LAMBETH SAFEGUARDING CHILDREN BOARD

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LAMBETH SAFEGUARDING CHILDREN BOARD

• Ade Adetosoye, Divisional Director Social Care
• and
• Sonia Burke, Assistant Director of Adult Mental
• Health Services

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Mental Health Protocol

• A new Joint Adults and Children Services Protocol
  - but WHY?
• Strategic Aims - Policy Framework in Lambeth
• What do we know about mental health key
  messages from research and the impact on children
• LSCB response

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Mental Health Protocol

• Every Child really does Matter in Lambeth the
  outcomes we seek for every child are -
• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic well being
• Safeguarding is everybody's responsibility
• Section 11 Children Act 2004

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Mental Health Protocol

• What we know about adult mental health
• Scale of mental health problems
• 16 adults will develop a significant mental
  health problem at some point in life (ONS)
• Over 200,000 adults live in Lambeth (1 6
  34,000)
• 16 of parents develop psychiatric morbidity
• 4361 adults in Lambeth currently receive support
  from Adult Mental Health services
• 3,606 referrals were received by Adult Mental
  Health Services in the last 12 months
• 30- 50 of these adults are estimated to have
  dependent children
• 25 of new referrals to social care involve
  concerns about parental mental health about
  1000 children
• 25 of the children on a child protection plan in
  Lambeth live with a parent who has mental health
  problems
• Research strongly indicates that children are
  effected by enduring mental
• health problems in their parents.

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Mental Health Protocol

• Effects of adult mental health on children
• Potential Significant Harm
• A small number of children are killed in Britain
  by their parents as a result of parental mental
  illness every year.
• Studies vary but estimate that mental health is
  an issue in 33 - 55 of parents who murder their
  children (Falkov, Reder Duncan, DCSF RR023)
• Studies repeatedly say that adult and childrens
  services didnt work
• effectively together in these tragedies. (Ofsted,
  Falkov, Reder Duncan, DCSF RR023)

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Mental Health Protocol

• Other effects of parental mental health on
  children what is it like to be a child when
  their parent is mentally unwell? Children report
  
• Feeling ignored by agencies and parents
• Insecurity, false maturity, pressure to be good
• Fear of family breakdown
• Personal sense of shame and blame for their
  parents illness
• Confusion, lack of explanation or understanding
  of illness
• Withdrawal, stigma, isolation
• Disruption of education
• Young Carer responsibilities (and often not
  recognized by agencies)
• Being left to manage their parents illness
• Carrying responsibility for adults, but being
  left out of discussions
• Mental health problems of their own

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Mental Health Protocol

• Emotional/Psychological Effects identified by DoH
  research
• Child Development e.g. regression, language
  development, shorter attention span
• Education young carer, interruptions of
  schooling, poor focus
• Emotional wellbeing insecure attachments,
  guilt, worry
• Social isolation, stigma, bullying
• Cognitive motor skills, difficulty with
  concentration
• Other Effects
• Poverty social exclusion, ill health, poor
  housing
• Discrimination racism, family isolation and
  community stigma
• Falcov 1998, Alridge and Stuart 1998, Mackereth
  1999, Weir 1999

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Mental Health Protocol

• Conclusions
• To reach the five ECM outcomes, these children
  need joined up multi agency support at an early
  stage in the crises
• Support needs to be multi agency and holistic. It
  must address the needs of both parents and the
  children
• Good quality joint work between adults and
  children services work is essential to protecting
  children who are at risk from adult mental
  illness

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Mental Health Protocol

• The Lambeth Mental Health Protocol addresses
  these needs. For the first time Lambeth has a
  Protocol that
• Triggers the early identification and referral of
  children at risk of significant harm and whose
  families have complex need
• Identifies children with additional needs to get
  early multi agency holistic support and
  intervention to children and their parents before
  things escalate.
• Incorporates the Common Assessment Framework and
  Team Around the Child into referral pathways.

