Letters

Death exposes lack of services for
adolescents

The tragic death of Sarah Lawson draws attention once again to the
paucity of services for young people with mental health problems.
While there has been some progress in recent years in developing
child and adolescent mental health services (CAMHS), there are
still long waiting times and patchy provision. We have positive
expectations of the children’s National Service Framework, but we
are very concerned about the shortage of funds to adequately
resource services.

This year the Department of Health was to put a further £10
million into the NHS budget for CAMHS, as part of the £84
million investment over three years announced two years ago. This
year the money has gone into the health authorities base budgets,
without any requirement that it should be spent on CAMHS. It is
reliably estimated that at any one time 15-20 per cent of young
people in the UK have a significant mental health problem, and as
many as 25 per cent in inner city areas. This is about 3.5 million
children. If this was a physical condition there would be a public
outcry.

Young Minds has discovered, through local training needs analyses,
that 80 per cent of those working with children have no training in
children’s mental health. In cases such as Sarah’s, early
identification is crucial. Yet the professionals working daily with
children do not have the skills for this. As a result many mental
health problems, which could have been picked up in childhood, are
overlooked and, by adolescence, they are exacerbated by the onset
of puberty and the turbulence associated with this period of
development.

In many parts of the country there is a dangerous lack of clarity
about who should be providing mental health services for those
between the ages of 16 and 21. At precisely the time when the need
is greatest, and when the psychotic disorders are starting to
emerge, there is no service. This cannot be allowed to continue.
The missing £10 million could have gone some way towards
requiring local services to provide for this group.

Peter Wilson.
Director
Young Minds

We do what we can

I would like to respond to the article expressed by the
anonymous adoptive mother in Viewpoint (5 April) regarding her view
that social workers had lacked the courage to impose behavioural
boundaries on her 16-year-old son when he was admitted into
care.

I can only speak from a personal point of view as a manager (for 10
years) of a children’s home. Several points came to mind when
reading the article and I was eager to point these out in order to
defend and promote the residential task with young people.

A parent should not expect residential or field social workers to
have an effective working relationship with (in this case) a 14-
year-old boy from the beginning. Sometimes young people come to our
attention very quickly and there is not the time to do the
preventive work before they are accommodated. In addition, if the
parent who has known and brought up the child since he or she was
born, or in this case since the age of three, cannot impose
boundaries, then how can relative strangers be expected to do so
from almost day one of knowing the child?

In our case, each residential worker is especially responsible for
the welfare of a resident of the home. Hopefully, a parent-like
relationship based on care, support and guidance can develop but it
takes time, especially as the worker is only in the home for around
37 hours a week. Additionally, the young person may have a deep
distrust of adults, and may have psychological or behavioural
problems. There is also the influence of up to six other young
people living in the home. The Department of Health now recognises
through research the value of smaller homes of only three or four
young people and it would appear that such homes are now becoming
more common.

Nevertheless, when a young person of any age is displaying
intimidating behaviour to other residents or staff we will
challenge that behaviour and make clear that it cannot continue.
After a process of verbal and then written warnings, criminal
prosecution will follow if the behaviour does not stop. We have to
balance the need to protect others with the need not to criminalise
young people and to understand the difficulties some of them go
through during adolescence. However, we do feel that whatever the
circumstances of individuals, it is a mistake not to expect young
people to take responsibility for what they do.Two points were made
in the article with which I do agree.

First, courage is needed to impose such boundaries. And, second,
the judicial system can also give the picture to young people that
aggression and lack of self-control is not really a problem despite
government statements to the contrary. Having been assaulted myself
last July, the 15-year-old girl was then not interviewed until
November, four months after the incident. She went to court in
February and received a £25 fine.

In summary, we do what we can. Being confronted by adolescents who
may be under the influence of drugs or alcohol is a difficult
enough task but when you don’t know them very well and are only
just starting to develop a meaningful relationship with them it is
even harder.
In residential care, a lot of positive work by committed people
takes place, often with limited resources. While there are failures
and faults, there is also a lot of positive and successful work
which others often don’t get to hear about.

Name and address supplied

Free care – yes, but when we can afford it

I was disappointed to read your comments on grey power and free
personal care (Comment, 17 May) not because there isn’t merit in
the case but because it tried to turn the election into a single
issue. Whatever the merits of free personal care for older people,
who is to judge and prioritise the country’s limited resources
against other areas Ð education, NHS, the police, and so on.
Even within the sphere of social care we have demands for services
escalating, particularly in regard to children and care in the
community.

We have had massive increases in resources into social services, an
11 per cent increase in 1999-2000, but it does not meet the demands
in many authorities, and I would find it hard to justify removing
personal care charges for older people when other potentially
life-threatening situations are under-funded elsewhere. I actually
believe that personal care should be free but only when we can
afford it.

The real battle now is to secure increased funding across the board
for social care and I believe the government has a proven record in
this, no matter how critical we might be of some of the detail.
Whatever the outcome of the General Election, everybody in social
care must be united in pushing the next government to continue
increasing funding for social care to a level that allows the needs
of our communities to be met.

Councillor Colin Thompson
Lead member for social services
Rochdale Council

The MBA vision
Your article ‘A qualified success?’ (10 May) asked the
relevance of an MBA to social services. I suggest it is highly
relevant. The MBA equips you to create strategic vision and turn it
into operational reality, operating outside normal rules where
necessary.

Social services operate in a competitive world and they have to
perform better than the independent and health sectors if they are
to survive. The MBA brings you into contact with the best of other
sectors. It is not only for top directors – these people achieve
through the quality of staff below them.

I do not accept that in today’s world vocational qualifications are
enough. The MBA is competency based Ð you learn the theory,
put it into practice, and are assessed on doing so. My current role
in social services procurement, and ‘hands on’ and strategic
experience in construction, criminal justice and international
development (among others), tells me the focus an MBA affords is
invaluable.

As for people proving themselves before being sponsored Ð I
funded my own MBA and higher education as the public sector were
too blinkered to help. Do not be surprised if a lack of investment
in your staff leads to quality people leaving.

Peter Starr
Thatcham, Berkshire

Anything but clear

How I agree with Graham Hopkins (‘A Word to the Wise…’, 10 May)
about the curse of social services-speak. It has done an immense
amount of harm to our credibility.

A tip for spotters. Whenever a big cheese from social services is
before the media following some disaster, listen for the opening
word ‘clearly’. You can guarantee that the explanation which
follows will be anything but clear, and will be peppered with
social services-speak to keep questioners off the scent. Look out
for it in meetings too.

Derek Fearnside
Worcester