How women and children are falling through the gaps and what to do about it  

Throughout 2021 Fulfilling Lives South East has worked with volunteers, experts by experience and partners to understand the impact of child care proceedings on women with multiple and complex needs. Our work culminated in publishing a Guide to Child Protection and Care proceedings as well as a leaflet for women and workers with the aim to help navigate a complex system. In this blog piece, we have decided to focus on Clare’s story to bring to light the missed opportunities the current support system perpetuates.


Clare’s story

Clare is an amalgamation of the stories we have heard and witnessed from our clients who have experienced the repeated removal of children into care. Through sharing this story, we hope to highlight four key missed opportunities. While the system continues to miss opportunities to support women like Clare, this cycle will continue.  

Missed opportunity 1 – Access to Mental Health Support 

Clares Story: Clare grew up in an unstable home with parents who used drugs and she experienced sexual abuse from a young age. After being removed from her parents and entering the care system age 11, she began using drugs as a teenager and left care to live with a man she was in a relationship with, where she was a victim of domestic abuse. While living in temporary accommodation with her abusive partner, Clare fell pregnant and concerns for the safety of herself and unborn baby meant she was moved out of area, to another temporary accommodation away from her support network. During her pregnancy, Clare’s drug use continued and despite having suspected depression and a possible personality disorder she wasn’t able to get a formal mental health diagnosis due to her substance misuse. Mental health services ask that referrals be 6 months sober before being added to their waiting lists. In addition, her new temporary accommodation was far away from support services. A care order was placed on her unborn child and after going into hospital to give birth, Clare’s baby was removed 3 days after birth. An emergency c-section meant that Clare wasn’t able to physically hold her baby during the three days they were both at the hospital. Clare didn’t meet the referral criteria of the Perinatal Mental Health Team as there was no plan in place for her child to return to her care, so she was ultimately discharged from hospital without support.   

Recommendation  

The gaps and barriers in mental health support are felt most at the intersection of overlapping disadvantage. We can see this in Clare’s case when she is unable to receive an assessment for support before she gives birth due to her drug use, and after birth when she does not meet the threshold for support from the Perinatal Mental Health team. The void in mental health support for women whose children are placed into care at or soon after birth has devastating effects.   

Linking women experiencing multiple and complex needs in with mental health support at this difficult time is essential. Referrals to other sources of mental health support should be made when women don’t meet the referral criteria for crisis care in primary care settings and at the very least the woman should be signposted to sources of support before she is discharged from hospital. Such a formative time for both mother and child should also not be overlooked and every effort should be made to allow mothers to bond with their new-born. Fulfilling Lives is not seeking to challenge decisions to remove children, but to identify and highlight opportunities for more supportive interventions to be considered. Tools like hope boxes can be used alongside other mental health support to help women to process and feel a sense of attachment to their child despite the circumstances. Many services offer mental health support, however siloed working and a lack of capacity mean that healthcare professionals are sometimes not aware of the support available to women. By developing channels of communications and a multi-agency approach across children and family services as well adult social care, services can work together to prevent women falling through the cracks and referrals can be made before the point of mental health crises.   

Missed opportunity 2 – Advocacy support for Court Proceedings

Clares Story: Care proceedings began, but the process of going through care proceedings wasn’t explained to Clare. This additional stress led to a decline in her mental health and drug use which meant that she missed meetings with social workers. Professionals interpreted her absence as a lack of engagement instead of seeing it as an opportunity to provide information about advocacy services in the area that could talk her through the care proceedings and represent her voice during multi-agency meetings. The child protection case went to court, in a different town to where Clare was now living in temporary accommodation, so she was unable to attend, and her child was placed into foster care.   Quotes gathered from FL research: “I felt very alone through the whole process.”  “I lost trust in the system.”    

Recommendation

In our experience, women often feel disempowered throughout the process of working with social services, not understanding their rights or having a firm grasp of what is happening at each stage. Many women have also had negative experiences of social services in the past, often as children themselves, leading to a distrust and disengagement from services. Many women don’t have an Adult Social Care key worker and are only interacting with Children’s Services, whose main priority justifiably is the safety of the child. This leads to a lack of support for the women experiencing repeat childcare proceedings. Our clients have reported that they felt like passive recipients of a process that is making permanent decisions about their own lives and those of their children. 

We would advocate that accessible information be made available to women, including an information pack with leaflets for support services and a simple guide to their rights and care proceedings. All women experiencing multiple and complex needs should be offered independent advocacy services to help to represent their voice, explain the process and support them with the practicalities, for example financial support to cover the cost of transport to meetings and hearings. This time is often one of crisis for women and having continuity of care and a clear source they can go to for information and support is pivotal in maintaining their well-being. The assertive outreach model means that this support would also reach women who are isolated and perhaps not on the radar of other services.

