Michael Jones, a barrister at Dean’s Court chambers in Manchester considers the problem of women who have experienced, or are at risk of, repeated pregnancies that result in children needing to be removed from their care and the work of Pause, a charity which aims to give women the chance to pause and take control of their lives.
The number of public law care cases being issued over recent years has steadily increased, with the system now operating under severe constraints in terms of resources. Austerity has led to a reduction in the available support for many families who were barely managing to provide an appropriate level of care to their children, resulting in children within those families suffering significant harm and local authorities proceeding to instigating protective measures by way of issuing care proceedings.
Recent years have seen the introduction of innovations such as the introduction of the Family Drug and Alcohol Court, which offered many positives for families but which unfortunately, was never made available as a nationwide resource.
A recurring theme that practitioners in the public law arena face on a regular basis, is dealing with care proceedings relating to children of parents who have already had previous children removed from their care. These cases are notable due to the fact that the risks presented to the subject child are often identical to those presented to a parent’s elder children; in short, little if anything has changed for that parent. There may well be some cases where the absence of any such change is due to a lack of motivation and engagement on the part of a parent, however there are certainly many cases in which it can be directly attributed to a lack of support offered following the conclusion of care proceedings, particularly to vulnerable mothers who have entered a recurring cycle of domestic abuse and drug and alcohol use, which seems difficult to break.
In light of the amount of financial resources consumed by instigating care proceedings, one has to question whether a more cost effective (not to mention a more ethical) way of addressing the issues that many mothers in these situations face, is to look towards increasing funding for the support offered to these women, namely those who have had a child removed from their care and are at serious risk of suffering the removal of any further children they may have.
The organisation Pause, has been steadily extending its practice throughout the country and has been supported by many within the legal profession, notably Sir James Munby, former President of the Family Division. It is perhaps now more important than ever, that an organisation such as Pause is given wider recognition and support, particularly in light of overwhelmingly positive impact it has had upon mothers who have had previous children removed from their care.
What is Pause?
Pause is an organisation that works with women who have experienced, or are at risk of, repeated pregnancies that result in children being removed from their care within care proceedings. It targets its resources towards breaking this recurring cycle and aims to provide women with the opportunity to access support and to re-take control of their lives.
Put simply, the purpose of Pause is to prevent the damaging consequences of thousands more children being brought into the care system each year. The dynamic aspect of Pause is that it takes a holistic approach; it does not consign the provision of support to addressing one particular area, such as alcohol or drug use, in isolation and aims to provide support by professionals with frontline experience of working with vulnerable adults such as care leavers and sex workers, as well as in family courts and in the field of child protection.
It is not unrealistic to suggest that the majority (if not all) of the local authorities in England and Wales will have, at some point over the past 12-18 months, issued care proceedings in relation to a child whose elder siblings or half-siblings, have been removed from the care of their mother. This will often be attributable to a cycle of behaviour which has not been broken. The system needs to look towards how this cycle and the consequent removal of further children, can be stopped.
It is important to remember that many women who have children removed from their care are themselves care leavers and are often amongst the most vulnerable individuals in society today. They are significantly more likely to require interventions from public services throughout their lives and to have their children removed from their care. Once a child has been removed into care these women still need support but too often the appropriate care is not made available following the conclusion of care proceedings. A permanence plan is approved by the Court and mothers are then left to their own devices; the Court is concerned with the welfare of the subject child, as are Children’s Services departments within local authorities, however when proceedings are drawn to a close in cases where the subject child is permanently removed from their mother’s care, that mother is often left with little practical support from statutory agencies.
Research carried out in the London Borough of Hackney in 2013 has been further supported by a national study undertaken by Broadhurst et al in 2014 which compiled a comprehensive national data set. This resulted in a 2014 study which estimated the scale and pattern of recurrent care proceedings over a seven year period. The numbers are significant, showing a total of 46,094 birth mothers appearing before the courts of which 15.5% (7,143) were linked to current care applications. As each woman may be linked to more than one child, the total number of care applications associated with this cohort is as high as 29% of all care applications (22,790) (Broadhurst et al 2014). Additional findings confirmed that ‘the women are caught in a cycle of short interval pregnancies and subsequent proceedings, giving them little time to make or evidence changes in their lives’ (Broadhurst et al 2014). The Hackney study from 2013 showed that 49 women had had 205 children removed from their care. The results of these studies are alarming but will not in any way surprising to public law practitioners.
