The Bessborough Centre: Providing vulnerable families with building blocks for good parenting

Bessborough has a dark past but is now being hailed as a model for keeping families together and supporting parents in need, says Noel Baker

The crib in the hall told of Christmas, as did the cards lined up in a row on the reception desk and the newly-delivered flowers waiting to be placed around the campus. The Christmas party was a few days away, and there was an undeniably festive air at the Bessborough Centre on the outskirts of Cork City.

Maybe it hasn’t always been like this, but that’s another story — that’s certainly the view of Dr Thomas Quigley, chief executive of the Bessborough Centre, and a defender of the here and now.

As the temperatures outside remained unseasonably mild, and cows munch on grass on the fields in front of the centre, inside, there was a chance for some reflection.

Thomas Quigley, CEO, Bessborough Centre, Blackrock, Cork. ‘Legacy issues impact on our work, especially morale.’ Pictures: Denis Scannell

In the recently published final report of the Child Law Reporting Project, the services at Bessborough were praised by lead author Carol Coulter. The Reporting Project followed cases that came before family courts all around the country; very often hugely depressing stories of abuse and neglect, of parental failure and harm to children.

On the issue of substance abuse, the report recommended a “greater integration of drug and alcohol treatment programmes with the welfare needs of children and parenting programmes”. It said: “Drug and alcohol treatment centres should consider providing parenting support, and mother and baby residential units should consider including the provision of addiction services. The model of the Bessborough Centre in Cork, which provides psychotherapy and addiction counselling as well as parenting programmes, should be used elsewhere in the country.”

Among the recommendations were that “the State should consider the provision of centres like Bessborough in other parts of the country, so that comprehensive and integrated supports can be provided to very vulnerable families, including those with addiction issues”.

The report was similarly glowing regarding young parents and parents in care, outlining how “a considerable proportion of the parents facing child protection proceedings were themselves in care” and “will have received poor parenting themselves, especially if they entered the care system late.

“This means they have no models on which to base their own attempts to parent. If they are to succeed as parents, they need intensive support, and this should start before they become parents. This could come from intensive parenting programmes, from co-parenting arrangements with foster families or from special units like Bessborough in Cork.

“Consideration should be given to the establishment of centres providing the comprehensive service offered by Bessborough on a national basis.”

This is music to the ears of Dr Quigley. Bessborough has both voluntary clients and clients referred to the service from elsewhere. There are no shocks when it comes to the reasons why many clients come to the attention of social services, with Bessborough often viewed as a last chance to repair damage caused by mental health issues, addiction, neglect, and legacy issues from the childhood of adults who now have children themselves.

“What we want to do is to keep the family united and together,” Thomas says. “Because of the complexity [of the cases] we have to put supports in place for the mother at the same time as the father.” That is, if the father is present.

In many of the cases, there are serious concerns regarding the safety of the child when they are transferred to Bessborough, so the therapeutic supports need to address underlying issues, such as possible drug use by the mother, while at the same time teaching at least one of the parents the basics, such as how to bathe a child. It is a residential service, and after some months, those in charge can “come to some conclusions on their capacity to change their lifestyle”.

The Bessborough Centre, Blackrock, Cork, which provides psychotherapy and addiction counselling, as well as parenting programmes.

“Our staff is the model, the role of good parenting, for the parent in the hope that they will pick it up — and that takes time,” he says. “We are also assisting the parents that the children have a mind and experiences of their own. So, a child is crying: they don’t ask why they are crying. Their reflective capacity is stifled.

“The reason the cases are referred here is they [social services] do not see enough of what happens in the community. How do you demonstrate that there is appropriate emotional warmth between parent and child? We are trying to encourage that. Social workers popping in and out of a house will not see that. We are observing and then assisting, in floor play, cuddling, hugging, teaching them that language: what is your child feeling now?”

Bessborough has six integrated services: residential services for infants; community outreach and aftercare; supervised access in which children in foster care can interact with their parents in monitored surroundings — currently around 55 children use that service; a creche facility; a small secondary school, which allows parents a second chance at getting an education, up to Leaving Certificate level; and employment support.

