Identifying risk and safeguarding vulnerable and young people during lockdown. Lessons and recommendations.

I write this piece in response to a request from the wonderful Tammy Banks of TAYE Training, seeking input from related professionals and colleagues in respect of their therapeutic, educational, and front line practitioner experiences in caring for the needs of younger and vulnerable persons during the UK-wide period of lockdown resultant of the Covid-19 emergency,

Q: From your experience, what are the most successful methods, and what has been found to be unsuccessful, in identifying risk and safeguarding vulnerable children and young people during lockdown?

Q: What would you say are the lessons learnt and what new methods can be implemented to identify, support, and protect vulnerable children, young people and families coming out of lockdown period (including extra familial safeguarding need)

Introduction

As a psychotherapist practising in a charitable setting, it has never been my first choice to work with children or young people. Despite my reluctance to do so, I have naturally engaged with younger people across the years, and indeed have found that during this period of lockdown I have worked solely with this client group, inundated with referrals from CAMHS and related services as my department was.

Impact of the lockdown on young people and their families

Despite the reported and seemingly mild effects of the virus upon younger people, the lockdown nonetheless appears to have had a detrimental effect on the wellbeing of younger people (I will respectfully refer to them as kids from now on!). Finding themselves incarcerated at home, often with parents who rarely, due to the demands of their own working lives, spend more than a few waking hours each day in each other’s company, those children have borne witness to the stresses, demands, and often unresolved disagreements which take place between adults, and which have been exacerbated by the need for close proximity living across an extended period of time. Initially most kids will likely have found this enjoyable, and my own CBT clients have reported that they have benefitted from being away from school and its rigid demands. What quickly became apparent to me however, was that this lack of structure, conformity to rules (and the psycho-social rewards which accompany these), and missing sense of the familiar has had a deleterious effect on the mental health of those very kids. Despite the obvious sense of pain redolent of separation and the overnight absence of human in-vivo contact, I have found there to have been no expectation or contingency from official bodies of government and education in respect of how these psycho-emotional challenges might be addressed. This has led to a vacuum of action, of responsibility, and a growing and understabdable sense of bewilderment amongst parents who have often scrambled to consider how best they might address the emotional and educational needs of their children.

Now this has caused problems for the kids themselves. Despite the time served notions that young persons are ignorant and dismissive of their parents and societal behaviours, I have found the opposite to be true. Kids are very much attuned to the sensitivities of their care givers, and finding themselves bear witness to that sense of bewilderment, bemusement and occasional incompetence amongst their parents which were driven by the demands of the lockdown has in itself led to a reported sense of confusion, mistrust and even disappointment in the parents of those young people I have counselled. Those parents very suddenly stopped being superheroes to their kids. Finding yourself suddenly confronted with your own, if occasional, ineptitude can prove demonstrating for anyone, and for those parents of already troubled teenagers finding yourself challenged and questioned not just by your own kids, but often by your partner as well, can prove particularly galling. The side effects of this toxic mix of close proximity living, limited access to the familiar comfort of people, places and other everyday things, and the creeping sense of self-doubt which accompanies your own thinking when your kids or partner cast doubt on your abilities or willingness to connect with or even care for them, has proven overwhelming for many parents, and thus their kids have often found themselves unwitting witnesses to an emotional, psychological, and sometimes physical conflict zone during lockdown. To top it all off the kids have been told they need to work extra hard and do really well with their home-based schooling, a message exacerbated by media outlets loudly and constantly proclaiming that their compromised educational attendance during lockdown has ruined the lives of everyone aged under 21 and that they might as well all go live on the dust heap now. I mean, really, what is that even about? Whatever happened to resilience and the belief that people can and do bounce back from periods of trauma and adversity. They can and they do, and I say this from personal experience of both.

Whilst I have no direct evidence of such amongst my own client group, and even if I did, I would never report such publicly, I am made anecdotally aware that some of those children referred to my similar family support services have borne witness to incidences of domestic violence during lockdown, particularly against women. Warring parents with unresolved difficulties most often, if unknowingly, take their frustrations out on their children, and without the obvious reporting and safety structures afforded by school structures and staff, children will naturally have found their opportunities to share, offload or confide their concerns severely restricted, if not eliminated. As Social Work teams and other front line practitioner teams found themselves restricted to home working, they quickly found themselves reliant on telephone-based outreach to clients, having to accept at face value when contacting a client that all might be well in a household where child safety concerns might be a factor.

In the course of my lockdown-period work (in a learning and teaching capacity for governmental and local authority staff) I learned of the large scale increases in online and digital inquiries to counselling, child safety, and domestic abuse organisations, particularly by children and young people themselves. These are clearly coping measures by those children, if not an act of desperation by at least some of them.

