The Needs of Children Living in Limerick

1
The Needs of Children Living in Limerick

• How research has informed the design and
  development of services within the Limerick
  regeneration areas
• Claire Hickey Senior Research Manager,
  Barnardos
• Stephanie Whyte Assistant Director of
  Childrens Services, Southern Region, Barnardos
• Kevin OFarrell, Child Care Manager, HSE,
  Limerick

2
Presentation Content

• Describe the research process and the key
  findings
• Show how the research has been used by Barnardos
  in considering and planning services in the city
• Discuss the development of the services for
  children and their families in the context of the
  regeneration activities in the city

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Purpose of the Research

• To establish a picture of need in Limerick city
  and to investigate the determinants of those
  needs
• To establish the normative prevalence of needs in
  Limerick, thereby establishing a benchmark
  against which Barnardos can pitch its
  achievement of outcomes
• To establish a picture of need among children
  attending Barnardos services and illustrate the
  difference between their of needs and those of
  the general child population in Limerick city
• To inform the service design choices for Limerick
  going forward

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About Limerick City Population 52,539 19,513
households 22 per cent aged 17 years or less 8
per cent unemployment 32 per cent lone parent
households 18 per cent of adults are educated to
primary school level only
Moyross
St Marys Park
Weston Ballinacurra
Southill
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Defining Need

• Children are said to be in need when their
  well-being is below a threshold that is regarded
  as either normal or minimal. Our conceptual
  understanding of need included three dimensions
• Child
• Parents
• Wider environment

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Methodology

• Random sample of 200 households with children in
  Limerick city interviews with mothers
• Convenience sample of mothers whose children
  attend Barnardos services in Limerick in Moyross,
  Southside and Islandgate

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Questionnaire Content

• Maternal measures of well-being
• Positive Negative Affect Scale (PANAS)
• Depression Scale
• Hope Scale
• Positive Emotions Scale
• Parent-Child Conflict Tactics Scale
• Support Networks

• Household measures of well-being
• Household Income
• Financial well-being
• Neighbourhood characteristics
• Tenure type/stability
• Use of services

• Child measures for well-being
• SDQ
• Physical health rating
• Presence of disability
• Home education environment
• School attendance
• PCRI

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Comparing Demographic Details
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Child Mental Well-Being
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Normal distribution curve in achieving outcomes
for children, how much change do we need to
affect to bring them within the normal range of
the population?
x
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Childrens Health Disability
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Childrens Education

• 21 per cent of children in the Limerick projects
  may have reading difficulties compared to 6 per
  cent in Limerick city and Ireland
• Compared to both Limerick city and Ireland,
  children in our Limerick services have fewer
  books in the home, are read to less frequently
  before primary school, have less access to
  computers and the internet, and there are lower
  maternal expectations of their staying in school
• 20 per cent of children in the Limerick projects
  are absent from school for 20 days, compared to
  2 per cent in Limerick city and 11 per cent in
  Ireland

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Maternal Mental Health and Physical Well-Being

• About two-thirds of mothers in our services are
  depressed compared to 17 per cent in Limerick
  city
• Mothers in our Limerick services experience less
  satisfaction with life compared with mothers in
  Limerick city
• 17 per cent of mothers in the Limerick projects
  rate their health as excellent or good compared
  to 65 per cent in Limerick city and Ireland
• 33 per cent of mothers in the Limerick projects
  take sedatives, tranquilisers or anti-depressants
  compared with 13 per cent in Limerick city and 5
  per cent in Ireland (the rate in Ballymun is 15
  per cent)

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Parenting Skills

• Mothers in the Limerick projects have weaker
  parenting relationships compared to mothers in
  Limerick city and Ireland
• Two main areas of weakness in the parenting
  relationship are (i) feeling dissatisfied with
  their role as a parent (ii) difficulty in
  setting appropriate limits on child
• Mothers in our services use 2.5 times more
  discipline compared with mothers in Limerick city
  and Ireland, especially non-violent discipline
  and psychological aggression

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Comments on the Findings So Far.

