Benefits of services in the past may have been undermined by dealing with children in isolation A Government policy on health and social services for children, which was launched yesterday, could signal a major change in the way authorities work with young people and their families, writes Carl O'Brien
On the streets of Letterkenny in Co Donegal young people have been developing a fearsome reputation. Gangs congregating in large numbers, drink-fuelled violence and boy racers have all been the source of growing numbers of complaints from residents, business people and politicians.
Once upon a time the response might have been a law-and-order crackdown. But, this time, authorities are approaching the problem differently.
Under a "dialogue day" to be held later this week, young people will talk to gardaí, health authorities and local residents about the source of the local problems: where else can young people hang out; what kind of facilities are needed; whether they feel unfairly treated.
"It's about discussing the issues from their perspective and seeing what we can do," says Aisling Gillen, a senior manager with the Health Service Executive (HSE) in the northwest who is involved in planning children's services.
"Young people tend to get vilified a lot, so we're trying to work pro-actively with young people, involve them in decision-making and identify solutions that are to everyone's benefit."
This change in approach goes to the heart of a new Government policy on health and social services for young people. The Agenda for Children's Services, published by Minister for Children Brendan Smith yesterday, emphasises the need for professionals to work in partnership with families and communities, involve them in decision-making and ultimately achieve better outcomes.
The policy is aimed primarily at helping policymakers, HSE managers and frontline workers in engaging more with children and their families. Ultimately, it aims to ensure services are "evidence-based, accessible, effective and sustainable".
It also includes a series of reflective questions aimed at helping professionals ensure their work is delivering the best possible outcome for children and their families.
While high-minded in its aspirations, many may grumble that the Government should be focusing on much more pressing issues such as waiting lists for vital children's services such as psychiatric assessments or speech and language therapy.
However, those in charge of implementing the new policy say the policy could help deal with these issues by emphasising more "joined-up" thinking between health services and other service providers, and examining new ways of resolving old problems.
The effects of the policy are likely to be seen most dramatically in the way social services deal with vulnerable young people and their families.
It seems incredible but, despite the affluence of modern society, child neglect remains the most common reason for children being taken into care. Some 60 per cent of the 2,300 children taken into care in 2005 was because they were neglected at home.
Social workers deal on a daily basis with the symptoms of society's failings, trying to help parents who fall through the cracks, linking them in with health or social supports, while ensuring children's needs are met.
The cost, they say, is a compromised service which is affecting the quality of support available to vulnerable children and families.
The new policy tacitly admits that the benefits of services in the past may have been undermined by dealing with children in isolation from their family and community.
Under the new vision, it says better outcomes can be achieved if professionals recognise the support children receive from their family and other networks of support in the community.
"Effective protection of children and young people at risk or in crisis, as well as the promotion of children's wellbeing, requires working in partnership with families.
"Retaining the trust of families is the key," the policy document states.
It also states that a child's wider family provides a valuable source of support which can be overlooked by social workers and other professionals.
"Help from these networks [beyond the immediate family] can be available on a 24-hour basis in a less stigmatising fashion and can be very cost-effective.
"They operate in the immediate world of the children and young people," it says.
Ann Kelly, a principal social worker who works in Sligo, Leitrim and Roscommon, says family and community are important stabilising factors for vulnerable young people.
"The most important things in their lives are their family, their friends, their community, the football team they might be involved in. There is a lot of strength and support to be drawn from that," she says.
The new policy, Kelly says, underlines this and gives greater emphasis to good practice in parts of the service. In the northwest, for example, social workers were the first to use family welfare conferences, a way of working in partnership with families to deal with their problems and identify solutions on their own terms.
"It's about identifying the strengths and weaknesses of families and their communities and building on those," Kelly says.
This family welfare model is now being extended to other parts of the State.
The new policy's emphasis on involving young people in decision-making could also have a significant effect on services if it is properly implemented by authorities.
Dr Philip Crowley, deputy chief medical officer at the Department of Health, says this involvement means that the views of young people are being actively considered in the development of policies and services.
For example, in building up primary care teams, officials will be engaging with young people in the community to identify their needs.
"Young people, for example, might want to have access to primary care in a way that doesn't involve their parents, whether that's relating to mental health or sexual health," he says.
"Services in the past may unintentionally have excluded different groups. Looking forward, the new policy will help ensure this is not the case.
"The participation of young people isn't tokenistic; it's not participation for the sake of it. It's about allowing young people to be involved and to see the practical benefits of that."