Think Family: Getting the whole picture

Chris Cuthbert

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Contents

• Who are families at risk and why do they matter?

• What have we learned about support for families at risk?

• What would a system that ‘Thinks Family’ look like?

• How do we get there?

• What can you do?

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Who are Families At Risk?

Economic well being

Communities and staying safe

Health and family

structures

Poverty and debt WorklessnessEducation and skills

Domestic violenceRelationship conflict

Mental and physical health

Crime and ASBAlcohol and drugsPoor housing and homelessness

Most Excluded Families

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The influence of family (and parents) is rarely neutralCommunities and staying safe

HOUSING• 51,060 families were accepted as homeless in 2006

WHY IT MATTERS

• Bad housing, overcrowding and homelessness is linked to poor mental and physical health for children and parents

• Homelessness can lead to missed school for children and lower levels of engagement with services such as Sure Start

• Homelessness can increase child vulnerability and increases the risk of a child being on the Child Protection Register from 1% to 12%

• Number of children living in non-decent homes across the social and private rented sectors fell by 1.4 million between 1997-2005

•Since 2001, the number of non-decent homes in the social sector has reduced by over 50%

CRIME • Around 162,000 children have a parent in prison• 55% of female prisoners have a child under 16

WHY IT MATTERS

• Parental imprisonment disrupts contact between parent and child

• Children of prisoners have about three times the risk for mental health problems and anti-social or delinquent behaviour compared to their peers

• 63% of boys with convicted fathers go on to be convicted themselves

• Crime has fallen by 44% since 1995, representing 8.4 million fewer crimes in total

ASB• 9,431 ASBOs issued between 1999-2005

WHY IT MATTERS

• Parents who engage in anti-social behaviour are more likely to raise children who also behave anti-socially

• Children who know of their parents’ involvement in drug misuse or crime are at increased risk of misusing drugs and engaging in offending behaviour themselves

• The Respect Action Plan (2006) focuses on addressing anti-social behaviour

•Family Intervention projects are aimed at improving parenting and strengthening communities

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Families experiencing multiple disadvantage

Approximately 140,000 families

with children experience 5 or

more disadvantages

%

Basket of indicators of disadvantages includes:

• No parent in the family is in work

• Family lives in poor quality or overcrowded housing

• No parent has any qualifications

• Mother has mental health problems

• At least one parent has a long-standing limiting illness, disability or infirmity

• Family has low income (below 60% median)

• Family cannot afford a number of food and clothing items

Percentage of families with children experiencing 5 or more disadvantages

2.2 2.1 2 1.9 2

2001 2002 2003 2004 2005

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2.5 2.81.4

6.5

1

4 4.5 4.3

8.1

2.9

5.16.2

7.3

9.7

5.65.4

10.4 11.112.5

10.2

0

2

4

6

8

10

12

14

16

18

20

Well below average atmaths (2005)

Well below average atEnglish (2005)

Child suspended orexcluded in last year

(2005)

Not seen friends in lastweek and never goes

to organised socialactivities (2004)

In trouble with policein last year (2005)

None 1 or 2 3 or 4 5 or more family disadvantages

Enjoy and achieve Make a positive contribution

Source: Families and Children Survey (2004 and 2005)

Outcomes for children:Children from families facing multiple disadvantages are at greater risk of a range of negative outcomes

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4.9

2.2 1.6

7.7

1.6 2.1

7.5

4.6

2.6

16.3

5.4

7.3

0

5

10

15

20

25

Child spent less than an hour onphysical activity in last week (2005)

Child drinks alcohol at least once aweek (2004)

Child feels unhappy about their family(2004)

None 1 or 2 3 or 4 5 or more family disadvantages

Be Healthy

Source: Families and Children Survey (2004 and 2005)

Outcomes for childrenChildren from families facing multiple disadvantages are at greater risk of a range of negative outcomes

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3.25.4 5.5

10.9

5.88.9

11.3

18.3

9.911.9

13.2

23.2

16.518

21.4

33

0

5

10

15

20

25

30

35

Mother thinks child hasproblem with smoking,

drinking or taking drugs(2005)

Child admits running awayfrom home before (2004)

Bullied in a frightening orupsetting way 3 times ormore in last year (2004)

Strong worries about beingmugged where they live orafraid to walk alone after

dark (2004)

None 1 or 2 3 or 4 5 or more family disadvantages

Stay safe

Source: Families and Children Survey (2004 and 2005)

Outcomes for childrenChildren from families facing multiple disadvantages are at greater risk of a range of negative outcomes

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Contents

• Who do we mean by families at risk?

• What have we learned about support for families at risk?

• What would a system that ‘Thinks Family’ look like?

• How do we get there?

• What can you do?

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Services and programmesServices that ‘think family’ can improve outcomes and help build family capital

Why we need to ‘think family’

• To build on family strengths – family belief systems, family cohesion and coping strategies can all have a major impact on how effectively family members are able to respond to adversity.

• The problems of the individual do not exist in isolation – Understanding the whole family situation can be highly important in diagnosing the root causes of a problem and in developing appropriate responses.

