I share my life with a child who presents very much like Michael, the fictional star of a recent Barnardo’s TV advert. If you find Michael’s distress difficult to watch, imagine parenting him. Imagine mealtimes, bedtimes, schooling. Imagine how he might react if you had to say ‘no’ to something. Imagine fearing for his safety and your own.
Now imagine asking for help and being told, ‘I could refer you to child and adolescent mental health services (Camhs), but they don’t have the expertise’, or, ‘we don’t have the budget to support you’, or, worse still, ‘this is your fault, you aren’t parenting him firmly enough’.
An unsupportive adoption system
This is too often the reality for adoptive families in crisis. At the same time, ministers want to recruit more adopters for the increasing numbers of children who, like Michael, need loving and therapeutic parenting to begin the healing process.
There’s a clear case for investing in post-adoption support, but it’s hampered by numerous obstacles: lack of ownership, perverse incentives, budget constraints and historical ‘they’ll bounce back’ attitudes. Many adopters find support money is spread thinly and obtusely around social services, Camhs and schools. One likened it to “unlocking the Da Vinci Code”, while another, whose daughter is now back in care, pleaded for therapeutic services but was instead offered cookery lessons for the child.
“No one understood our needs or reacted with compassion,” the adopter explained. “We were blamed for our daughter’s problems and feel completely ruined by the situation.”
What would adopters use their personal budget for?
I asked adopters what services they’d buy if they had access to a personalised support budget.
Their responses centred around three areas: family attachment and trauma-based therapy; training in therapeutic parenting and good quality respite care. Another less costly answer kept coming up too – compassion and understanding.
Again and again adopters report feeling under such huge scrutiny that asking for help would be interpreted as a sign of weakness and possible failure.
They talk of a readiness to blame and a combative approach taken by some social work departments.
‘Giving adopters more choice’ The case for personal budgets
At the end of last year, however, the government announced its intention to pilot personal budgets for adoption support in a number of local authority areas, and legislate to extend them to all areas from 2015. Ministers said this would “put more choice into the hands of adoptive parents”.
The document acknowledges that parents sometimes “don’t receive an effective assessment of need and can’t access the right services with the right level of expertise in adoption”. Ministers hope to shape it up by issuing guidelines and placing money, and therefore power, in the hands of adopters.
After all, getting effective support can seem like a postcode lottery. A strong social worker can advocate on their clients’ behalf and may be able to access support or, at least, provide a friendly ear. A poorly informed social worker acts like a road block, preventing access to support and shifting blame on to the adopters. The same goes for GPs and mental health service providers.
What do adopters think of personalised budgets?
When I asked adopters what they thought of this initial proposal, the response was a resounding ‘yes, in principle’. One said: “Yes, then what it’s used for could be tailored to what my child needs, not what suits budgets.” Another said they’d like the freedom to shop around because “some resources that are best for my child are in the wrong sector for present social work frameworks”.
Another wanted the freedom to spend money outside Camhs: “There was such an insistence by the local authority that Camhs is the one and only answer – it wasn’t and it isn’t.” A significant number reported inflexibility between councils, which could be resolved if adopters were given more control.
Elizabeth Webb, adoption director of the charity TACT, agrees with personal budgets and sees councils playing a sign-posting role, as advisors, advocates and providers of some direct services.
While most adopters agree local authorities should sign-post to effective, credited support, others say they would prefer to go it alone. There’s also the question of how hard families will be expected to fight for a budget, particularly in the early stages when they may be less experienced and less informed.
One adopter said: “Our social services gave us no help, no post-adoption support and we live in a small local authority with little therapy available. I wouldn’t have known where to start if I also had to think about the budget.”
Another pointed out being well-informed can come at a cost. “Choice is as much about freedom of information. Money is not always the issue. I was self-taught on the job at my daughter’s emotional expense. This has not proved humane or cost-effective in the long run.”
Adopters’ main concern is that personalised budgets will not be adequately funded, fearing small budgets will be more thinly spread. I put this to Adoption UK chief Hugh Thornbery. He said local authorities have so far been incentivised to “act parochially” and will have to start thinking more creatively.
“When support is provided too late, or not at all, and adopted children end up back in care the costs are huge and dwarf what it would have cost to support that child within its adoptive family,” he said.
What do sector leaders and experts think?
Martin Narey, government adoption adviser (left): “Adoptive parents should have the option to hold the purse strings through personal budgets, but this might not be appropriate in all cases. Indeed, some adoptive parents might prefer the council to remain in control. The government’s approach is to provide more choice for parents and different models of personal budgets will be tested. Who actually holds the purse strings might vary from case to case.”
Sherry Malik, director of children’s services in Hounslow (centre): “Personal budgets could help secure support quicker, without the added bureaucracy of support coming from a distance if children are placed outside the local authority. It can also help reaffirm the role of adopters as parents, and is a useful way to identify a fund for promoting [the child’s] health and emotional wellbeing. This is especially useful if the child has high support needs.”
Hugh Thornbery, chief executive of the charity Adoption UK (right): “Adopters have the right to an assessment of need, but not to receive any services, so I welcome giving adopters a budget and greater freedom to shop around. Camhs provision is patchy and there’s a lack of knowledge and expertise. If adopters are given more control, services should improve as a result of market forces.”
Image of Martin Narey courtesy of Rex Features
- Sally Donovan is an adoptive parent who blogs about her experiences and a regular contributor to Community Care.
Government to trial personal budget for adoption support