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We need a national placements strategy

I recently listened to a podcast (Children locked away: Britain’s modern Bedlam) about some of our most deeply vulnerable children and young people who are in extreme distress. Multiple attempts to self-harm, harm others and take their own lives are common features, but their risk-taking behaviour is often a symptom of something more. Many of these children have experienced abuse, neglect, trauma or personal loss. Timely access to appropriate therapeutic intervention or mental health support can make a huge difference to them, often what they are faced with is a system that cannot meet their needs.

This is the group we increasingly read about in the press following critical high court judgements, most people will remember the judgement handed down by the then President of the Family Division, Sir James Munby, relating to Child X. Sadly, as the podcast notes, Child X was not an isolated case. Children’s services are responding to needs which, under normal circumstances, should have been met earlier in the system and not escalated to the point of crisis. Funding is not keeping pace with this reality, neither are the foundations needed to make the system a success, such as having enough of the right placements for children when they need them. Something must change because children are paying the biggest price. Directors of children’s services (DCSs) are ambitious to our core for children yet at times it can feel like we’re swimming against the tide when system factors act as barriers and hinder what we can do for the benefit of children.

There are growing difficulties in accessing the right care and support for these children, gaps in mental health provision plus long waiting times are a factor. A rising number of applications to the National Deprivation of Liberty (DoLs) Court, due to the need to safeguard more high risk children in care, and the continued use of unregistered placements for some of our most vulnerable children evidence this. Applications to the DoLs Court are often sought to use restrictive practices to manage complex mental health presentation and high-risk behaviours in the community due to a lack of Tier 4 beds and secure welfare placements. This course of action is a last resort.

Where secure welfare placements are required and not available, local authorities reported that they are using non-secure provisions such as bespoke unregistered or unregulated provisions within the community, supported by a deprivation of liberty order when necessary. The cost of funding bespoke packages are very high, running to tens of thousands of pounds per week, but we are most concerned about the impact on children.

We need to develop the system, so it meets children’s needs. Local authorities are exploring a range of solutions to mitigate the lack of secure welfare and mental health provision, such as establishing children’s homes to accommodate children with complex needs and/or high risk behaviours. There is more for government to do here, a comprehensive national placements strategy is needed as is a review of children’s mental health services.

This column first appeared on the MJ website on 19 June.

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