No harm in trying

Case notes

The name of the service user mentioned in this article has been
changed.

Situation: Alana Stewart is three weeks from her 16th birthday. She
has spent the past three years in care after her parents became
unable to cope with her aggression and self-harming. She has had 17
placements in either foster care or residential care. She has a
history of school exclusion and will leave care with no
qualifications but says she is not bothered and that school means
nothing. Yet her school record until the few weeks leading to her
being taken into care was very good. Alana’s behaviour in care
became more challenging, resulting in her family wanting nothing to
do with her, nor she with them.

Problem: Alana has just been arrested for the fourth time in the
past two months for shoplifting. She has been shoplifting to raise
money to buy alcohol and occasionally soft drugs. She has refused
to have anything to do with the health service. This, Alana says,
is because her mother made her have an abortion after she became
pregnant at 12. The doctor agreed with her mother. Alana did not
want the abortion but was, she says, “bullied” into it. She has
also started self-harming again – three times in the past two weeks
by running a razor over her knuckles. She had not indulged in this
for at least two years. This started about the same time she
discovered through self-test that she had become pregnant
again.

Panel responses

Emily Joslin
It seems that Alana is an intelligent young woman, but one
who must confront many issues. I feel there is more to Alana’s
history than meets the eye. Her self-destructive behaviour and
early sexual activity suggests that she could well have been
abused, sexually or physically, before going into care. This needs
to be looked at if she is willing because, until you find out what
is going on for her, this pattern of self-harm will continue with
potentially disastrous consequences.

When Alana says that school means nothing to her, what she is
really saying is that she means nothing to herself. She needs to
feel loved, cared for and valued in this time of transition, even
though her behaviour is trying to push people away.

I believe that she is pushing people away because she is frightened
of rejection.

As she leaves care she needs to be placed in a supported
environment, perhaps with a couple who have no other children who
can give her the time and attention she needs.

She is too young and vulnerable to be put into a hostel or to live
independently. Indeed, this would be the worst possible thing as
all her behaviour is shouting out that she needs and wants to be
looked after.

As for the shoplifting, alcohol and soft drugs, I think they are
symptoms of her bigger problems and that, when the problems begin
to be sorted out, she will find it easier to move away from what
is, again, destructive behaviour.

Alana’s renewed self-harming stems from her fear. She is about to
leave the care of social services and is pregnant again. It is her
way of saying “I can’t cope and I hate myself.”

Her social worker needs to ensure that she has regular contact with
Alana to reassure her that she will not be abandoned. I would also
suggest that a mentor might benefit Alana as someone to give her
time and attention.

There will be no quick fix for this young woman. She needs patience
and acceptance from those around her and time to work things
out.

Mark Houston
One needs to appreciate that this is a serious and complex problem.
It is clear that Alana has severe emotional difficulties, which
need addressing urgently. It really would have been much better if
Alana had received the correct help before she deteriorated this
far. However, we are unable to change that.

As much as I believe the care system has failed to offer Alana the
right support, I genuinely feel that it would be unwise for social
services to stop supporting Alana completely and let her live
independently at the age of 16.

One can see that the best thing for Alana would be some form of
psychiatric help, but this will be incredibly difficult to provide
while Alana refuses to accept anything from the health
service.

It would certainly be advisable to encourage Alana to develop other
interests to try to motivate her and raise her self-esteem. I feel
that she would benefit from a mentor to whom she is entitled under
the Children (Leaving Care) Act 2000.

Although people may say that Alana is not aware enough of what is
in her best interest, a mentor would be able to talk to her about
how and why she feels the way she does, and they will be able to
come up with a plan together.

The worst thing the authorities could do would be to make decisions
and then just tell Alana what they will do with her.

At 16, Alana is old enough to be prosecuted for shoplifting. But to
give Alana a criminal record would be disastrous. It would make her
life worse, and there would be a high possibility of Alana turning
to more serious crime.

But, of course, it is essential that we prevent her becoming
involved in any form of crime.

If her mentor was fairly young, they would be able to take her out
and encourage her to take part in young people’s activities and
show her how much more she could enjoy her life.

But this method will not be instant, and it will probably take
several months to right things. But it is always worth
persevering.

Independent comment

Alana’s sufferings can be turned around, writes Phil Frampton.
It will take time, understanding, care and support on a level that,
perhaps, she has never received. Sadly, many young people still
face similar situations but there also many who have gone on to
become fine, understanding adults.

I make this point because there are so many people who could use
Alana’s suffering as an excuse for shoddy treatment.

Certainly it appears that education and social services have been
appallingly neglectful. One wonders, given the bullying parents,
the self-harm and Alana’s pregnancy, whether the whole family was
not offered therapy before Alana was sent into “care” or since
then.

“Care” is not moving a young person 17 times in three years. The
authority should be sued for psychological abuse and neglect. A
child has a right to a home – which isn’t simply a roof over one’s
head. It means somewhere stable and a full engagement with the
physical and social environment.

Repeated moves can prevent maintaining or developing relations with
peers. It often means new schools and all the problems of trying to
make friends, fending off bullies, gaining understanding from
teachers and catching up with the rest of the class again – if at
all.

Alana needs a long-term residential placement with supportive,
respectful people who will meet her needs: somewhere that she can
return to over time and still feel welcome. The local authority
could have encouraged Alana into a therapeutic community or a young
people’s psychiatric unit but presumably it lacked the wit.

Many young people like Alana are finding their way back into
learning through education programmes where learning is voluntary
and courses are tailored to students’ requests. Run for those
excluded or self-excluded from school, such schemes use group work
and assist young people in relating to other young people and
forming new relationships with their peers and adults.

Through Connexions Alana should be given a highly skilled personal
adviser to build a one-to-one relationship and advocate for her
needs. Alana needs an advocate. She also needs to get together with
other young people in care and demand an end to this appalling
treatment.

Phil Frampton spent his childhood in care. He is national
chairperson of Care Leavers Association.