FOSTER care and other out-of-home care (OOHC) arrangements may be doing more harm than good for many of Australia’s most vulnerable children, a leading paediatrician has argued, amid growing consensus that the child protection system is failing.

Professor Peter Jones, Dean of Medicine at Queensland’s Bond University has written a Perspective in the MJA calling attention to the massive increase in Australian children being taken from their families and put into OOHC, with 46 448 children in such care at June 2016.

The number of Indigenous children in OOHC care more than tripled over the past 18 years and more than doubled for non-Indigenous children.

“In Australia, OOHC has been assumed to be the safest option for vulnerable children if there is any suggestion of risk of further harm to the child. This assumption needs to be challenged,” Professor Jones wrote.

He cited a review showing that there was “no clear evidence for an overall decrease in child maltreatment” as a result of contemporary child protection policies.

There was also “no evidence to indicate that OOHC reduces the prevalence of mental health problems,” he wrote.

In contrast, there was reason to be concerned about the harms of placement instability, he said, with one study showing that almost a quarter of children in care experienced an average of 11 placements.

“How devastating must that be to their mental health and feelings of self-worth? It’s just terrible,” Professor Jones told MJA InSight in an exclusive podcast. “They disappear into this terrible vortex of foster care where they may go from one carer to the next, and before you know it, you’ve compounded all the difficulties that have confronted this child.”

Professor Jones said that the popular perception that children needed to be removed from their families to prevent deaths was “out of proportion with the statistics”, noting that the homicide rate for children had remained stable for decades.

On the other hand, he noted that in NSW in 2012–13 alone, 14 children in care died due to suspected abuse or neglect.

“We must incrementally reduce our reliance on OOHC as a key goal in overcoming the complex problem of child abuse, neglect and increasing inequity in Australia,” he wrote.

Although legislation in each of the states and territories describes OOHC as a “last resort”, Professor Jones said that it was “a last resort that was being turned to more and more often”.

“One in 19 Indigenous children is in OOHC,” he said. “What on earth are we doing in these communities that makes life so bad that this seems to be a sensible option?”

He noted that the Australian experience was at odds with the decline in children in OOHC in the US and New Zealand. In the US, adoption is the preferred child protection option if restoration with the family is not achieved within 2 years of foster care. In New Zealand, vulnerable children are increasingly placed with kin, without being formally placed under the guardianship of the court.

Professor Jones said that more resources should be poured into strengthening vulnerable families. He also suggested that policies should perhaps be developed to “encourage disadvantaged families to have fewer children”.

Ms Jacqui Reed, CEO of the CREATE Foundation, the peak body representing children in OOHC, agreed that the current child protection system was failing.

“I can’t think of any consistent indicators for which you could say the outcomes for kids in care have improved over the past 10 years,” she told MJA InSight.

“Since 2009, most jurisdictions in Australia have had strong child protection policies in place, but the policies are very different from the practice on the ground because we haven’t resourced this area.”

She disagreed with the call to reduce the number of children in OOHC, saying she feared it was “driven by economics” rather than a genuine focus on the needs of children and young people.

“We can’t throw the baby out with the bathwater,” she said. “If we invested properly in equipping carers, developing a therapeutic approach to children in care and monitoring the outcomes, we could make a substantial improvement,” she said. “The problem is that within society, these kids are viewed as ‘difficult’ rather than as victims of abuse, and so politically, there are no votes in child protection.”

Ms Reed also disagreed with the call for policies to discourage disadvantaged women from having more children, saying these women instead required support to be effective parents.

She also warned that adoption – which is increasingly used in NSW – was not clearly a better option for all children.

“Kids want the permanency of adoption, but they’re also very concerned about being separated from their siblings,” she said. “Adoption may be good for some children, but for many the better option is long term guardianship orders that enable them to retain their connections with their birth family.”

Ms Reed is a strong supporter of the growing Home Stretch campaign urging state governments to lift the leaving age for children in state care from 18 to 21 years. According to the Home Stretch website, within 1 year, 50% of state care leavers are unemployed, in jail, homeless or a new parent.