In residential services, Thomas says, “we have more than 200 people coming through the gates”. In residential care settings some of the placements can be long-term, ranging from three to nine months, using between 25 and 30 family units in any one year. As well as the 55 children in the access service, there is also 35 families availing of community outreach. Referrals can come from social workers or via the courts where there is a perceived risk, and as Thomas explains, Bessborough often arrives on the scene after other avenues have been exhausted: “The last ditch effort is ‘get Bessborough in and hope it initiates a change in the capacity of the parents’.”

The majority of clients come from Cork City and surrounding areas, although some referrals have come from Clare, Waterford and Limerick. However, as clinical manager, Nicola O’Sullivan, explains, Cork and Kerry is where the standard service level agreement with Tusla applies, so stays are relatively open-ended. If a client comes from farther away, there is a chance that they might only be funded to stay for a 12 week period, although according to Nicola, in cases where there is a strong feeling that the client would benefit from staying on longer, Bessborough will make a case for that to happen.

Of the client base, Thomas says: “It’s a range but the vast majority that we see would have gone through the care system themselves. I would say 70% of them are addiction-related, probably alongside a mental health issue in 50% of those cases, 90% would have suffered from neglect themselves. They had no model of parenting themselves when they grew up. Those with cognitive limits are also on our agenda. They would make up our third category.”

At the end of any particular placement, those in charge at Bessborough have to make a recommendation to social services or the courts as to what they believe is the best course of action, although Thomas stresses that it is ultimately not their decision as to what does happen — nor do they always agree with the decision. As it stands, approximately two-thirds of clients leave Bessborough with their children; the other third do not, with the child going into the care system.

Philippa Granleese, substance misuse practitioner, The Bessborough Centre, Blackrock, Cork. Picture: Denis Scannell

“If the child is taken into care, we will stay with that parent in the community for a period of time so she can deal with the grief of it,” he says.

“The premise that we start with is the family should be together. Child safety is the primary concern. How do we manage the two? We work with them to see if they have a capacity to change and if so, we work further with them.”

The approach is early intervention, in the hope of aiding the natural bond and attachment between parent and child. Sometimes that early intervention can take place even before a child is born, as Dr Calem De Burca, clinical psychologist, outlines. “We would encourage social workers to get in contact with us during pregnancy,” he says. “We would hope that we would have built a relationship with a pregnant mother and have an assessment of what her needs will be.”

In some cases domestic violence is an issue. It is not unknown for a woman to return from hospital having had a baby, only to return there for medical treatment after being injured at home.

According to Dr De Burca, in such circumstances a mother would be encouraged to leave the relationship and attend Bessborough on her own with her child in what is a secure environment.

Follow-up treatment would include giving the mother an appreciation of what a healthy relationship looks like, but in some cases the different factors at play mean there is no quick fix. “These are not short little injections of support,” he says. “They are long term. Ideally we would like them to remain in services for a two-year period. It’s not a three-month situation.”

According to Calem: “It’s building trust. The majority of them have had experiences where trust has been breached. Often when someone gets to childbearing age, they are quite distrustful of services in general. The main challenge is to get a buy-in from the parents. If we can work with the parent from during pregnancy, then you can have the best and most individually tailored assessment plan for them.”

He says many people have grown up with “a sense of failure” which permeates every aspect of their life, including their ability to parent.

In addition, Bessborough also operates a Safeguarding Babies programme, in which risk factors that might pre-dispose maltreatment of babies are screened — factors such as domestic violence reports, engagement with certain services, and so on. It was launched last March and is still in development, but so far, only four referrals have been received. It also has a complementary ‘safe space’ programme in which some clients are referred from maternity hospitals for a period of four weeks — so far there have been five referrals for that programme.

Thomas believes that introducing a new legal ‘holding order’, as recommended in the Child Law Report, would allow the mother in these circumstances access to legal support, a chance to bond with her child and to move past the post partum period when she is possibly not in a position to “fight her case”.

“Bessborough has in place a safe space — it’s exactly for that type of client,” he says. “We are holding them safely, together, until they are in a position to fight the case.”

