The All Party Parliamentary Group for Children has held two meetings since mid February:
- Monday 26 February: Housing and Every Child Matters. With speakers Caroline Davey (Deputy Director of Policy and Research, Shelter); Anne Whiteley (Director for Children and Young People’s Services, Devon County Council); and young people from the Sunderland YMCA foyer.
- Monday 12 March: Mental Health Bill. With contributions from Louis Appleby, National Director for Mental Health; Camilla Parker, a representative from the Office of the Children’s Commissioner who specialises in Mental Health and Human Rights; and Kathryn Pugh from Young Minds.
Monday 26 February – Housing and Every Child Matters
Caroline Davey gave an overview of the impact of poor housing on the 1.6 million children and young people living in substandard housing in the UK. These children are twice as likely to:
- leave school without any GCSEs,
- have been excluded from school,
- suffer from poor health, and
- suffer from persistent bullying.
Children in temporary accommodation miss an average of a quarter of their school year, and it is very hard for them to catch up. Poor housing and overcrowding affect their physical and mental health, as well as having an impact on the family as a whole. Clare said that the integration of services is fundamental to addressing this issue. In the past, housing has been seen as separate from services such as education and social services. The need for these services to work together is now being recognised, and Every Child Matters and the new children’s trusts provide a perfect opportunity to take this forward.
Housing in Devon
Anne Whiteley reported to the Group on the experiences of joint working between the children’s trust and the housing sector in Devon. A needs analysis in the County revealed a lack of:
- affordable independent and semi independent move-on accommodation;
- flexible community support;
- supportive emergency accommodation, assessment and mediation options;
- effective protocols, care pathways and information sharing between agencies; and
- skills and best practice sharing between agencies.
Young people were scared of leaving the social housing sector and making themselves homeless, and their biggest concern was having safe accommodation.
To address these issues, Devon is bringing together all the district housing authorities, Supporting People and children and young people’s services to achieve clarity about priorities for services, with joint performance targets aligned to funding streams. They are:
– developing and designing new services;
– developing new joint protocols and training; and
– involving young people in designing the evaluation of services.
Local Area Agreements and partnership working have helped them to align money with their priorities, and they are planning to use the Local Area Agreement to formally pool elements of different departments’ budgets.
Experiences of Homelessness in the North East
Finally, Vicky, a young person from the Sunderland YMCA Foyer, told the meeting about the experiences of Emma, Nicole, and herself.
Vicky became homeless when she was 16 years old, and ended up staying on the sofas of friends in poor housing conditions, living on the streets, living in B&Bs, and at one point living with an abusive boyfriend. The local authority would not help her because it considered her to be intentionally homeless, even though she had been made to leave home by her parents. She could not claim job seekers’ allowances and benefits because she had no fixed abode, but she had no money to pay for accommodation.
Emma had lived with her grandmother for three years from the age of 13, and then moved into a council house. She was harassed by a neighbour, but the council would not take action or offer her alternative accommodation. She became depressed, and ended up leaving and becoming homeless.
Nicole left home aged 16, and went into a B&B. She was constantly moved around and the accommodation was of very poor quality and felt unsafe. All this contributed to her increasingly low self-esteem, and this made it hard for her to get into training.
All three are now living in the Sunderland YMCA Foyer. They feel safe and secure, and have access to training opportunities, a support worker and an outreach service for when are ready to live independently. However, moving on is difficult because there is such little housing available, and they cannot afford deposits and the high level of rent for private rented accommodation.
Monday 12 March – Mental Health Bill
This was an opportunity to discuss how measures in the Bill will impact upon children and young.
Louis Appleby said that the key purpose of mental health legislation is to make sure that vulnerable people get the treatment they need even when, through no fault of their own, they do not themselves recognise they need it. He concentrated on two key measures in the Bill and their impact on children and young people: Supervised Community Treatment (STC) and the abolition of the ‘treatability test’.
Supervised Community Treatment
Supervised Community Treatment (STC) is designed to ensure that patients with a relapsing psychotic illness, including under-16s, who have been discharged from hospital continue to comply with treatment, subject to recall to hospital. Louis said that psychotic illness most often begins in early adult life, from the teen to the late twenties. Non-cooperation with treatment is very high in those age groups at the start of illness, and suicide risk is also at its highest in the first one to three years of illness.