The Department of Education has completed an evaluation of Pause in its research report dated July 2017. The findings of this study suggest an increase over time in many women’s access to, and engagement with, the services they need to meet their basic needs, including GP and housing services. A cost benefit analysis was conducted as part of the survey, focussing on savings attached to reductions in the number of child removals during the Pause intervention period. The analysis indicates that the full costs of delivering Pause to a cohort of 125 women are likely to be offset by savings to local authorities within 2 to 3 years, with estimated net cost savings of between £1.2 million and £2.1 million per year after the 18 month intervention period. Further potential cost savings from reductions in levels of domestic violence, harmful alcohol use, and Class A drug use were also identified; these savings were estimated to total between £628,207 and £732,005 per year.
The total cost of delivering Pause for a period of 18 months was £2,525,230, which equates to £1,683,487 for a 12 month period. The study found that the cost per woman supported was £20,202 over 18 months, equivalent to £13,468 for a 12 month period.
The women involved
It is all too easy to view a mother who has had previous children removed from her care as conforming to a certain stereotype, however in reality, each of these women is unique and will have specific needs and underlying issues that they will require support in addressing.
Presenting social issues can involve a plethora of different factors including domestic abuse, drug and alcohol addiction, street sex work, chronic mental health issues, criminal antecedents, and learning difficulties all being examples. Pause has observed that generally, the women that it supports become involved in a recurring cycle of having children removed from their care due to a number of notable factors;
• The women are often under-prioritised by services once they are no longer responsible for a child (a situation many of us working in this area will be only too familiar with encountering)
• Although this group of women have complex needs, they often do not fit the referral criteria for help for specific organisations (for example, referrals to adult services and primary mental health services often have a high eligibility threshold)
• The women may have built up hostility and mistrust towards different services so that engagement can be problematic
• Often the trauma of loss and grief from having children removed has not been effectively addressed and it represents a substantial barrier to these women moving forward positively with their lives
• The long term, very intensive and systemic support needed by these women is typically unavailable through existing universal or specialist services (anecdotally, the writer can unfortunately bring to mind many cases where a recommendation for a specific therapy such as DBT has been made for a mother within care proceedings, with that therapy being highly difficult to source unless privately funded)
What is the Pause model and how does it work to support women?
Pause uses an integrated support model to offer an intense programme of therapeutic, practical and behavioural support. Each woman has a bespoke programme designed around their individual needs. The program looks to provide support in the following areas;
• Loss and grief (addressing past and childhood trauma)
• Therapeutic work in the form of counselling and drug and alcohol support
• Practical support around issues such as accommodation and accessing benefits
• Support in relation to health needs, including sexual health, GP and dental referrals
• Support around accessing education and employment
• Support in respect of relationship issues and domestic abuse
• Provision of social activities and focussed group work
Pause works with a range of partners across the third sector and local authorities in an effort to identify those who may benefit from Pause support in each area. Should women who are identified and referred to Pause wish to take the programme forward, it works with them to set up an individual program of support and to embed the service provision.
The economic benefits
The central benefits of Pause are overwhelmingly obvious; successful engagement with the organisation is likely to break the recurring cycle of children being repeatedly removed from the care of the women it works with. An independent evaluation of Pause by the Opcit Research and University of Central Lancashire on behalf of the Department for Education (England), found that financially, for every £1 spent on Pause, £1.38 was saved by children’s services departments alone, with other services, such as health, housing and criminal justice, also seeing savings. Over two years, this equated to a cost saving for children’s services of £976,836. In light of this, one has to question why Pause practices are not being established in every local authority area in England and Wales. There are currently 20 local Pause practices throughout the country and there is evidently room for the expansion of this.
Increasing the Impact of Pause Services
Pause’s primary goal is to expand the number of women accessing services and supporting them; this can be achieved via expanding current Pause projects and by moving projects into new local authority areas.
As a charitable organisation, Pause has a number of funders and supporters on a national level, however some working in the child protection arena remain unaware of Pause as an organisation and of the benefits that it can offer to localities. Pause needs the support of local partners in order to establish practices in local authority areas; this is key. In light of the ever increasing number of care cases issued, the financial implications of this and, more importantly, the human element and the irreparable trauma that the permanent removal of a child causes to the family, it is essential that Pause as an organisation, receives the recognition and support it needs to expand its practices nationwide. Child protection professionals work to safeguard children, however if resources and support can be made available to women in line with the Pause model, the need for the future intervention of children’s services departments will almost certainly be reduced if not removed entirely in many cases. Emphasis has to be placed upon supporting women who are susceptible to having children removed from their care in the future; it is not difficult to identify these individuals but it is often difficult for them to access the support that they so clearly need. This is where Pause can assist in making a lasting change.
For more information about Pause as an organisation and for details of how to support Pause and assist in raising the profile of the work it does, its website is accessed at https://www.pause.org.uk