It is a comment from Nicola O’Sullivan which really illuminates the sadness at the core of many of these cases. Outsiders looking in on these stories of parents failing to provide for their children, and losing them as they are taken into care, sometimes ponder just why some people who demonstrably cannot, or struggle to, look after children, keep having more children.

For Nicola, some of these instances are an “unconscious” reflection of grief and loss. Yes, babies bring attention and services, but sometimes it’s more elemental — “more and more babies to replace the ones that have been taken away.”

Given the relatively high number of cases that come to Bessborough having already passed through other elements of the care services, it’s no surprise that Thomas sees room for improvement.

Philippa Granleese, substance misuse practitioner, The Bessborough Centre, Blackrock, Cork.  Picture: Denis Scannell

“The care system is trying to make up for a lot of neglect that their children have had through their young lives, to undo a lack of appropriate attachment,” he says. “It takes a lot of work, psychological support, modelling, to have them all aired and aligned. Doing that eludes people.

“We are a charity, not a state.”

He believes the constitutional amendment on the rights of the child will, in time, improve services provided to vulnerable children, but admits that its effects have not been seen as yet. However, he also believes the State needs to do more in the short term.

“If the Government is serious about early intervention, then setting up the Child and Family Agency without access to mental health services or public nursing services, then it is not going to go very far. From the very beginning, it is limited in trying to integrate services. It needs access to their own ring-fenced psychological or mental health services.”

Closer to home, the cuts of recent years have also had an impact.

“We haven’t seen a turnaround in our financial situation,” Thomas says, pointing out that Bessborough has had its funding reduced by €250,000 in the last six years. Some 98% of the funding for its services comes from state agencies, and while it does own the campus and buildings, they are getting older.

The centre would also like to develop a family training unit and expand speech and language therapy and occupational therapy services, among others, if funding is available.

“Our focus in all of that is on the most vulnerable,” he says. “Some people can pay for them [services] and we can also provide them for people who can’t afford them.”

The work in Bessborough has always been based on mothers and children, but in recent years the history of Bessborough has taken on a darker aspect. With each historical revelation regarding infant deaths, claims of mistreatment of women, and other allegations, references to Bessborough in the media are understandably critical and questioning.

“The legacy issues at Bessborough and its treatment impacts on our work,” Thomas says, citing morale among staff as one factor, as is “the fact that we are doing good work and it’s not heard”.

“The perception was that it was always a bad place. Our services are very different from what they were in the past.”

He says that five years ago all files were handed over by the Sisters of the Sacred Hearts of Jesus and Mary, adding: “We are hoping the Commission of Inquiry will undertake a thorough examination of it in terms of the context of Ireland at the time.”

One argument on dealing with the legacy issues was to change the name of the centre. “We took advice on the brand name of Bessborough from a PR company five years ago and their advice was that it was a very strong name and it was not appropriate to change that brand name,” Thomas says. “We are in Bessborough.” But things change.

He says of the possibility of changing the name: “It might be prudent to look at it.”

On the commission looking into those historical issues, he says it would have been beneficial if a similar budget was spent on resourcing present-day services.

“It’s about time everything came out in the open,” he says, before referring to resourcing at Bessborough having been cut by a quarter of a million euro over a number of years. It prompts him to ask: “Is it today’s children having services withdrawn so we ask in 50 years time ‘what did we do for children?’”

Case Study

‘I didn’t want to come in, but Bessborough was a lifesaver for me’

Sarah* had some family history with Bessborough, even before she first drove down the long lane to reception.

“My aunts used to work out in the fields for the nuns,” she says.

Nicola O’Sullivan, the clinical manager at the centre who was there for Sarah during her care and who is sitting in on the interview for support, puts it another way. “She was embarrassed, being here at the start.”

Sarah is not embarrassed any more. She does make reference to the historical baggage that, arguably, continues to weigh down on Bessborough, but her view of the work carried out here could not be any clearer. Anything that happened in the past needs to be dealt with, she says. “But I left here with my child.”

