Teenagers and serious case reviews

Research published in January shows that harsh experiences suffered by older, hard-to-reach children and young people are not being sufficiently recognised.

In a contribution to the first government-sponsored overview of serious case reviews in 2002, the chair of an area child protection committee (now local safeguarding children boards) wrote: “Serious case reviews represent everything that is good about this country. Professionals devoted to public service, the comfortably off searching their souls to prevent child tragedies. It means that lonely and unloved children have not suffered in vain.”

The learning process is proving to be a long hard road, however. Back in 2002 it could only be estimated that there were about 90 child deaths each year subject to a full SCR. We have since had a shake-up of the whole system in the wake of Victoria Climbié’s murder, and the Commission for Social Care Inspection now maintains a more thorough database of critical incidents. Yet the problem of varying standards of record-keeping between local authorities continues, and while SCRs contribute to local understanding of child protection, identifying important global issues is anything but straightforward.

The government now commissions research into SCRs every two years. Marian Brandon, a senior lecturer in social work at the University of East Anglia, led the research team that produced January’s overview, covering April 2003 to March 2005. She pays tribute to the professionals who work day in, day out on the kind of harrowing cases she examined.

“This is raw,” she says. “The stories of the older young people are particularly difficult to read and do make you very angry.”

Two-thirds of the 161 children in Brandon’s study died and a third were seriously injured. Of these there were a surprising number of cases involving children over the age of 13, an issue that had not come up before. “Part of the reason why older children are being uncovered is that there is a new criteria requiring local safeguarding children boards to consider death through suicide,” she says. “That will pick up these much older children because we had a considerable minority of children over 16 and the bulk of these were cases of suicide.”

In an in-depth analysis of selected cases, the research team found that many older children had a long history of involvement with specialist agencies. “Not just children’s social care, but child and adolescent mental health services, often youth offending. They had often been offered services including accommodation but were reluctant to accept them. Ironically at the time of these incidences they were getting very little help.”

Start again syndrome

The findings have made her critical of services that don’t work well together, thus contributing to the “start-again syndrome”. “What we found with these cases is that there were pockets of excellent practice with almost all of them at some point, but by the time of the incident they were receiving a low-level service only. Because these children were hard to offer services to, they wouldn’t stay in foster care or residential care. A number of them had been discharged home, where the problem started in the first place. Most of these young people were severely rejected.”

About a sixth of looked-after children at any one time are adolescents presenting seriously challenging behaviour, and local authorities find them hard to cope with. The neglect that these young people are facing is down to the bare fact that they are expensive. “They’ve already been in the system for a long time and cost a lot of taxpayers’ money, so for managers looking after budgets they do pose a problem. But they will continue to pose problems unless we find more effective ways to help them, and some of the schemes being considered by voluntary organisations are creative and useful,” says Brandon.

One scheme she points to is the children’s charity Kids Company. Based in south London, the organisation prides itself on a holistic, multi-disciplinary approach to dealing with children. It works closely with schools, combining educational programmes with social work and therapy. Director Camila Batmanghelidjh is sceptical about statutory services’ ability to cope with the kind of young people she deals with.

“The government needs to put itself in the shoes of a child who doesn’t have a functioning carer in their life,” she says. “The delivery of visions like Every Child Matters is only as good as the commitment of the workforce and the managers at street level. One of the problems is that if you’re a child or young person who doesn’t have a functioning adult in your life to advocate on your behalf, then you’ve got no power to hold service providers accountable.”

Exhausted workforce

Batmanghelidjh knows from experience that it can be very difficult to get complex cases into the system, due to what she calls an “exhausted” workforce. “Right now we’re in the middle of initiating a judicial review on behalf of one of our young people. The difficulty is that agencies are so depleted in some neighbourhoods that they actually don’t want these cases. A sort of immunity develops in the workforce where they’re almost over-familiar with the levels of neglect that these young people are experiencing. The normal alarm mechanisms don’t ring, the sense of urgency isn’t aroused.”

Brandon is clear that no single group should be made scapegoats. “It can’t just be a problem for children’s social services, particularly for older children because they are in transition to adult services.”

In fact, the blame can be spread evenly among agencies. Although child and adolescent mental health services are singled out in the report for their “reluctance” to assess hard-to-reach young people as mentally ill or showing suicidal intent, the service is merely showing the symptoms of a common difficulty, according to Brandon. “It’s not just Camhs a lot of agencies are tightening eligibility for their services and if you tighten eligibility and say ‘I can’t help this young person, someone else has to’, it perpetuates the problems.”

Brandon has shared the results of the SCR report with local authorities across the country. The true dangers facing older children are only just starting to be uncovered.

Further information

Analysing Child Deaths and Serious Injuries through Abuse and Neglect: What Can we Learn?