Contingency Measures and Planning

It’s important to consider what might be done to mitigate the problematic effects of lockdown on families. I have found contingency and planning measures to be either ill-considerd and conceived, and at best or more likely non-existent: family and key worker practitioners have been placed under the most extraordinary pressures to digitally and remotely care for their clients, whilst most often, through no fault of their own being ignorant of the practicalities and requirements of delivering a virtual service to clients. This lack of planning, contingency, procedural and technical competence, equipment, and infrastructure is totally unacceptable — it presents an obvious and deplorable risk to children’s safety and is surely a violation of their rights. Naturally I must also consider that other vulnerable persons must surely suffer as a result of the same undesirable processes and procedures lacking in effectiveness. These conditions place those same staff members in the disgraceful position of trying to do the best possible job with their hands metaphorically tied behind their backs. Since such great play has been made of Britain’s technological capacities during this lockdown (have you actually tried using Teams, Zoom or Adobe connect during working hours? Let’s do another piece on just how challenfinf virtual working can be at times!), and if surveillance tools which have been utilised to enforce lockdown and social distancing and enable contact tracing have proven to be an effective tool in controlling the spread of the virus across the United Kingdom, then surely this same technology and infrastructure might be utilised to ensure the safety and wellbeing of citizens in other situations, for example with educational compliance, monitoring of mental and physical health, and the detection and tracking of families in distress where support is rightly required to help them through the toughest of times. This approach would naturally include the sharing of personal information regarding those children and their families, but despite the clear risks of winding back legal protections and rights for individuals it is surely, arguably better to ensure the safety and wellbeing of our most vulnerable members in our society than to rely solely upon telephone-based self-reporting by client families in the hope that when someone tells us all is well in their household, that it in fact actually is. Experience, alas, serves to tell me otherwise.

Recommendations

Widespread media and academic reporting indicate that those young people and vulnerable persons from the most deprived communities are at the greatest risk of being adversely affected by the health and economic impacts of Covid-19. My own psychotherapy clients have reported on the challenges which lockdown has visited upon them, and thus I would seek to highlight the following possibilities as being worthy of consideration by those in positions of societal influence.

• A root and branch national review of Mental Health Delivery and services across the UK. Community based access must be an absolute priority, especially as access to clinically driven services is so often difficult, disjointed, and the services themselves frankly dysfunctional, not good enough to meet the needs of local populations. Knowing that the poorest in society have suffered the most during lockdown, it would seem logical to create some sort of non-clinical community based service, such as a hub where all families could receive support and guidance to a required degree of competence and expertise, no matter where in the UK that client might be from.

• Truly and effectively integrate family support agencies, with appropriate associated funding, for the purpose of working in partnership with schools in our most deprived communities. By choosing not to integrate services, not to share information on the same database, not even to receive the same training, staff from differing agencies ( NHS, schools, social work teams) are actively working against each other. This is a simply staggering nonsense to behold. The costs in terms of time, energy and even money are obvious in this case, and certainly do not represent taxpayer value for money.

• Provide explicit guidance (legislation?) to all UK local authorities and schools regarding the design and intention of community hub support models in order that childrens’ and vulnerable persons’ needs are properly anticipated, articulated and achieved. The implementation of this guidance must be overseen and scrutinised by 3rd parties, independent of local authorities and services.

• Schools, young persons, and vulnerable groups’ services must be prioritised where the accessing of additional family support is required, and these supports must not be limited to the time constraints of office bound staff working agreed contractual hours in local authority settings. Issue explicit guidance for clinical, psychological, family support services and school support services to work closely together to provide both direct and remote access services to ensure:

• We identify, assess, and address the presenting concerns of young and vulnerable persons, specifically where safeguarding and mental health issues are concerned.

• Actively offer support with financial issues to including food poverty, household finances, digital exclusion, and signposting for emotional support, including housing and welfare, on a self-referral or pro-active outreach basis.

• Provide additional enrichment activities outside school hours, remotely or otherwise, to support children’s learning and broader family support including respite and residential activities, emotional supports, and responsibilities to build individual and family resilience.

• Make play therapy available to children and young people. Evidence from such establishments including Tavistock, Oxford, Sussex and similar institutions strongly suggests that younger people are at much higher risk of experiencing lifelong and adverse impacts, particularly where their families have struggled emotionally, financially and physically during their formative years, something clearly exacerbated by lockdown-related requirements

Summary

This commentary, its conclusions, recommendations, and content are my own work, ideas and experiences in respect of the specific client groups I have described. It is intended solely for the purpose of encouraging deliberation and discourse concerning the needs of the some of the most vulnerable persons in our society. Your comments, input, ideas and recommendations are warmly welcomed: my only insistence is that commentators remain ever-respectful of others’ contributions.

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