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Mental Health Protocol

• Mental health is a key priority area in the LSCB
  Strategic Plan 2008
• 2011. The LSCB has taken the following action
  since 2008
• The Divisional Director of Adult Social Services
  and the Director of Mental Health Services attend
  the LSCB
• A strategic Adult and Children Services
  Sub-committee addresses joint work
• Safeguarding champions are now in every adult
  mental health team
• Every family in adult services is screened for
  child protection risk
• New specialist joint training has been
  commissioned for 2009 for adult and social care
  workers
• Lambeth has begun to roll out the CAF and TAC in
  Adult Services, with completion date December
  2009
• A new joint children and adults post has been
  commissioned

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Mental Health Protocol

• In Lambeth every
• child matters
• Thank you

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A Protocol between Adult Services and Children
and Young Peoples Services
Safeguarding Children Where parents, carers or
other adults have mental health problems
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Aims of the protocol are

• To ensure that professionals working in Lambeth
  are clearly aware of their duty to work together
  to safeguard and promote the welfare of children
  and young people
• To improve the identification of children who may
  be affected by adult mental health problems and
  ensure good quality and early support and
  intervention for them and their families
• To improve communication and joint working
  between services responsible for supporting
  children, and the services responsible for
  supporting adults with mental health problems

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Why have a protocol?

• We all have a legal duty to carry out our
  functions with a view to safeguarding and
  promoting the welfare of children and young
  people Children Act 2004 Sect 11
• A number of serious case reviews and statutory
  guidance has brought about further requirements
  for all services who come into contact with a
  child or young person to consider their specific
  needs within a whole family context
• This protocol brings together current tools and
  best practice from both adult and childrens
  services to ensure we safeguard all our children,
  young people and adults

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Identifying the Needs

• Every Child really does Matter in Lambeth the
  outcomes we seek for every child are -
• Be healthy
• Stay safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic well being
• Safeguarding is everybody's responsibility
• Section 11 Children Act 2004

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Identifying the Needs

• Any professional working in Lambeth who comes
  into contact with an adult or pregnant woman who
  appears to have a mental health problem must
  consider
• How their mental health is impacting on the
  safety or welfare of any children in their care,
  or who have significant contact with them, if at
  all
• Whether they have access to relevant support
  services
• Whether the child or young person is a young
  carer

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Identifying the Needs

• Staff in adult and older adult services must use
  the new
• child need risk screen contained within the risk
  section of the
• Electronic Patient Journey System (EPJS) to
  identify need or
• risk
• Appendix 2 on page 15 of the Protocol has
  details

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Identifying the Needs

• If there are concerns for the child verify
  whether the child
• is at risk of significant harm or whether in need
  of
• additional support from services
• Complete the pre-assessment checklist (appendix
  1)
• Consult the significant harm checklist (section
  5)

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Referral Routes

• There are two referral routes
• 1) Child is considered at risk of significant
  harm refer immediately to Social Care by
  telephone and follow up with written CAF referral
  form. (tel. Referral and Assessment 020 7926
  6508. Out of hours ( 5pm-9am) 0207 926 1000. If
  you think a child is in immediate danger contact
  the police on 999
• 2) Child has additional needs
• Seek parent/carers consent to share information
  on a CAF
• Complete a CAF and engage identified services

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Common Assessment Framework

• Pre assessment checklist
• A tool to allow professionals to decide whether a
  CAF is necessary, utilising the five Every Child
  Matters Outcomes
• CAF Form
• Undertake a Common Assessment with consent from
  the parent/carer and/or young person, when it
  will assist the child to achieve one or more of
  the five ECM outcomes

Designed for when - There are concerns about
progress - Needs are unclear - The support of
more than one agency may be needed

• Need not be done when
• - Progress is good
• - Needs are identified and being met

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CAF Assessment Headings
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The CAF as part of a continuum
Targeted Meeting Specific needs when required
Acute Serious Chronic and complex needs
Universal Every day needs
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Who to Contact

• Lambeth Children and Families Social Care
• 020 7926 7856
• Team around the Child
• South East 020 7926 5723
• South West 020 7926 5724
• North 020 7926 5710
• Adult Mental Health Teams
• North Sector 020 3228 7200
• South East Sector 020 3228 5600
• South West Sector 020 3228 8100
• Police Child Abuse Investigation Team
• 020 7230 3700

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Mental Health Protocol

• Going Forward
• CAF Training is being rolled out across adult
  social care and mental health services in 2009.
• Email caf_at_lambeth.gov.uk for training dates and
  to apply
• Joint training for mental health and childrens
  workers is
• planned for the autumn 2009
• See LSCB website for more details about joint
  training
• http//lambethscb.org.uk/

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Mental Health Protocol

• In Lambeth every
• child matters
• Thank you