Missed opportunity 3 – Collaboration between Children’s and Family Services and Adult Social Care

Clares Story: In order to have contact with her child, Clare was expected to be abstinent from all substances. Without therapeutic aftercare for the loss of her child, Clare used these drugs as a coping mechanism for her trauma and grief and continued to have relapses during this period. Clare felt like the requirements services put on her in order to be able to have any contact with her baby are designed to set her up to fail. Getting help for her mental health isn’t possible while she is still using drugs so her Emotionally Unstable Personality Disorder remains undiagnosed.  Quote from FL client: “I feel like everything is going to come crashing down around me. <…> I feel I haven’t been given enough time to turn my life around it’s just not fair. How can I be expected to just stop using and attend all these appointments without any period of lapse?  I’m not perfect.” 

Recommendation

The exclusive focus on the child seems to often come at the cost of supporting the mothers. Our partnerships with services that support women through this process highlight that a whole family approach is beneficial for both the women and children and their wider support networks. However, this needs to be the product of a coordinated effort by social services to collaborative and open working. The differing requirements put on women by services can be very overwhelming, and when they aren’t able to meet these, they feel judged, punished and like the opacity of the system is being used against them. We understand the pressure that social workers are under but by building an understanding that people with complex needs require a creative, flexible and joined-up approach from the professionals supporting them, women are given an active role in the decisions that affect them, empowering them rather than punishing them for seeking out support.  This trauma informed approach can lead to better outcomes for mothers and children.  

Missed opportunity 4 – Long-term Therapeutic Aftercare

Clares Story: After 6 months of waiting for the final court case and a ruling on the contact Clare will be able to have with her child it is decided that an adoption order will be applied, before which there will be a final contact opportunity for Clare. Clare didn’t have a support network or professionals that she engaged with who could help her emotionally prepare for the final contact, which was extremely difficult for her. Without continued therapeutic aftercare, Clare expressed that she doesn’t feel life is worth living without being able to see her child.   

Recommendation

Many of the women working with Fulfilling Lives have histories of Adverse Childhood Experiences (ACEs) and abuse, many are care leavers themselves and so the loss of their child in this way compounds their trauma, doing immeasurable damage to their well-being and sense of self-worth. The complex and lasting impact of these experiences can manifest as ‘challenging’ or difficult’ behaviours and the coping mechanisms that women develop such as drug use are seen as further justification for the removal of their children.    

Better access to open-ended therapeutic aftercare for women in this position allows time and space for the symptoms of trauma to be addressed and for these experiences to be reflected on in a meaningful way. Specialised support can help to develop women’s understanding of their relationship to motherhood and their bodies and look at what healthy relationships and attachment means to them. These trauma-informed and relationship-based therapeutic interventions are not quick fixes but instead offer ways of breaking the cycle of trauma and the repeat removal of children and build tools for resilience that women can access in themselves for a lifetime.    

Quote from FL client: “I still want to fight for my baby and maybe in a few years when I feel better after having the anger management and by entering the steps programme we could look at appealing.” 

From these recommendations, we have six system-wide calls to action –    

  • We would like Adult Social Care and Children & Family Services to collaborate and communicate with each other throughout the child care proceedings.  
  • We would like resource put in place which allows the Perinatal Mental Health team to support mothers who have their children removed after birth, independent of whether the child returns within 12 months.  
  • Reduce siloed working practices and create multi agency wrap around support for women experiencing MCN and care proceedings, including creative, flexible and assertive outreach. 
  • For staff to be trained in trauma informed approaches.  
  • An investment into advocacy services which leads to improved understanding of care proceedings. 
  • Long term, open ended specialist therapeutic aftercare for women who have experienced having a child removed from their care.  

Our active participation locally

We have published a Guide to Child Protection and Care proceedings as well as a leaflet for women and workers with the aim to help navigate a complex system. These resources are available for free here and received some positive feedback already: ‘Thank you so much for sharing these, what great resources, especially the video which I’m going to share with someone this morning! I’m so glad you reached out to us, I think your work is amazing and so needed for the women in our community.’ Nicola Johnson, Advocate, SpeakOut.  

We also published a blog about FLSE’s front line workers witnessing a direct child removal and how difficult this can be for workers, let alone mothers and discussed the importance of joined working when supporting women who experience recurrent child care proceedings.     

Link to Looking Forward report   Looking_Forward_Report_08_Final-09.12.21.pdf (bht.org.uk) 

Links to resources    Launch of Guide for Child Protection and Care proceedings, and Women’s Rights Leaflet – Fulfilling Lives South East Partnership (fulfilling-lives-se.org) 


Authors: Michaela Rossmann, Eve McCallam

For more information on this work please email: rebecca.rieley@bht.org.uk or eve.mccallam@bht.org.uk

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