• While comparisons between the two Limerick
  samples are interesting and important the
  difference in sample sizes and types should be
  borne in mind
• How the samples were sourced
• The representative nature of the samples
• The circumstances and environments in which the
  different sample populations live

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Factors Associated with Childrens Mental Health
Difficulties

• Main determinants are
• Medical card
• Sedatives, tranquilisers and anti-depressants
• Negative affect

• Primary influences include
• Mental health of mothers
• Parenting skills

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Factors Associated with Childrens Reading
Difficulties

• Main determinants are
• Being a lone parent
• Frequency of reading to child before primary
  school

Further analysis underlines the influence of
socio-economic factors on both reading to a child
and a child having reading difficulties
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Service Design

• 3 Barnardos Family Support Projects in Limerick
  Moyross, Southside
• and Islandgate and are funded by the Health
  Service Executive
• Five key issues relevant to service design and
  development were identified by the research
• the systematic nature of family difficulties,
• childrens mental health difficulties,
• childrens reading difficulties,
• maternal depression and
• excessive use of discipline

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Chain of Effects Showing Parental Child
Factors and their Connections

Parent overburdened
Poor parent / child relationship
Parental depression
Parents unmet childhood needs
High criticism/ harsh discipline low warmth
Child educational problems Child mental health
difficulties Child behavioural problems
KEY Factors relating to parents Factors relating
to children
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Chain of Effects Showing Parental Child
Factors, their Connections and Services

Parenting Support Package
Parent overburdened
Parental depression
Poor parent / child relationship
Child educational problems Child mental health
difficulties Child behavioural problems
Parents unmet childhood needs
High criticism/ harsh discipline low warmth
KEY Factors relating to parents Factors relating
to children Services
Services for the Child
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Parenting Support Package

• Parent/Child relationship
• Individual and group work to address
• Parent being overburdened
• Parents understanding of behavioural problems
• Preparation for being a parent
• Support in being a parent
• Creating links between home and school
• Partnership arrangements other agencies

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Services for the Child

• Early intervention
• Early childhood development - Tús Maith High
  Scope/REDI
• Reading difficulties
• Wizards of Words
• Poor social skills and peer relationships
• - Group work and Friendship Group
• Parent/Child relationship
• School support programmes
• Partnership with Parents
• Partnership arrangements other agencies

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Service Development

• Staff awareness and understanding linking
  practice to evidence
• Partnership participation in the development of
  a plan for child and family services in Limerick
  - HSE
• Limerick Regeneration

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Population Trends

• Limerick City has highest marital breakdown rate
  in the state
• Limerick City highest percentage of births
  outside marriage
• Limerick City highest teen parent rate

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Significant Issues

• Rise in serious drug use
• Feuding in city impacting on service delivery and
  staff safety
• High mobility of families in disadvantaged areas
• Rise in mental ill-health, self-harm and suicide
• Rise in reports of children of non-Irish
  nationals coming to the attention of services

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Process of Developing Family Support Plan

• Information Sharing Group (July 06)
• Children Services Committee priorities
• Annual Internal Review with funded agencies
• Messages from commissioned research and
  evaluations
• Focus group with senior HSE child care staff and
  major funded agencies
• Regeneration Vision Document
• RAPID Consultation
• Task Force (May 08)

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Identified Challenges

• Integrate family support responses to meet
  childrens assessed needs at all levels of need
• Develop info systems which are safe, legal and
  which inform planning practice
• Establish common assessment approach across
  statutory and non-statutory agencies
• HSE maintain core frontline staff
• Enhance mental health of mothers
• Engage with fathers
• Funding

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Plan

• Plan is based on the need to develop services
  appropriate to
• age
• level of need of children and their families

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Priorities within Family Support Plan

• Intensive parent support services pre-birth to
  18 years
• Intensive quality early years programmes
• Supports to high risk young people
• Enhanced drug alcohol services
• Reframe mental health services

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Key Delivery Issues

• Life cycle assessment of needs approach
• Re-align where necessary
• Outreach
• Early years services
• Timely intervention
• City wide provision
• Capacity building across a spectrum of needs/age
  bands
• Integration co-ordination
• Mobility of families

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Making a Difference

• Identify executive capacity to be responsible for
  ensuring programme delivery
• Use proven models wherever possible
• Establish integrated systems for identification
  of need, information sharing and service delivery
• Ensure evaluation and review are built in

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Hardiker Model (2000)Levels of Need
Children at Risk
Children Who are Vulnerable
Children in Need in the Community
All Children Young People
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Identification of Need
Specialist Assessment
Common Assessment Framework
Early Warning System
Personal/Shared Information
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Service Provision
Care Custody Treatment
Children with Additional Needs Meetings
Service Specific Providers
Universal Services