Children and Families — Debate
The Earl of Listowel (Crossbench)
My Lords, I, too, warmly thank the noble Baroness, Lady Massey of Darwen, for securing this debate and for her chairmanship of the children's group. I am most grateful to her, and to other noble Lords, including the right reverend Prelate, for speaking at length today about the needs of children in care. As vice-chair of All-Party Group on Children and Young People in Care, perhaps I may advise the House that, on
I thank the Minister for the attention that she has increasingly been giving to the children's workforce, especially child and family social workers. I am grateful for the establishment of the social work taskforce and look forward very much to its recommendations this autumn. Moira Gibb, chief executive of Camden local authority, has been appointed to lead the taskforce and is highly regarded by all the professionals I have spoken to. As the vacancy rate for child and family social workers in London is 20 per cent we know that her work is vital. I also thank the Minister and her colleagues for the recent additional investment of £58 million in child and family social work. However, given the concerns that we all continue to have about children's social care, I hope the Minister will continue to give thought to the need to ring-fence and increase the funding for these services.
I shall speak about access to mental health services for the carers of young people in care, for young people in care and for care leavers. On Tuesday I had the privilege of attending a discussion at which the Minister spoke. In the audience were a number of care leavers, foster carers, social workers and adoptive parents. Channel Four showed excerpts from its documentary "Lost in Care"—which was referred to earlier in the debate—in which care leavers spoke about having 15, 20 or 30 different placements while in care. That was not a representative sample. However, the trauma that children experience prior to entering care, which is sometimes compounded by trauma experienced while in the care system, gives rise to high rates of mental disorders within this group.
In its 2002 survey, the Office for National Statistics put disorder rates as high as 45 per cent for children in foster care and 72 per cent for children in residential care. As they are children, they may recover quickly. However, if their needs are not met, these disorders may harden into adult personality disorders which can be very hard to treat. Often the best treatment for such childhood disorders is a warm and stable relationship with a caring adult, as the right reverend Prelate so elegantly said. It is therefore absolutely right that the Minister places such high value on stability and that the Government have set a target for placement stability. At the same meeting on Tuesday, Stuart Hannah, a child psychotherapist at the Tavistock and Portman NHS Foundation Trust, drew attention to the important work of therapeutic children's homes such as the Mulberry Bush School. Key to the success of such facilities is ongoing consultation by a child psychotherapist or appropriately skilled clinical psychologist or psychiatrist with the staff group.
Children who have been traumatised may often sabotage future relationships with adults and avoid intimacy and love at all costs because of the pain that it has given them in the past. Given these children's resistance to forming stable relationships with carers it is essential that residential child care workers should be supported in their task by the best mental health professionals in the field. It is deeply regrettable, given the level of need and the inexperience of those working in the front line, that all children's home staff do not enjoy ongoing support from these kinds of consultants.
There needs to be appropriate high quality mental health provision throughout residential care. Consideration also needs to be given to providing such support to adoptive parents, child and family social workers, foster carers and GPs. The very best services already provide this. Kids Company, which was also referred to at our meeting on Tuesday, forges relationships of trust with our most neglected children. Staff do so while receiving regular support themselves from child psychotherapists. Such support was once a regular feature of child and family social work, as I think my noble friend Lady Howarth may be able to attest.
The final report of the national CAMHS review, Child and Adolescent Mental Health Service, published last December, recommended increased integration of CAMHS services with other services and a push to educate the childcare workforce in child development. The Government have established an independent advisory board to implement these recommendations. Will the Minister consider meeting the board—perhaps with her colleague, the noble Lord, Lord Darzi—and me to discuss the concerns that I am expressing today? What progress has been made in the integration of CAMHS with children's homes? How many children's homes offer ongoing consultation for staff by child psychotherapists or other clinicians? How is the quality of this consultation monitored?
Given that improvements in public care are still at an early stage, what assessments and access to services are offered to care leavers who may have mental health issues arising from abuse prior to care or from instability in the care system? Is there an infrastructure of support for self-help groups for care leavers, perhaps facilitated by a mental health professional, so that care leavers can resolve earlier trauma? Is individual therapy for care leavers made available and promoted? I look forward to the Minister's reply.