Care is not enough

A reduction in residential care has led to the use of foster carers for children with complex needs. But the need for specialist support services is proving expensive, write Nigel Spence and Eric Scott.

Increasingly out-of-home care options for young people in Australia are being tested by the high support needs of the clients, the limits on resources and the lack of service integration. With the huge reduction in residential care over the past 20 years the capacity of foster care and other community placement services to cater for 10 to 16 year olds with challenging behaviour has been sorely tested.

While large numbers of children and young people are being cared for in kinship placements, a shortage of foster carers for the rest of the out-of-home care population limits placement options – particularly for those children and young people who have complex needs, such as mental illness and aggressive behaviour. There is also a lack of specialist health, mental health, drug treatment and educational services for young people.

The result is that carers may be asked to take on children or young people without having the resources to assist them. Also, there may not be the necessary supports and specialist services to maintain the placement. There is concern about the damaging effects on young people and carers – and the high costs – caused by these inappropriate arrangements and the multiple placement breakdowns that result.

Most Australian state and territory governments are trying to address this problem. In Victoria, a report for the Department of Human Services entitled When Care is Not Enough recommended enhancing specialist services such as mental health and drug treatment programmes at a regional level; development of intensive therapeutic programmes for young people; an integrated cross-programme response by the Departments of Child Protection, Mental Health, Juvenile Justice and Drug Treatment Services; and a new specialist state-wide service to support the cross-programme services.

In New South Wales recently, it was calculated that 30 high-needs young people were costing A$21m (£7.5m) to look after each year. Concern was expressed by the incoming head of the Department of Community Services about the cost and nature of the services provided. They are mainly individual placements in which a team of carers or youth workers is assembled to look after a single young person, with substantial fees charged by the service provider. A further development has been the emergence of for-profit providers.

In response, the NSW government announced before Christmas 2002 a major injection of funding – A$1bn over the next five years, almost doubling the Department of Community Services budget for out-of-home care and child protection.

The debate about the challenges presented by this group of young people has prompted calls for the expansion of residential care services and the development of a set of treatment foster care and residential care programmes. Australian out-of-home care services have been dominated by a focus on care and accommodation, which has emphasised provision of a caring environment but is said to be ineffective with young people who have highly challenging behaviour.

Nigel Spence and Eric Scott are members of the Association of Children’s Welfare Agencies, Australia.

Background

• Australia covers 7,692,030 sq km with a population of about 19 million.
• The most densely populated 1 per cent of the continent contains 84 per cent of the population.
• The population includes 3.4 million children aged 0-12 and 1.3 million children aged 13-17.
• In Australia there were 137,938 child protection notifications in 2001-2 and 18,880 children in out-of-home care as at 30 June 2002.