6. The Scale of the Problem
Between 2007-2014, 43,541 women lost their children as a result of
care proceedings. Of this number, 7,022 were ‘repeat’ proceedings.
We can consider all 43,541 women who record an index episode as ‘at-
risk’ of a first repeat episode of proceedings…
At least 24% of women are likely to return to court within 7 years
7. Maternal Age and Recurrence
Teenage motherhood is associated with recurrence
Maternal age is a risk factor for recurrence, with the youngest women
most likely to record multiple repeat episodes
Young women may experience an index and first repeat episode before
they exit their teenage years
8. Need for change for women, their families and the
community
• Where a negative cycle of recurrent care proceedings remains unchecked, prognosis for
recovering parenting capacity is believed to be poor.
• Care proceedings get shorter over time, often women are already pregnant again during
care proceedings trying to replace what has been taken from them (Broadhurst, Harwin and
Shaw 2014).
• There is decreasing opportunity for change once a mother is caught in this cycle.
• Research has identified that looked after children and young people are several times
more likely to have a statement of special educational needs, to experience mental
health problems; to be excluded from school and to be NEET. Careleavers are more likely
to end up in the criminal justice system, as victims and perpetrators. They face adverse
outcomes across the lifespan: in work and education; in chronic physical and mental
conditions.(McAuley, Pecora and Rose 2006).
• The women that meet Pause criteria are likely to be regular sporadic and reactive users
of other local services including that of Housing, Substance misuse services, Health care
and Mental heath services, Probation and Criminal justice services and Domestic abuse
services.
• They are less likely to be engaged in preventative care and support. Helpseeking is one of
their primary difficulties.
11. Southwark statistics (21 women)
100% have experienced
violence within relationships
26 % have alcohol issues 47% have a history of being in
the care system
37% have substance misuse
issues
100% have experiencedmental
health difficulties
32% have a diagnosed learning
difficulty
75% have housing difficulties
25% have been in contact with
the criminal justice system
58% have a history of sexual
abuse or exploitation
12. 487
372
0 100 200 300 400 500 600
London-Southwark
London-Haringey
London-Lewisham
London-Lambeth
London-Greenwich
London-Ealing
London-Barking & Dagenham
London-Newham
London-Camden
London-Tower Hamlets
London-Islington
London-Brent
London-Hammersmith & Fulham
London-Croydon
London-Waltham Forest
London-Barnet
London-Hackney
London-Hounslow
London-Enfield
London-Bromley
London-Wandsworth
London-Bexley
London-Westminster
London-Hillingdon
London-Havering
London-Sutton
London-Merton
London-Redbridge
London-Harrow
London-Kensington & Chelsea
London-Kingston-upon-Thames
London-Richmond
City of London
Number of care applications
LocalAuthority
14. Lack of Access to Support
• “Not good enough” to parent, “not bad enough” to qualify for
services – and deeply mistrustful of professional help.
15. £34,870
Annualprison costs per prisoner
£7190
Cost of 10 arrest &
detention incidents
per annum
£6730
Cost of 10 anti
social behaviour
incidents
£28,360
Cost of 10 domestic abuse
incidents
A few more costs: Health, Police & Prison
Services
£6,800
Cost of 20 A&E
attendance & ambulance
service incidents
17. Loss of welfare entitlements and informal
social costs
• Loss of home – forced move ‘bedroom tax’
• Loss of benefits
• Sanctions on kin relationships (contact) and potential exile from
informal parent networks
18. Maternal Identities
• Ongoing identity as mother even where child is adopted and no ongoing
contact
• Ongoing identity not adequately acknowledged
• Holding out for child returning as an adult
• Visual representations
• Contact arrangements and perceived relationships with alternative carers
important
19. Legal stigmatisation
Family court history – is never ‘spent’
Particularly pronounced for care leavers:
47% women interviewed had spent time in care system
Felt under particular scrutiny by state
Deep mistrust of system
Fear
“Punishing me twice”
20. Why do things differently?
• Financial cost – across all systems
• Human cost – children, families, communities, and
women.
• Because the ‘bad mothers’ of today were yesterday’s
hurt children.
• And fundamentally, because it is not too late.
• Each one of our women is extraordinary and frankly,
we don’t want to miss out.
25. Hull
Newcastle
Birmingham
Bristol
National Programme
Key
Blackpool
Derby
Cork
Current Pause Practices
In development
Scoping exercises in progress/planned
Other Leads and interested areas
Slough
Scotland
Northern Ireland
Cumbria
St Helens
West Sussex
Wiltshire
North East Lincolnshire
London
Cardiff
Liverpool
Wigan
Sunderland
Morpeth
Durham
Medway
Peterborough
Rotherham
Maidstone
Truro
27. Projected
Spend
£906,844
Pause Budget
£428,535
Without Pause With Pause
Projected Cost Avoided
£478,309
• 29 women over 18
month period of
intervention
• Birth rate of 0.53 per
year
• No pregnancies & babies
removed into care
Pause Hackney: Cost Benefit
28. Working in arenas where mistakes are the
territory
• Our women have usually made many, many previous attempts to make friends, start
courses, stop drugs or drinking, get help with mental distress, gain housing, move away
from destructive relationships. They often lack resilience skills – they make a lot of starts
and give up easily. They may be at the pre-contemplative stage of the cycle of change.
