Tackling child neglect: Jan Horwath considers factors around referring neglect cases

Professor Jan Horwath considers the factors that influence a decision to refer in cases of child neglect

Despite a plethora of government guidance, we know that policies, guidance and procedures alone will not lead to effective safeguarding of children. This is particularly true when identifying neglect.

Part of the problem lies in various professionals identifying different concerns depending on their particular role. The two questions that practitioners should ask themselves and their colleagues, when faced with a case of possible neglect are:

● Is there evidence here that indicates that this child may be being neglected?
● Should I make a referral to children’s social care?

It is all too easy to presume that the answers to these questions will be based on the perceived needs of the child. But recent research from Ireland indicates that there are a range of personal and organisational factors that influence the decision to refer.

The personal factors included:

● Fear of verbal and physical aggression from the potential perpetrator. These fears were particularly strong among practitioners who worked and lived in the same community as the perpetrator.
● Concerns that referral could have negative consequences for the referrer. For example, affecting their relationship with the family or resulting in litigation.
● A “watch-my-back” approach. This meant that some practitioners felt they were not adequately trained to make a decision and therefore referred everything.

They feared missing a case of neglect could lead to a child dying and the practitioner being held to account.

Organisational factors that influenced decisions to refer included:

● Lack of confidence in the ability of social work services to meet the needs of the child, which in some situations, resulted in practitioners holding onto cases inappropriately. In these situations the practitioner considered that they could do better than social work services.
● Fears that the referral would not meet the required thresholds for assessment by social workers and so the case was dismissed by potential referrers as not reportable.
● Poor communication and feedback from social workers leading to anxiety on the part of the referrer as to what was  happening.

What also became clear from the study was that the decision to refer was not made in isolation. The team approach and the view of the manager influenced referral practice. An exploration of these influences indicated that in many cases perceptions and hearsay about how social work services would respond to referrals of child neglect informed practice. If these factors are impacting on referral practice we are in danger of losing the focus on the child.

So, what can be done? We have to recognise that we are working in a very difficult field; we are not automatons. It is inevitable that our fears, anxieties and perceptions will influence our practice so we owe it to children to be as honest as we can be about the factors influencing our decisions. If we ask ourselves the following questions it will begin to alert us to the subjective factors that influence our decision-making:

● What are my fears about this case?
● How has consultation with colleagues influenced my decision?
● What do I think is likely to happen to this case if I make a referral and how is this influencing my judgement?

Jan Horwath is professor of child welfare, University of Sheffield and author of Child Neglect: Identification and Assessment published this month by Palgrave/MacMillan

This article appeared in the 29 March issue under the headline “When should I refer”