Ms Reed said that it was nonsensical that in a country where most young people leave home at 26 years “we are expecting the most vulnerable population, who have been abused and neglected and suffered trauma, to be cast adrift at 18 [years]”.

Associate Professor Philip Mendes from the Department of Social Work at Monash University, who also supports the Home Stretch campaign, said that Australia needs to establish a national database to monitor the progress of care leavers until at least 21 years, measuring outcomes in areas such as education, employment, health, housing, parenthood, substance use, social connections and involvement in crime.

“We don’t actually know whether the outcomes are better for most young people compared with what would have happened if they had remained with their families of origin,” he told MJA InSight.

“Some young people experience inadequacies in state care, including poor quality caregivers, and constant shifts in placements, carers, schools and workers,” he said. “Nevertheless, many children and young people in OOHC experience supportive and stable placements, including an ongoing positive relationship with carers and workers, which enable them to overcome adversities resulting from their pre-care experiences.”

Professor Mendes agreed that there was a strong case for greater investment in early intervention family support services.

State and territory governments currently spend just 17% of total child protection funding on family support services ($700 million a year), he said, compared with 83% ($3.5 billion) on child protection statutory interventions and OOHC, including investigations of abuse and neglect and placements. (See Social justice in Australia: ending the over-representation of Indigenous children in out-of-home care and returning them to their communities by Philip Mendes (Monash University) for Gary Craig (ed.) A Handbook on Social Justice. Edward Elgar Publishing. In Press, 2017).

He said that this “skewed funding” reflected in part the massive increase in the number of notifications to child protection authorities to 272 980 in 2012–13 – more than six times the recorded number in 1989–90.

Professor Leah Bromfield, Deputy Director of the Australian Centre Child Protection, told MJA InSight that child protection was in a “perpetual state of reform” as authorities in each of the jurisdictions worked to improve their systems for vulnerable children.

“While unacceptable, I don’t think the idea that some children in OOHC may get worse is necessarily new, particularly children in residential care,” she said. “However, it would be unjustifiable to give up and leave children in abusive families of origin because we can’t provide safe care.

“We have to make all reasonable efforts to work within the family to address maltreatment concerns and prevent the need for OOHC, but where this fails out of home care is necessary.”

She said that the rising number of children in care was not simply explained by increasing removals and was contributed to by multiple factors: failure to intervene early, resulting in problems escalating and necessitating removal; a rising number of infants on longer orders; and a failure to reunify families.

“It’s easy to say that we need to focus more on vulnerable families and reduce levels of abuse, but we need to focus more on building the evidence to inform how we actually do that.” she said.

The National Children’s Commissioner, Ms Megan Mitchell, is this year undertaking research into vulnerable young parents and their children, which she said will have direct implications for Australia’s child protection policies.

“Children of vulnerable young parents are often at risk of being removed into the care and protection system, and are also more likely to become young parents themselves,” she said.

Ms Mitchell said that her research would include a focus on how to influence young parents’ decisions to delay the birth of a second child and how to improve the capacity of young parents for safe and effective parenting.

“We need to redouble our efforts to work intensively with struggling families as early as possible to help them develop the skills, capabilities and access to resources they need to keep their children safe and well,” she said.

Dr Paul Robertson, chair of the Faculty of Child and Adolescent Psychiatry at the Royal Australian and New Zealand College of Psychiatrists, said that the rising rate of children in OOHC was unacceptable.

“OOHC is like the ambulance at the bottom of the cliff,” he told MJA InSight. “Clearly, there needs to be much greater earlier intervention in at-risk families before children end up at the bottom.”

When OOHC was necessary, Dr Robertson said that it should be a therapeutic intervention designed around priorities such as improving mental health and psychosocial development.

 

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Poll

Australia's child protection policies need urgent reform
  • Strongly agree (71%, 39 Votes)
  • Agree (24%, 13 Votes)
  • Neutral (4%, 2 Votes)
  • Disagree (2%, 1 Votes)
  • Strongly disagree (0%, 0 Votes)

Total Voters: 55

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7 thoughts on “Foster care: is it doing more harm than good?