Her story is not untypical of many of the clients assisted by the Bessborough Centre, many from almost the moment of the birth of their child, and in some cases, before it. Sarah’s own life was chaotic and troubled. Only in recent times, as she recalls all that went before, can she fully appreciate how far she has travelled.

She has some other children from a different relationship in long-term foster care, a situation she says is the result of her having to take responsibility for a drugs seizure that actually belonged to her then-partner. It still irritates and frustrates her; she makes a point of stressing how she would like to see her older children more often than she does, but she pays tribute to the fantastic efforts of their foster carers.

“I have a great relationship with them”, she says, adding, “but I was in a bad way”.

Her life appears to have had a series of crisis points: She quite obviously detests her parents, particularly her “neglectful” mother, who she claims put her older sisters “on the game” and was abusive and violent.

Her father was an alcoholic. She has nothing to do with them now, claiming: “We aren’t good for each other.” As she grew up, Sarah went off the rails, as so many do. In addition to the trauma of her older children being taken into care, she became addicted to injecting heroin. A detox programme managed to get her clean, but she swiftly replaced one drug with another — alcohol. Then she got pregnant. Then she was diagnosed with Hepatitis C.

The idea of a referral to Bessborough, proposed by a social worker, went down like the proverbial lead balloon. “I didn’t want to come in at all,” she admits.

“I didn’t want to tell my other children that I was pregnant, that I was failing them.” She asked herself whether her latest child might be better off being placed for adoption. It was a messy time. Her daughter was born and both mother and baby were transferred to a unit in Bessborough. Sarah had no family network, no friends were there to support her. She says she “felt lonely”, she had the “baby blues”. But she says: “For me, Bessborough was a lifesaver.”

The pair spent more than six months in a residential unit initially, a time when there was “many, many arguments”, before moving into supported accommodation elsewhere in the city. The link with Bessborough remains, however, as Sarah says she still pops in to see the staff who helped her through. She says one senior member was “like the mother I never had”, even though she says at times it was a “tough love” approach — exactly what she needed, as it turns out.

“It was everybody else’s fault,” she says of her outlook before staying in the centre. “They gave me that confidence to parent first, that I was not a failure. It’s not how you parent, it’s how you were parented.”

By learning the skills required to be the parent she wanted to be, she managed to “break the cycle” that had enveloped her life up to that point, although it wasn’t easy. “It’s very hard because you’re in a unit with other parents from different walks of life or backgrounds,” she says. “I was in a bubble [prior to this]. I used to stick earphones in. I didn’t want to deal with my own thoughts, I didn’t want to deal with me.”

Sarah says it was only when her daughter moved past her first birthday, and they were still together, that she realised she had reached a point of fundamental change. “The people here are fantastic,” she says. “I have seen staff here crying when a baby has to leave without their parents.” In some cases, the parents simply give up, and walk away. “Maybe they want the life they were leading before, than they want this [their children] now,” Sarah reasons. “It’s not easy.”

Now, some years later, her daughter is still attending school in the area, and Sarah avails of some respite services offered by Bessborough, where registered foster carers take her child for a night a week — supporting her as a parent, rather than replacing her.

On Christmas Day, mother and daughter will be back in Bessborough to enjoy the festivities and the continuing support it offers.

Another mother, Erica*, will also call in with her daughter. They came to the attention of the centre after Erica, not long after giving birth, was violently assaulted by her partner and hospitalised. “I had been living stressfully before I ever had her [her child] so I have learned how to manage that,” she says. That said, for her, the first three to six months in Bessborough were incredibly stressful. She was scared — “I thought everyone was going to take my baby.”

Instead, those feelings of inadequacy, of thinking she was being judged when she wasn’t, faded in time. Erica volunteered for additional and intensive therapy, something which helped her resolve outstanding issues from her past, and facilitate “a change in myself”.

Now she is living independently, her child is in pre-school, Erica is back studying and the future seems bright,. “I am very thankful and if I had to do it again I wouldn’t even have to think,” she says. “I want to build something in my life.”

*Names and some details have been changed to avoid identification