As this week’s review into child deaths in care revealed, childhood neglect often continues from generation to generation of a family.
One residential family support service in Cork is trying to break this cycle by helping women bond with their babies as well as learn the basic skills of parenting, writes Claire O’Sullivan
MANY of the women who arrive at the Bessborough Mother and Baby Centre in Cork can’t make a bottle for their babies, regularly getting formula measurements confused.
Others on the residential programme can’t make eye contact with their babies and have to be encouraged to hug their infants.
When their baby cries, these women don’t automatically try to work out what’s ailing their baby. Much of what comes naturally to other mums is alien to them as they were themselves neglected as children. When they enter the Bessborough Estate, drive up the bucolic avenue with its pastures of grazing cattle running alongside, they are often entering last chance saloon: social services are on the verge of taking their babies into care.
In Ireland and internationally, neglect is the most common form of abuse reported to the health services. According to Children’s Minister Frances Fitzgerald earlier this year, more and more cases of neglect are being referred to the care services. It is also one of the most insidious, silently living with its victims long after they leave childhood behind.
Yet, in the words of Bessborough clinical psychologist, Dr Mairéad Ní Eidhin, neglect is the most ‘neglected’ type of child abuse. Physical and sexual assault gets far more emphasis in social services as physical and sexual assault appear to be the threshold at which resource-starved services jump into action.
However, this ‘neglect of neglect’ isn’t just confined to social services. There is a dearth of academic research in the area, with neglect accounting for just 2.6% of academic research output in the 1990s.
In Cork, Bessborough was once notorious as a mother and baby home where unmarried pregnant women were confined in the 19th and 20th century. It was from there that hundreds of mothers put their children up for adoption, often unwillingly.
In many ways, Bessborough has come full circle. Its residential centre is at the forefront of family support, no longer about concealed pregnancies or the ‘shame’ of single parenthood. It’s about meeting the needs of children whose mothers have drug, alcohol, serious mental health or learning difficulties or a combination of these. Some are also in aggressive relationships that are seen as a threat to their child. The Bessborough Mother and Baby Centre is now run by a chief executive and his board. The order of Sisters of the Sacred Hearts of Jesus and Mary are the organisation’s trustees.
“Very many of the mothers have experienced childhood neglect themselves and so have no experience of parenting,” said Dr Ní Eidhin.
At any one time there are always six to seven women availing of the three-month residential programme at Bessborough. It’s estimated that on average, just two of the women each year choose to attend the Mother and Baby Centre of their own accord for a “period of reflection” as they consider putting their child up for adoption.
The women that come here are as young as 15 but they come at all ages. Last year, they had a 51-year-old mother, with serious mental health problems, who had just had another baby. Her other children were in care in another country and she knew her child would be considered “at risk”.
However increasingly cases come from child protection departments in Cork, Kerry and to a lesser extent Clare, Waterford and Limerick. Again, a large proportion of these are facing a court date over child protection failures. Domestic violence projects like Edel House and homeless units like Liberty Street House may also refer women to Bessborough. About 60% of the women already have children in care.
“The vast majority have never experienced good parenting. They do not know what it is to look after a child properly. A great many can’t consistently make up a baby’s bottle properly. They might be shown how it’s done, then do it properly once or twice, but then they have problems continually doing it.
“They can’t respond to a baby’s very basic needs, such as that when it cries it may need a bottle. They are totally unaware that a child needs to be stimulated. A great many also have very low self-esteem,” said Thomas Quigley, the centre’s chief executive.
The unit is not adverse to male participation either. They have apartments where a father can stay with his family and each year up to four fathers choose to complete the residential programme with their partner. “Sometimes fathers represent a source of support to the mother or are an alternative source of care for the child or children,” said Mr Quigley.
“Research on fathers shows that the presence of a positive father or father figure decreases the likelihood of neglect in the home. Having a father in the household not only may provide children and the mother with an additional source of emotional support, but it also may provide the family with more money and other resources”.
The image (see adjacent) shows the brain of a child who has been suffered extreme neglect in the first three years of life. The child’s brain is nearly half the size of an average child’s brain.
“Brain development is regulated by genes and genes are triggered by life experiences, particularly early childhood experiences. Scientific studies have shown how neglect can cause important regions of the brain to fail to form or grow properly, resulting in impaired neurobiological development,” says Dr Ní Eidhin.
For instance, the frontal lobes of a child’s brain is the section that deals with self-regulation. Babies and young children who suffer neglect often have difficulties regulating their behaviour as they grow older because that section of their brain development was not helped along by a caring adult.
These children find it difficult to judge others, to stay attentive and have issues with reliability and predictability. They can also be more prone to risk-taking behaviour like drug taking, alcohol abuse and unprotected sex. This all makes it easier to understand how former child abuse victims often find themselves, as parents, in conflict with social services.
The courts and HSE look favourably upon Bessborough as they can see the benefit to parents of an intensive emphasis on parenting. Before they even arrive, the women are subject to a pre-admission discussion on why they’re being referred. A care and parenting plan is then drawn up with Dr Ní Eidhin and a key worker and parenting mentor allocated. Throughout their three months, good parenting is demonstrated by the staff.
“A great many of these people have never experienced parental warmth. We continually prompt them around “how do you think the baby feels now?” says Dr Ní Eidhin. The need to respond to a crying baby or a wet nappy is constantly re-enforced in the hope the women can learn what they never experienced as children. Baby massage is also used by the team to aid bonding and attachment.
During their stay, weekly multidisciplinary meetings are also held by the staff so they discuss how attachment, emotional warmth, responsiveness to the child etc is progressing. Aftercare is also provided in different circumstances including, a ‘community mothering’ service, daily phonecalls, weekly infant mental health checks and weekly meetings with the mother.
Up to half of the women will also be subject to a parenting assessment during their stay as the HSE are using this time to determine whether their child should be put in care or not. “They’re looking for a good robust argument as to why the children so go or stay,” says Mr Quigley.
“They see the benefit of parenting supports and assessment in tandem”.
In a utopian world, the biological love these women feel for their children, a desire to rear their children and the intensive parenting lessons they receive would prove the magic recipe that would allow the women to keep their children out of care.
However the centre’s overriding objective isn’t to ensure that parents retain their children. It’s about ensuring “the needs of the child” will be met while “trying to protect the mother — the better functioning the mother is, the better their relationship will be”. Very often these women were in care as children themselves and experienced “abandonment” as a result.
“They can once again experience overwhelming feelings of abandonment when their children are placed in care. During their time here, we help them to come to a better understanding about what is best for their children,” said Dr Ní Eidhin.
How does the centre measure ‘success’ I ask? It’s a loaded question I know. “A good outcome could be that the children are taken into care as that is the best for all. It could be that the mother and child are left together.
“Success could be that they remain together with supervision. What we often see is that the mother and child leave here, but because of inadequate supports in the family, drugs being available, or an abusive environment, that the parenting breaks down afterwards. In that situation, a good situation can be where the mother then asks that the children are taken into care. That too is a success as she has recognised what is best for her children,” said Mr Quigley.
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