Referring to personal experience, Louis told of a 17 year-old male, who was admitted to hospital, and released after successful treatment. After that, it became very hard to keep track of his progress and keep in contact enough to provide treatment. The young man had many more serious relapses that resulted in numerous admissions, and he eventually committed suicide. The STC measures in the Bill will help clinicians ensure patients like that young man continued treatment.
The Treatability Test
Louis went on to say that the ‘treatability test’, whereby a patient can only be detained for treatment if his illness is treatable, is an impediment to care. It creates a legal ‘grey area’ for clinicians where it can be unclear whether a patient can be detained even if there is high risk, and it excludes patients with personality disorders. He gave an example where this had caused problems in the treatment of a 17 year-old patient with a borderline personality disorder.
The Bill creates a new test – the ‘appropriate treatment test’ – where the emphasis will be on ‘therapeutic purpose’ rather than ‘therapeutic benefit’. Referring to the Lords’ amendments relating to age-appropriate care and access to CAMHS specialists, Louis said that these specifics should be in the Code of Practice, rather than legislation.
Children’s Rights
Camilla Parker provided a children’s rights perspective on the Bill. Referring to the UN Convention on the Rights of the Child, she highlighted the key issues as being:
- participation (Article 12) – making sure children and young people are engaged in decisions;
- provision (Articles 24, 26, 27 and 28) – making sure they can access the services they need; and
- protection (Article 19) – from violence, injury and abuse.
She then assessed measures in the Bill in terms of their impact on those key rights. For example, advocacy services for all under-18s would ensure children and young people were involved in decision-making (participation), signposted to services (provision), and informed of their rights (protection). However, she viewed STCs as providing no benefits in terms of children’s rights to participate in decisions that affect them, and rights to services, and suggested that insufficient safeguards to protect children have been provided for in the Bill.
Welcoming the Government amendment allowing 16-17 year olds to consent to and refuse treatment, she then set out her support for a proposed amendment to give all children the right to consent to and refuse treatment, where they have sufficient understanding and intelligence to be able to understand fully what is being proposed and to make up his or her mind: i.e. ‘competent’.
Age-Appropriate Treatment
Kathryn Pugh welcomed the new amendments relating to children and young people passed by the Lords. Referring to age-appropriate treatment, she said that putting requirements only in the Code of Practice would be a flawed approach. She said that financial pressures meant that commissioners usually only managed to secure the services that they had to, and maybe that had targets attached, but rarely those services that were needed or that they would have liked to provide. If the requirement for age-appropriate care only goes into the Code of Practice, it will continue to be a lower priority; getting it into law is therefore the only way of making sure it happens and that commissioners get the funding they need.
Approximately 955 children and young people per year end up on an adult ward, and the average stay is one month. While some of the adult wards are very good, they are inappropriate environments for the unwell children and young people. They are scared and traumatised, and they experience verbal, physical and sexual assault, and are offered alcohol and drugs. Many of the children on adult wards receive limited therapeutic care, no education, and highly disorganised discharge.
Kathryn said that this situation is creating exactly the situations the Bill is trying to address: revolving door patients. The children who end up on adult wards can be so traumatised by the experience that they do not want to go back so desperately that they may later refuse treatment.
Forthcoming meetings of the APPGC are:
- We are currently planning a meeting on the Home Office’s recently published consultation paper, Planning Better Outcomes and Support for Unaccompanied Asylum Seeking Children. Further details will appear on the APPGC area of the NCB website.
- Monday 14 May: Every Child Matters and Social Care Confirmed speaker: Roger Morgan (Children’s Rights Director); other speakers to be confirmed – Monday 14 May 2006, 5-6pm.
Please contact Sally Cole, Clerk to the APPGC on 020 7843 1907 or by email to [email protected]:
- To be added to the email mailing list to receive minutes and invitations to meetings,
- For copies of minutes from any of the meetings,
- For any further information about the Group.
Sally Cole is the Parliamentary Officer for the National Children’s Bureau, and is clerk to the All Party Parliamentary Group for Children.