• This is often reflected in services’ engagement with short bursts of support followed by
eviction, disengagement, discharge or expulsion.
• Our work requires practically linking women into housing, drug and alcohol help, mental
health input, and breaking away from problematic relationships.
• But the efforts they make with us will be one in a long line of efforts. How do we make
this effort different?
29. A fundamental shift in
approach
Mistakes, lapses and setbacks are not the things that take us off map
Mistakes, lapses and setbacks are the territory:
they are what women, systems and services need to learn to navigate.
30. What we know about the consequences of
ACEs
• Brain is not the problem
• The problem is
• Resilience
• Connecting
31. Reflecting and connecting
• We target increasing reflective and connective capacity – because if
we can connect with someone when we’re hurt, pain lessens, and
when pain goes down, we open up space to learn
• and learning from things that go wrong is the difference between
adaptive and maladaptive.
• At Pause Southwark, we positively reward relating – we want women
to associate both being reflective and communicating with feeling
safe (emotionally and relationally), feeling understood, feeling
important, respected, intelligent, and with laughter, safety, kindness
and trust.
Self explanatory –
Creative example of her narrative and Pause providing an alternatve narrative for her
Life story
Developed with her Pause practitioner – explain who Linsay is and how this came about
Importance of this example
We’ve learnt over the last 12 months and as we come to the end of our first cohort, that the most important bit in supporting change for women at risk of repeat removal is YOU.
And moving on, the systems around the women will be the difference between success and failure. We’re going to be celebrating some of the people who’ve made a huge difference to Pause women, and we’re going to be inviting everyone to consolidate on what they have already given and help us think creatively how we can continue to do things differently for Pause women, to end the cycle of repeat removal.
Variation in care applications – London Boroughs
11% to 32% is range across London Boroughs
Range across England is 11% to 39% based on local authorities that have recorded more than 100 care applications during the observational window.
Adjustment required to ensure comparability of local authorities – future work.
Quant shown these widows but we don’t know whats going on our qual datashows whts going on at this time.
Integrated and systemic model
Woman at the centre
Assessment developed with her , understanding her history and also what are her current needs, what she wants to do differently
Practitioner – role to understand the issues
Know about children, when removed etc
Use of genograms and ecomaps- triangulat what we know with other agencies
Plan developed with her – collaborative
May need to focus on primary needs in first instance – Maslow – basic needs first as opposed to “ counselling “ being seen as solution
Use of tools and evidence based approaches
Her experience of assessment
Integrated needs but role of practitioner not to “ signpost “
Relationship being key
Womens resource – why key – how can be used
How we locate women – data in local area
Don’t rely on referral system in the first instance and why
16 weeks to make decision around working with Pause and taking LARC
Challenges of locating the women Talk though- intensive focus around contact activity – identifying women, going out to try and locate them, engaging them in potential support from Pause, undertaking initial assessment of the current needs/ risks and strengths and what they want to achieve through intervention
Focus on relationship building and dealing often with multiple crises which may be around housing/ mental health/ outcome of proceedings, contact, relationship issues
Need to be clear around language re consent/ agreement / sharing information
If women come off LARC or become pregnant , what do we do
Peaks and dips around intervention – much around stabilisation in early period and developing relationship
Transition phase should be well planned, considered and involve the woman – into other services, doing on her own , foundations, better equipped, different decisions, less crises, experience of help seeking, reducing risks inc future pregnancies resulting in removal and children into care
Day in the life of a practitioner and what this could look like in terms of types of intervention being provided
Approaches being used
Tenacity, use of self . Creativity, reflexivity, doing with , modelling, navigating systems and bureaucracy, role modelling, stabilisation , women's identity – maternal identity, other needs and focus on her, plans being developed with her in mind / alongside her/ with her/
The relationship between the practitioner and the woman she is supporting is key.
Develop professional, supportive, non-judgemental accepting relationship.
Our work requires practical support in linking them into services; attending with them, advocating for them and modelling how to navigate systems.
Doing for, doing with, supporting to do and cheering on - providing positive reinforcements and empowering independence.
We work to increase reflective and connective ability, which enables the women to become aware of themselves, their relationships and make better informed choices and decisions.
Being curious and learning through positive experiences which leads to increased skills and confidence and new ways of behaving and achieving
You might want to make reference to use of the women's resources- how this can help with practical things as well as positive experiences that they may not have had access to,
Doing with – examples of the practice – bike riding, gym, bread making and cooking, creative activities, going swimming
Creativity