Sunday 2 September 2018

START, STOP, GO !....CHILD AND YOUTH CARE IN SOUTH AFRICA.



You will by now be aware, social media posts often provide subject for these blog talks.This week it was a potent comment asking if Managers should be held accountable and be sanctioned with "consequences" when children and young people stay in child and youth care centres for 5 years and longer. Then, if not the Manager.....who ??? 

Good question.

And.... a question one would think should not have to be asked in 2018.

The transformation of the child and youth care system in South Africa  has had a long history. In 1995, South Africa signed the UN Convention on the Rights of the Child. In 1996, The South African policy for the  transformation of the child and youth care system was published in a book we called "the green bible", and implemented. The Transformation "bible"is congruent with the UN Convention and lists 17 Principles against which the work of  child and youth care centres came to be assessed. The most relevant to the problem of prolonged stay in institutional care are these; Normalisation, continuity of care, continuum of care. The Children's Act at that time was amended to contain a statutory  period of stay of 2 years, Thereafter any  further stay had to be well argued before the Child Commissioner. It was the parents who were declared "unfit". So it was the social workers task to show movement and give reason for an extended stay. Some of this has changed, but the principle of "shortest possible stay" remains. In concept, "movement" of the child underpinned the transformation policy and the South African system, and still does. The principles and the system hold good.

The whole of the transformed system is based on the idea of the child being in the "least restrictive, most empowering" life style.

In the macro system .....just a reminder of the range of broad categories.... Prevention, Early Intervention, Statutory. In the statutory continuum, there is ....remain with parent under supervision of a social worker ( and now possibly a child care worker)  foster care, adoption, place of safety, children's home, and what we now call child and youth care centres. (of old, ..places of detention).

But at a micro level, the concept of "least restrictive, most empowering" was applied to any residential service. Individualisation of programme and environment design was intended to provide children and young people the opportunity to move along a less restrictive continuum of care WITHIN the facility too. In this way they are supported, prepared, made ready, to move out (exit) to the more empowering life spaces in the macro system at the same time as any reunification, permanency plan work is done.

The social media post implied that this was not happening as it should for all young people. That some are getting stuck. Blame is being tossed around. Some say the Managers are to blame, some say the Commissioners,some say lack of resources, some say reunification services, some say lack of effort, some say once the child is in care the problem has gone away.

Because prolonged institutional stay is regarded as having negative effects for a young person transitioning into adulthood and because it is not in line with the major charters that mandate child and youth care, .. I thought that prolonging stay in a residential setting is an ethical issue .I still think this.

Then I wondered about the numbers or percentages of children placed in care where circumstances realistically made it impossible for them to be moved, in any way, out of a group residential programme as intended in our system. The best homework I could do was a statistical profile of children and young people in residential services recently conducted by the Department of Social Development in the Eastern Cape Province. The profile was done to get statistics on the children in residential services, to establish needs and their potential for some exit plan on the principles of the continuum and continuity of care. 1300 children were profiled. Of which, 112 had severe behaviour disorders,82 were abandoned, 38 were orphaned. 150 were in temporary care in places of safety of which 10 had severe behavioural disorders and 50 had stayed longer than 12 months with no plan.. ( the legal period of stay being 6 months). Taking these statistics and computing roughly, it would appear asif  3-5% of children coming into residential services require permanent alternative care in the Eastern Cape. From way back there lurked in the back of my mind that there were 2-3% of children coming into residential care in South Africa who would for various reasons not be be reunited, find kinship care, or some other form of placement. Also, there is a clear need for children's homes to take on a role of a treatment centre for some children , if not most. The reasons were, and still are the unmanageability of some children outside of professional care. Some have no support systems that can be traced (the so-called true orphan). some are too old for foster placement or adoption. They are legitimately somehow, stuck in the system. These children have their rights and hopefully their needs, met in what is frequently called "alternative care". SOS Childrens Villages were established and geared to provide such a service.

If the estimated calculations are somewhere near accurate, then it was legitimate to ask the question about prolonged stays in residential institutions. We certainly cant blame the system. As always South Africa leads the way with policy, statute and system. We often have issues with implementation.

In about 1996 the Department of Social Development (Dept of Welfare as it was then known) instituted a project called "Operation GO !"  Project GO teams were established. Mainly social workers in the Department, District, Provincial and National together with the facility social worker, Manager and the child care worker who was the child's "focus" worker. The purpose was to look at the status of the exit and permanency plan as the period of stay neared the two year mark. Plans were made for after-care, safety-net, and family support. Given logistic and resource shortages and heavy case loads, it often happened that the facility provided these services in the community. One could say that even then we had developed something close to the Integrated Case Management model. Certainly a Multi-disciplinary team approach. In Gauteng , and for a few years, Operation Go! worked very well. Then for some reason it stopped. In some provinces I have heard say that it didn't work that well. It would have floundered if the allocation of tasks didn't include the child's primary worker. and permit the support of the facility or if there was some form of professional territorialism.

I see hope in the Provincial undertaking to profile children in residential services, Though I was told that this was mooted in 2005.!! It seems to be a good start for the re-introduction of some form of Operation Go! This time round with Integrated Case Management, guaranteed effort-filled post residential care and support, professional transitioning for children, young people and families or community care givers. Isibindi is a very good programme to allow that young people get the professional support they need in a non-statutory non-residential setting.....and we didn't have the benefit of that resource in 1996.!! 

Then who will be to blame?  The full team !!

LET'S GO !






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