Striving for a proactive approach to children

The Ombudsman for Children says early intervention would prevent the ‘torrent’ of child abuse complaints that can overwhelm child and family services, writes Claire O’Sullivan

THE Office of the Ombudsman for Children.

It sounds like a lovely job, fighting for the rights of children.

Who couldn’t but want to ensure that the voice of a child is heard?

Nobody outwardly, but the sphere of child and family is intensely political and a complex juggling of competing demands.

The actual physical office is built for children.

It’s all primary colours, bean bags dotted everywhere.

It’s bright, welcoming, designed to look like a space where the wishes of children are front and centre; basically, it’s a space where they can feel comfortable, where they matter.

There has been a marked improvement in children’s rights, says the ombudsman, Niall Muldoon, a clinical psychologist who was formerly the national clinical director of the Cari Foundation.

He took over last year from the first ombudsman, Emily Logan, who held the position for two terms.

“Huge strides” have been made in recent years, he says, pointing to the Department of Children and Youth Affairs, which now operates as a full ministry, and the separation in 2014 of the Child and Family Agency, Tusla, from the HSE.

One of his objectives as we move from the downturn to a potentially more stable budgetary position is “to push the agenda to early intervention”.

This desire colours large swathes of our conversation.

In terms of children, “there is too much time spent on being reactive, rather than proactive”, he says.

He wants stakeholders such as Tusla, and the Departments of Education, Housing and Justice “to invest in children before they find themselves in trouble at school or with the gardaí”.

It’s a frustration held by social workers nationwide: They could prevent so much if they could give families a helping hand in the early days.

“We should not only be helping those where concerns are reported,” he says.

Public health nurses, he says, can identify the children that could be at risk from poverty, addiction, neglect, or from parents with serious mental problems.

“There will be some children who aren’t so easily identified, but many of these cases are relatively easy to identify,” he says.

What hope is there for the 2,000-plus children who are without a home?

The number of families living without a home has risen by 40% since last year, according to Focus Ireland.

He emphasises “housing” as a major part of the suite of “wraparound family supports”.

“You need a village of 17 ministers to rear some children,” he says.

His office has engaged with Housing Minister Simon Coveney regarding the Government’s plan to solve the housing crisis and “have been very clear that there has to be a focus on children”.

“The minister for children [Katherine Zappone] also has been clear on this.

"In the short term, we need to look at free transport to children in cases where they are living in a B&B miles from school.

"We hear stories of children getting off buses at their old estate, miles from new accommodation, as this will suggest [to their friends] that they are still living there,” he says.

Dr Muldoon believes families should only be offered emergency accommodation on bus routes to their schools and former communities.

“The time for saying that we weren’t expecting this is gone,” he says.

He worked in the field of child protection for 20 years.

Early intervention, he says, would prevent the “torrent” of child abuse complaints that can overwhelm child and family services.

“We will always chase our tail if we only react when something is reported, if we only respond when neglect is reported at age three or four,” he says.

Scandinavia and parts of Australia have ensured children’s lives have very different outcomes, due to such early intervention.

A similar philosophy colours the office’s campaign to give abused children a right to therapy. The National Counselling Service (NCS) is available to adults who were abused.

“There should be something similar for children. NCS services are all available within an hour-and-a-half of the adult, yet we can’t guarantee that for children. We need easily accessible child services so we can reduce the number of damaged older children and adults using mental health services at a later date,” he says.

“If you spend two or three years with an abused child offering counselling, they will come out fully strong, but if you don’t get them until they are 18, it can take up to 10 years to turn things around,” he says.

In 2011, the HSE commissioned the Mott McDonald review on child sexual abuse services. Virtually none of its recommendations have been put in place.

“It had a real vision... It’s a real dark shadow on them, they have only been tinkering around the edges,” he says.

The report’s authors urged major investment to ensure that services are available to all child victims when they need them and as near as is possible to their home. Five years later, children travel from Donegal to Dublin for forensic examinations.

“Even if we do it five years later, we have to do it. We can’t afford to wait another five years. Even if we do have to make a business case for it [in terms of saving on long-term spending] we must, as we can’t afford to wait another five years. We have already neglected 10,000 kids,” he says.

One of the recent achievements of the ombudsman’s office has been its conferral with the right to represent children in direct provision.

This should have started last month, but there have been delays.

In the interim, Dr Muldoon has visited centres and met managers and agencies that support the children, such as youth groups.

He has spoken to gardaí and social workers.

He isn’t allowed yet to meet the children or their parents.

“We want to be as equally available to these children as all other children. It’s very clear that problems exist in these centres around right to family life [and] privacy. Child safety issues are rampant there. Children in direct provision do not have the ability to live as full a life as possible,” he says.

Another coup for the office was the passing of the Child and Family Relations Act last year. Again, legislative change needs to be resourced if, as the bill says, the “voice of the child” is to be heard.

Under the bill, a child’s “best interests” will be of “paramount consideration” to the court in guardianship, custody, or access proceedings.

“In the case of parents separating, it creates a whole new energy, but if the child has input, we have to be flexible. Some children will need help, others are capable, but we need to know that they are not being influenced,” he says pointing to the UK where the equivalent of €50m a year is spent on this.

“The president of the district court has described it as a ‘seismic piece of legislation’, but it needs to be resourced. There is a limitation to hearing the voice of child, if it is not authentic. Children need to be given somewhere local to give testimony and there has to be a flexibility, depending on the child and where they are,” he says.

You would think that with the bill commenced in January of this year, that work would have started on putting the practicalities into place.

It hasn’t and the Office of the Children’s Ombudsman is watching closely to see when and if this will change.

“The options are limited now for judges; do they bring the children in? The court system is trying its best, but they have no time or money to give to this,” says Dr Muldoon.

Across the board, he says there needs to be an attitude change. Spend money on children and future generations and wider society will reap the rewards.

He says governments also need to change their mindset from one of “if the resources are available, we will give” to one of “we will ensure resources”.

It’s 12 years since the signing into law of the EPSEN Act, which gives children with disabilities automatic entitlement to school care and teaching supports, but it still hasn’t been implemented.

“Many parents think that an assessment is the holy grail, but we need resources again to ensure needs are met. Again, we are being reactive,” says Dr Muldoon. For too long, he says, authorities have failed to “see children with a disability as a child first and as a child with a disability second”.

There are many who think we are living through a child and teen mental health crisis. Dr Muldoon says there are families who have spent weekends in emergency departments with enormously distressed children as they are in desperate need of a child and adolescent psychiatrist.

Due to the massive pressure on Child and Adolescent Mental Health Services (CAMHS), it is only at the point of attempted suicide that some CAMHS in the community can intervene immediately.

This means children with worsening depression and anxiety languish on long primary-care counselling waiting lists.

“It’s the opposite of child-friendly. Children with mental health want access to 24/7 care,” he says.

In this centenary year, we heard repeated reference to the ideals of our republic, to the proclamation that pledged “to treat all children of the nation equally”.

Yet, far too many children are still being left behind.