people in
commissioning and developing services;
• What’s needed:
• Address continued stigma attached to mental health difficulties.
• Increased strategic and financial support for early intervention and
preventative approaches;
• A shift in culture to embed collaborative working and knowledge
sharing;
• Improved information and access to services for vulnerable groups;
•
Source: Barnardo’s Policy and Research Unit, 2008
Some ECM positives for
disadvantaged children
• Sure Start children’s centres = flagship of ECM.
• Accessible premises in an area of high disadvantage
• Integrated childcare and learning for 0-5 year olds, 48 weeks
per year, 5 days per week and 10 hours per day
• Link to Jobcentre Plus to maximize employment prospects
for parents
• Community health facilities
• Special needs and disabilities early identification and support
service
• Family outreach services - …. but …
• This initiative is already in retreat under the Coalition Gov
Integrated services at the margins
• ? Services that follow the child?
• Children on the margins of society are the least likely to achieve
the 5 ECM outcomes. Time and again research has shown that
where a child is prey to disadvantage or marginalization, poverty
is one of the associated factors. Children living below the poverty
line experience a poorer education, achieve less qualifications,
live in substandard housing and enjoy less good health (Hirsch, 2007)
• Crucially, poverty prevents them participating in social childhood
activities. Tomlinson & Walker (2009) found that 16% of the
poorest fifth families in England could not afford for their child to
have a friend for tea once a fortnight.
• Figures from the DWP (2009) revealed that 13.5 million people in
the UK were in the ‘income poor’ category – this affects 1 in 6
children. The number of children in workless households rose to
1.9 million (BBC News, 2009)
Young carers
• Children from disadvantaged backgrounds are most
likely to have carer responsibilities (Bibby and Becker, 2004) and
the least likely to achieve ECM outcomes
• Olu is 10 and lives with his mother who has a mental health
problem. Sometimes she’s fine, but when she’s ill she becomes
very depresses and hardly gets out of bed. At these times,
Olu has to look after the flat, get food for himself and his
mum, get to school and back on his own and deal with the
things his mother can’t do, such as collecting her money and
paying the rent and the bills. (www.youngcarers.net, 2010)
Messages from young carers to
service providers
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‘introduce yourself, tell us who you are and what your job is’
‘tell us what is going to happen next’
‘give us as much information as you can’
‘remember to talk to us: we have first hand experience of
what is going on’
• ‘keep on talking to us and keep us informed. Tell us it’s not our
fault’
• ‘tell us if there is anyone we can contact’. (Daniel, 2008: 101-2)
Children of single parents
• Number of children living in single-parent families has
increased significantly to 3 million (Gingerbread, 2010)
• single parents score highly on the child poverty indicator
predictor index
• Research about children living in single parent families
is almost entirely adult based and adult defined (Walker et al,
2008)
• Interviews with 40 children from single parent families
about their experiences of service provision revealed
their perceptions that the greatest support came from
extended family (grandparents particularly) and friends
rather than from integrated services (Walker et al, 2008)
Children’s perspectives
• At the weekends I go to Nanas. I sleep Saturday and Sunday
night … so my mum can get some peace [Annie, aged 8]
• Children talked about their parent relationship being very
important but time poor because of the pressure on busy
single parents juggling work and care commitments (impact of
welfare to work policies)
• Children identified limitations for play as a significant quality
of childhood issue [lack of space at home, too far from parks
and transport costs too high to get to organized leisure
activities]
• Healthy living – children reported their parent could only
afford to put cheap food on the table and items such as fresh
fruit were far too expensive
Voluntary sector
• Voluntary sector is particularly skilled at service
provision for marginalised families due to their extensive
local knowledge
• In a prime position to provide quality support towards
achieving the 5 ECM outcomes
• Children’s experiences reveal the positive impact that
many voluntary organisations have on the quality of their
childhoods.
Storybook dads
• Established in Dartmoor prison in 2004 and has since
helped over 6,000 prisoners in 70 prisons to stay
connected with their children
– I miss my Dad so much. When I feel lonely I listen to my CD
and hearing his voice makes me feel better.
– Daddy’s done a CD for me which was The Frog Prince and he
did Jack and the Beanstalk for my brother. They’re both
really good. He says he will do another one for us for
Christmas. (www.storybookdads.co.uk)
Barnardo’s Hamara family project
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‘hamara’ means ‘our’ in Urdu/Hindi
Works with black and minority ethnic communities
Inclusive play and holiday short break opportunities
Play activities to children with life-limiting conditions
Support programme for children newly diagnosed with
autistic spectrum disorder
Music therapy service
Dad’s group
Club for mothers of disabled children
Crisis intervention service for vulnerable families
Voluntary sector squeeze
• Harder for voluntary organisations to compete on a level
playing field in tendering processes
• Notable shift towards short term contracts
• Greater risk of being squeezed out despite being ideally
placed to provide services for many of the most
marginalised
What can marginalized children’s
experiences teach us about
effective service provision?
• needs-driven not resource driven (including better
accommodation of voluntary sector)
• holistic provision that attends to the wellbeing of the
whole child
• early intervention (one of the real positives of ECM has
been the Sure Start children’s centres)
• Effective inter-agency communication
• the imperative of listening to children’s voice
Messages from children about
ECM and integrated services
• ‘ask us what we think on our own and listen to what
we say’
• ‘we want to be looked after by adults we can trust’
• ‘don’t always believe an adult over a child – ask for
evidence and decide for yourself’
• ‘keeping us busy keeps us out of trouble’
• ‘when we make a complaint – sort it, not report it’
References
• BBC News (2009) One in six UK homes ‘has no work’, 26 August,
http://news.bbc.co.uk/1/hi/8222145.stm [accessed 17/01/11]. Sharma, N. and Morrison,
J. (2008) Don’t Push Me Around: Disabled children’s experiences of wheelchair services
in the UK, Ilford: Whizz-Kidz in association with Barnardos.
• Barnardo’s (2008) Barnardo’s response to the CAMHS review: improving the mental
health and psychological well-being of children and young people: call for evidence,
http://www.barnardos.org.uk/barnardo_s_response_to_camhs_review_3rd_july_08.pdf
• Daniel, G. (2008) ‘Talking with children: constructing victim-hood or agency?’, in P.
Kennison and A. Goodman (eds) Children as Victims. Exeter, Learning Matters.Sharma,
N. and Morrison, J. (2008) Don’t Push Me Around: Disabled Children’s Experiences of
Wheelchair Services in the UK. Ilford, Whizz-Kidz/Barnardo’s.
• Gingerbread (2010) Gingerbread factfile,
http://www.gingerbread.org.uk/content/365/Gingerbread-Factfile
• Walker, J. Crawford, J. and Taylor, F. (2008) ‘Listening to children: gaining a perspective
of the experiences of poverty and social exclusion from children and young people of
single-parent families’ Health and Social Care in the Community,16 (4), 429–436.
• UNICEF (2007) Child Poverty in Perspective: An Overview of Child Well-being in Rich
Countries. Florence, Innocenti Research Centre/UNICEF.
• 11 Million (2007) Pushed into the Shadows: Young People’s Experiences of Mental
Health Facilities. London, Office of the Children’s Commissioner.
Children’s Perspectives of Integrated
Services: Every Child Matters in Policy and
Practice,
Palgrave Macmillan (available late Aug 2011)