  1. Anonymous says:

    “Ms Reed also disagreed with the call for policies to discourage disadvantaged women from having more children, saying these women instead required support to be effective parents.”
    This is bewildering. The two goals are critical in reducing harm, how could they possibly be regarded as mutually exclusive?

  2. Anonymous says:

    Bond University – with namesake Alan Bond who was convicted of fraud?

  3. Anonymous says:

    Can’t agree more. I have seen first hand the devastating effect of a child who is a relative being taken. She is now on her fourteenth placement. Her mother has been mentally and physically destroyed by grief. The child is no better off.

  4. Anonymous says:

    My personal exposure to Child Protection has been enlightening. The fundamental position taken by Child Protection is that all parents are totally competent and without flaw so that any actions seen as harmful to the child are read as being deliberate malicious acts. The reality is that the target group in the sights of Child protection contains a great many parents with significant health problems, both physical and mental. A case occurred where a mother required support for 6 weeks after intrusive abdominal surgery. The response was to put her children permanently into care.
    A senior Investigator disclosed that in record keeping, only records of negative events are recorded. Any positive attempts by parents to rectify the wrongs perceived by Child Protection are omitted. Secondly, Child protection records all anonymous reports and hearsay as if it were established fact. They do not record when these allegations are dis-proven by Police or Courts, the reports remain on the record without annotation. In Court cases especially where Legal Aid is involved, the witnesses from Child Protection will present in Affidavits, evidence which is hearsay, dis-proven and entirely fictitious working on the basis, apparently, that the Legal Aid representative will not challenge them in court. In fact Legal Aid will threaten to withdraw support if the client wishes to challenge the issue. This is bullying, if not blackmail.
    Parents are also effectively prevented from seeking independent advice, both on medical and social matters pertaining to their children and legal, by virtue that they are most frequently captive by Legal Aid who are essentially covering their own backs. A recent case where the Legal Aid absolutely refused to put the parents viewpoint was followed very quickly by that persons rise up the ladder to the position of Prosecutor. The system sucks and would appear to be irrevocably broken.

  5. Anonymous says:

    Drug abuse, particularly with methamphetamine , is increasing and must be acknowledged as a social disruptor of major concern As a worker assisting in drug and alcohol management, my observations of Child Protection in Western Australia are at variance with some views expressed above.

    Parents who have had their children removed from their care are encouraged to seek assistance for their addiction, and ongoing drug usage is usually the only barrier to having their children returned to their sole care. In most instances the children are placed in the care of a grandparent or close relative, and contact with the children is maintained. Violence and very erratic behaviour in the households of drug users is more the norm than the exception, as is relapse after a brief spell of abstinence, such that a too early return of the children would be more harmful and disruptive..

    We assist parents to have their children returned, and are their advocates, but only within a framework of support with their addiction and assistance in dealing with their mental health and addiction related issues..The work of Child Protection is a difficult one. Errors are inevitable, and when Child Protection has failed to protect a child from harm the public outcry is deafening.

    Not addressed in the article or comments is concern over perpetuation of a cycle of disadvantage and dysfunction as children reproduce the behaviours and environments of their parents.

    .

  6. Anonymous says:

    I foster and see the damage to children who were left in their family home when they should have been removed and then further damage done when they are replaced with their family only to bounce back into care often after being physically, emotionally and or sexually abused and often permanently damaged. I think Australia would be wise to have a policy where children who have bounced more than once or who’s parents cannot be helped after 18 mths then they should be able to be adopted. No child should be taken from a home where the family only need some extra support and education but this rarely happens.
    Contraception should be mandatory for mothers who cannot care for their children safely and reviewed every 3-5 years to see if it can be with held.

  7. Sue says:

    I agee with anon. Whilst I wholeheartly support reunification for children whose parents have actively engaged with support services and priortised their children there needs to be timeframe for those who aren’t.
    Child protection services and courts are supposedly aimed at the best interests of children thus providing permancy and security is important. Ongoing short term orders does not provide security. Particularly for those children placed in care at infancy therefor habing little or no attachment or relationship with their birth parents.

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