Neglect and serious case reviews (PDF, 735KB) - nspcc

More documents

Recommendations

Info

Neglect and Serious Case Reviews 72 agency involvement: learning: is a characteristic response to the kind of caregiving that he experienced over many years. In addition, his early adverse experiences are likely to have increased his sensitivity to stress leaving him vulnerable to stress related psychiatric disorders, self harm and suicidal ideation (Howe 2005: 163). Discharging Frazer home to his mother’s care catapulted him into danger as he was reminded that he was unwanted and bad and this left him unable to cope with the feelings this evoked. His mother was also helpless to contain his powerful and self destructive urges. Children’s social care were involved with Frazer’s family on and off from the time of his birth. He had a child protection plan intermittently between the ages of five and nine (in the categories of neglect and physical injury). He was accommodated at the age of 13 and later made the subject of a care order. From the age of eleven he was known to Child and Adolescent Mental Health Services and from age 14 to the youth offending service. He was assessed as ‘not mentally ill with no real suicidal intent’ numerous times. Themes emerging from the serious case reviews included: • young people who are hard to help: Frazer will have transferred his un successful coping strategies from home to his placements. Those helping him interpreted his behaviour as sabotaging attempts to contain him and offer safe and trusting relationships. Good quality support and training for his carers might have helped them to understand the complexities of his behaviour and how helpless and angry Frazer made them feel. Strategies for dealing with and anticipating his behaviour and understanding why he could not trust anyone but himself, might have helped them to stick with him for longer and perhaps reduce Frazer’s need to run away. • the danger of return home. Although it may be the worst place for them, many young people in transition, like Frazer, feel compelled to go back home and will push for it relentlessly. Once back home Frazer and his mother needed a high level, intensive support not a low level service.
themeS aNd learNiNg poiNtS the long-term adverse effects of chronic neglect This section offers a longer term perspective and illustrates the impact of neglect over time. Whilst the previous vignettes have focussed on more immediate catastrophic consequences of neglect, this vignette illustrates the appalling long-term effects of chronic neglect and of neglect in combination with other maltreatment. Gilbert and colleagues’ systematic review notes that of itself the consequences of childhood neglect may be more serious than those of other types of maltreatment (Gilbert et al 2009:16). Obviously when neglect and other maltreatment are combined, the impact is even more severe. By adolescence the impact of neglect on development very often presents as described in the vignette, namely: conduct disorder, alcohol abuse, drug abuse, risk taking behaviour and recurrent victimisation (MacMillan 2009). Over time there is a moderate to strong link between maltreatment and attempted suicide, especially when the harm is cumulative, including neglect (Gilbert et al 2009). history of caregiving and current caregiving 3. A thematic analysis of neglect For these young people neglect often began at an early age and continued sporadically or continuously into adolescence, combining often, with other types of maltreatment. One child had on a number of occasions been left home alone at the age of two, then when a little older was sometimes not collected from nursery. For another young person a pattern of poor weight gain and failure to thrive from the age of two continued throughout childhood, and as an adolescent this young person talked of being hungry with access to limited and poor quality food at home. At the age of nine another child was found out alone at night, wandering, with no shoes on. One child’s mother warned him she was going to die and he would have no one to look after him so he would be better off dead. Another child’s father regularly issued threats to kill himself and his son. Loss, death of significant adult figures (often parents) and rejection were a feature of many childhoods. One adolescent was reported when at primary school to want to die like his father. As children these young people had to fend for themselves physically and emotionally and were described variously as ‘left to his own devices’ ‘seen out late without mum’ and experiencing ‘no emotional warmth’. As well as looking out for themselves many, like Frazer, also took on caring roles for siblings. One adolescent had been a carer for a sibling during childhood because of her mother’s mental ill health and at one stage the home she shared with her mother and siblings was declared unfit for habitation. Although things improved somewhat during her middle years, during adolescence the problems at home recurred. As they grew up these young people experienced either an unpredictable, or a frightening family life characterised by inconsistent bouts of parental mental ill health or violence towards them and their siblings and between adults; bouts of parental alcohol and or drug misuse abuse, and for some, sexual abuse from their mothers’ partners or associates. 73
Page 1 and 2:
Neglect aNd SeriouS caSe reviewS A
Page 3 and 4:
Contents Executive Summary 7 1. The
Page 5 and 6:
tableS Tables and Figures appeNdix
Page 7 and 8:
iNtroductioN Key fiNdiNgS Executive
Page 9 and 10:
fiNdiNgS how ofteN iS Neglect evide
Page 11 and 12:
Neglect iN all ScrS from 2009-11 To
Page 13 and 14:
Sudden unexpected deaths in infancy
Page 15 and 16:
maintaining a healthy, safe relatio
Page 17 and 18:
1. The context of neglect and serio
Page 19 and 20:
Summary 1. The context of neglect a
Page 21 and 22: 2.2 reSultS 2. Neglect in the lives
Page 23 and 24: There are encouraging signs of a dr
Page 25 and 26: figure 2.1: age distribution of chi
Page 27 and 28: 2. Neglect in the lives of children
Page 31 and 32: what did Neglect co-exiSt with? 2.
Page 35 and 36: figure 2.2: incidence of cp plan fo
Page 37 and 38: Summary 2. Neglect in the lives of
Page 39 and 40: what did Neglect coexiSt with? 2. N
Page 41 and 42: 3. A thematic analysis of neglect h
Page 43 and 44: As discussed in Chapter 2, it was n
Page 45 and 46: • There had been a lack of proper
Page 47 and 48: In reading the set of serious case
Page 49 and 50: The SCRs drew our attention to undu
Page 51 and 52: or more of a burden to his mother,
Page 53 and 54: parental learning disability Parent
Page 55 and 56: event prompting the serious case re
Page 57 and 58: themeS aNd learNiNg poiNtS ‘an ac
Page 59 and 60: 3.5 SuddeN uNexpected death iN iNfa
Page 61 and 62: agency involvement: learning: There
Page 63 and 64: Sudi riSKS aNd targeted iNterveNtio
Page 65 and 66: event prompting the Serious case re
Page 67 and 68: learning: themeS aNd learNiNg poiNt
Page 69 and 70: uising and rough handling An unders
Page 71: event prompting the Serious case re
Page 75 and 76: situation or dangers posed by, for
Page 77 and 78: Sudden unexpected deaths in infancy
Page 79 and 80: 4 Implications for policy and pract
Page 81 and 82: maiNtaiNiNg a healthy, Safe relatio
Page 83 and 84: Bibliography Blair, P., Sidebotham,
Page 85 and 86: Bibliography Ofsted (2008) Learning
Page 87 and 88: Appendix Table A.2 Category of abus
Page 89 and 90: 3. extreme Neglect / deprivatioNal
Page 92: Photography by Jon Challicom, posed
show all

Neglect and serious case reviews (PDF, 735KB) - nspcc

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?