WHISPERS IN THE STORM - A VOICE FROM RESIDENTIAL CHILD AND YOUTH CARE SERVICES IN SOUTH AFRICA

Amidst the cacophony over the last few weeks in the social media on salary issues,came a lone, somewhat quiet voice from a child and youth care worker in a residential setting. 

Listed were four comments made in the best interests of children and young people.These whispers amidst the storm need to be heard.

Broadly, child and youth care workers in residential settings tend to feel swamped by what they experience as a deluge of focus on community-based care services..... dominantly,.. Isibindi. The comment is that they seem to be forgotten. Certainly social media is seemingly quiet from the non-governmental sector.  Yes, passion and love of the profession and the children comes up time and time again, But, then, "If  you want to care for children, don't expect to be well paid." I hear it often, "It's a vocation, a calling, not a job."

The whisper in the social media, did not mention salary.

The first whisper was that residential services do experience instances of "inappropriate placements" of children "for shelter or convenience" when more appropriate placements could or should have been made. The comment went further to say that this meant that the service's programs and/or system in those instances did not meet the needs of  those children.

I used to call those placements "pap en pampoen" (porridge and pumpkin) placements. In my first appointment to a residential service, a calculation based on an analysis of  the situations surrounding the children was that well over 40% of the children didn't need residential care. - some other community-based, family-based solution could be made. As a non-governmental organisation it was possible to orchestrate, with some success, a program of disengagement and family support for most of those children especially as the old Child Care Act required that there be at least a 6 month period of "after care"which was frequently undertaken by the residential facility itself. When, in my second appointment, 16 children were discharged at one time, I cried. Not because I would miss the children (as the staff thought) but because of their deinstitutionalisation.

The issue of removal and placement of children in alternative forms of care , especially residential facilities is well explored in a classic book by Anna Freud and others, Beyond the Best Interests of the Child  (the Free Press NY 1973 ) - note the year!, ...and the issues of removal and placement still persist. 

Four placement considerations expressed in this classic work are worth mentioning.
1. Removal and placement is a Moral Issue--it is an ethical decision. Is it ethically right? This means, equally, that an admission decision is an ethical decision.
2. Removal and placement decisions are based on the "least detrimental alternative".  I quote "Placement should provide the least detrimental available alternative for safeguarding the child's growth and development"   In South Africa we use the term "least restrictive, most empowering". 
3.Residential placement is a Last Resort. It  only morally defensible she says, in instances when the child faces "irrevocable harm" 
The concept or criterion of "irrevocable harm" applies only when NO other form of intervention would prevent PERMANENT damage to the child's psyche. 
4. Lastly, there must be advocacy available for the child's own view on removal, placement.and program. Adults view of ethical placement, she says, frequently differs from that of a child.  Such an advocate for the child must be a person who can express, for the child, its understanding, perceptions needs and decisions. 

There was this whisper of residential services admitting children and young people in order to maintain its numbers. If subsidisation is based on a "heads on beds" calculation, it can be enticing to keep the numbers up no matter what. - enticing to entertain placements and prolong stays.

The final whisper shouted that a "one size fits all" system and program was not meeting the needs of inappropriately placed children.

It has been my experience that admission criteria in some residential facilities have either not been established in policy, or is given to the facility from "above". This inevitably leads to inappropriate placements. On arrival in my second appointment in a residential care facility, I inherited a very simple admission policy. It had no criteria for admission at all. The policy was: " We don't refuse any boy " Well that certainly kept "heads on beds" but couldn't be defended ethically. sounded good, especially from the church perspective. It meant that the young person had to fit the program, rather than the program fitting the child.

This is what the whisper was shouting. Whats the point of having an Individual Development Program (IDP) if the system is not based on the individual..? The motions are gone through as required but the practice in the life-space, on the ground, doesn't always match the intention 

I always thought that the "hot house" for the growing of child and youth care practice was to be found in the residential facility. I thought that as the Grand Prix leads the way for the improvement of passenger cars, so residential care leads the way for child and youth care in any setting, especially community- based care. Isibindi as a model, has proved me wrong. We have a lot to learn from this now nationally and internationally accredited model of professional child and youth care .

It is time, I think, that we start again to rethink residential care and grow a South African indigenous model of best practice  for residential settings . One that can be rolled out, adapted as contexts require, and provide high quality developmental treatment to children and young people who would otherwise experience irrevocable harm,

Let the whisper become a shout for excellence in South African residential care.