Examples

• Family Group Conferencing (FGC)

• Family Intervention Projects (FIPs)

• Multi-systemic Therapy (MST)

• Family Nurse Partnership (FNP)

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Family Nurse Partnerships

Family Nurse Partnership Pilots• Structured home visiting programme for

disadvantaged parents from pregnancy until child age two

Goals• Improve pregnancy outcomes• Improve child health and development and

future school readiness and achievement• Improve parents’ economic self-sufficiency

30 years development and 3 large scale trials

Improvements in women’s prenatal health

Reductions in children’s injuries

Fewer subsequent pregnancies

Greater intervals between births

Increases in fathers’ involvement

Increases in employment

Reductions in welfare and food stamps

Improvements in school readiness

£30m over the CSR period to expand the programme

www.everychildmatters.gov.uk/parents/healthledsupport/

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Family Intervention Projects

The Dundee Families project, established in 1997 by the NCH charity, has successfully helped families with multiple disadvantages and who cause problems for their communities, supporting them to resolve their issues ranging from a lack of basic parenting skills to alcohol and drug addiction. 53 of these projects have now been rolled out across the country

Key Components: Dedicated key worker with low case load

and persistent and assertive working style who takes the lead in engaging families and coordinating agencies and services

Whole family assessment which ensures the needs of the whole family are met and regularly reviewed

A contract which sets out the changes in behaviour that are expected and the support that will facilitate change

Intensive and structured support which enables key workers to engage, assess and focus intensively on their families for as long as is needed

A coordinated and integrated response where agencies commit to working together, sharing appropriate and relevant information, agreeing objectives and dedicating resources to resolve a client’s difficulties

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The next piece in the puzzle?Adult services can play a key role in improving outcomes for children and families

Parenting support Promoting effective

parenting

• Increased investment in parenting support

• National Academy of Parenting Practitioners

• Expansion of Family Intervention Projects

Children’s services Investing in the individual child

• ECM integration of children’s services

• Investment in education

• Expansion of early years provision

Adults’ services ? • Do adults’ services recognise and respond to the parental and family roles of their

clients?

• Are we exploiting the opportunities to tackle the parent-based drivers of poor child and family outcomes?

Opportunities and outcomes for children and families

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Systems reform There are opportunities to improve outcomes by building on progress in systems reform

The systems of support around families at risk are inadequate because they:

• Are complex and highly fragmented

• Intervene too late

• Lack a focus upon the most at risk families

Three key areas of opportunity for systems change:

• Extending the logic of collaboration from Every Child Matters beyond children’s services to better coordinate all of the services working with families at risk

• Capitalising on the reach and expertise of the public and third sectors to identify and intervene earlier to support families better

• Ensuring we have effective services to work with families and to address parent-based risks and getting the incentives right so that support reaches those who need it most

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Working with families

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Contents

• Who do we mean by families at risk?

• What have we learned about support for families at risk?

• What would a system that ‘Thinks Family’ look like?

• How do we get there?

• What can you do?

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Think Family: The key characteristics

No wrong door

Contact with any service offers an open door into a system of joined up support

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Look at the whole family

Services working with both adults and children take into account family circumstances and responsibilities

Think Family: The key characteristics

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Think Family: The key characteristics

Build on family strengths

Practitioners work in partnership with families recognising and promoting resilience and helping them to build their capabilities

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Think Family: The key characteristics

Provide support tailored to need

Tailored and family-centred packages of support that knit together relevant interventions are offered to all families at risk

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Contents

• Who do we mean by families at risk?

• What have we learned about support for families at risk?

• What would a system that ‘Thinks Family’ look like?

• How do we get there?

• What can you do?

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ECM and Children’s Trusts have introduced a dynamic for increased collaboration between children’s services

ChildHealth

Housing

Police

ChildSocial Serv

Schools

SpecialistServ

LSC

Youth

Vol orgs

Child Leisure

DAT

YOT

CAMHS

Outcomes for children and young

people

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However, systems around families facing multiple disadvantages are still highly fragmented

ChildHealth

Housing

Police

ChildSocial Serv

Schools

SpecialistServ

LSC

Youth

Vol orgs

Child Leisure

DAT

JC+

AdultHealth

Housing

Police

AdultSocial Serv

Private orgs Specialist

Serv

LSC

Vol orgs

Adult

DATLeisure

Probation

Prison

YOT

Adviceservices

CAMHSAMHS

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Opportunity to extend the logic of cooperation from ECM to encompass all services working with the family

ChildHealth

Housing

Police

ChildSocial Serv

Schools

SpecialistServ

LSC

Youth

Vol orgs

Child Leisure

DAT

JC+

AdultHealth

Housing

Police

AdultSocial Serv

Private orgs Specialist

Serv

LSC

Vol orgs

Parent

DAT Leisure

Probation

Prison

YOT

Adviceservices

CAMHSAMHS

Family

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12-15 local Family Pathfinders

£13m Family Pathfinders to test and develop the Think Family approach:

• Aim to improve outcomes for families at risk, including those not being effectively engaged and supported by existing services

• Build on ECM and encourage greater cooperation between children’s services and key adults’ services, including social care, employment, housing, adult mental health etc.

• Develop locally led learning on how system change across adults’ and children’s services can improve support for vulnerable families

• Tell us what works – and what needs to change

• Share learning (e.g. linking into the LGA Narrowing the Gap network of LAs)

£3m Extended Family Pathfinders for young carers:

• 5-6 areas will extend their work to include systems and support services which will address directly and in more detail the support needs of families with young carers

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Family Pathfinders: testing local systems change

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What can you do?

• Ask what more could be done in your area to ensure systems and services are truly ‘thinking family’?

• Ask families about their experiences of services – what they like and what they want to see changed.

• Talk to practitioners to find out what helps and what inhibits them from ‘thinking family’

• Let us know about innovative work with families in your area

• Champion the ‘think family’ approach and...spread the word!

For a Family Pathfinder application pack visit: www.everychildmatters.gov.uk/parents/pathfinders/

Deadline for receipt of bids 29th February 2008