A child's right to be seen - Kirsty in adversity

Christmas is something Caley dreads.

It is a time of year where she feels pressured to make it a special time for her two-year-old daughter, Kirsty, but it has been a terrible year and she feels increasingly isolated.

Caley is the mother of Kirsty, the Holyrood baby, a fictional baby born as the current crop of MSPs first took their seats for the Scottish Parliament’s fifth session in 2016. And as explored already in the pages of Holyrood, the fact Kirsty lives in one of Scotland’s most deprived communities probably has had an impact on her brain development already, as Caley’s economic circumstances dictate her environment, life chances and choices.

It impacts on relationships too, according to the Joseph Rowntree Foundation: “The stress of living on a low income can be linked to relationship breakdown among couples, and to the relationships between parents and children.”

Caley’s mental health is also very likely to have been affected. Her own relationships have come under severe strain this year, as her own mother has become frail and increasingly dependent on her. Caley is separated from Kirsty’s father, Scott, and his erratic working patterns have disrupted any set routine.

With Caley under increasing pressure and feeling less and less in control, how are Kirsty’s needs and rights going to be met?

A growing wealth of research shows that adverse experiences in childhood – ACEs – have a direct bearing on outcomes later in life.

In her programme for government, Nicola Sturgeon made a bold commitment to embed children’s rights in all policy from next year.

“I said last year that we would consider how to further embed the principles of the UN Convention on the Rights of the Child (UNCRC) into domestic law and policy, including the option of incorporation,” she told MSPs.

“Having now carefully considered this matter, I can announce today that we will incorporate the principles of the UN Convention into Scots law.

“We will work with partners and parliament to do it in the most effective way possible but in this Year of Young People, there can be few more powerful symbols of this government’s commitment to our young people.”

Clearly, targets to reduce child poverty by 2030 will not help Kirsty yet, but what are the UNCRC rights, and does practice on the ground really protect them?

Under the terms of the legally binding international agreement, governments are required to meet her basic needs and help her reach her full potential. This is not just about keeping her safe and giving her an education, it is also about giving her agency and a right to live with her family.

Kirsty was due a review with the health visitor at 27-30 weeks, but whether this has happened depends on if there was a health visitor available. 

A shortage of health visitors in Scotland has led to the job being recently re-evaluated to become a band seven post on the NHS Agenda for Change pay scale, meaning the salary should be much more attractive in the future.

If Caley lives in an area which is using the ‘named person’, this would be the health visitor and they would have built up a relationship.

If that happened, they might have noticed that Caley is not doing well. If Caley has spoken to anyone about her mental health, it is likely to have been her GP. And like many GPs, his or her response would have been to prescribe medication.

Increasingly stressed and paranoid, Caley cannot work, but it is probably too early for the benefits system to acknowledge this and provide extra support, and in any case, like many people, Caley probably wouldn’t know what she is entitled to.

Kirsty is living in adversity.

Neighbours have heard shouting in Caley’s flat when Scott has been round, and Kirsty cries at night when Caley is in a sedative state due to her medication.

by Tom Freeman

Highland council ‘working to be aware of ACEs’

Her cries are not being answered.

For Kirsty, this is clearly an intervention point when Getting It Right For Every Child (GIRFEC), the Scottish Government’s approach to supporting children and young people, needs to come into play. 

But services interpret that in different ways, while local provision will depend on what preventative measures are put in place. These are largely provided by the third sector, and many family support services suffer from short-term funding awards which are under increasing pressure from local government budget cuts.

In researching what help there might be for Caley and Kirsty, Holyrood could not find a consistent picture across the country. Charities like Quarriers, Circle and One Parent Families Scotland do provide family support services in several locations, but operate in challenging financial times.

There are some places that appear to have very little in the way of support networks at all.

As private tenants, it is very unlikely Caley and Kirsty will be visible to council services such as housing or social work until things get even more serious, meaning any timely preventative approaches that might have made a difference are too late.

If engaged, council services would work to build trust, focus on Caley’s strengths and attempt to work in partnership with each other, but it would become a formal system, a process that could end in child protection.

A social worker told Holyrood that all agencies need the skills to provide a supportive initial response, recognising that mothers like Caley find it hard to trust social services once contact has been made. 

Both they and Mary Glasgow, chief executive of child protection charity Children 1st, raised the “huge financial pressure” felt by the third sector services that might be able to provide the initial help Caley and Kirsty need at this point.

Glasgow says a lack of resources inhibits GIRFEC becoming a reality.

“The policy is good, but the practice and implementation is challenging and not consistent,” she tells Holyrood.

“GIRFEC is all about proportionate early help for children, and we’re miles from that.”

If Kirsty has a ‘named person’, they would be a central point of contact for both Caley and services, and if a health visitor, someone who would know the family from before Kirsty was born.

Although healthcare staff have a role in identifying risk factors, Caley and Kirsty’s care needs are looked after by five GPs in a big practice, so they do not have a close relationship with one particular GP. From the GPs’ perspective, there has been no visible issues flagged up.

“The continued concern we’ve got is around government administration, which continues to silo children by their issues,” says Glasgow. 

“We need child-centred, family minded, community-focused practice. In this country, we need to remember children live in families and families live in communities. 

“When you say ‘get it right for every child’, sometimes folk focus on the child to the exclusion of the family. We push the fundamental right of those children to live in their own family, in their own communities, and for their family to get the help they require early enough to make sure it is safe enough for the child, so the right to be safe is also respected.”

Glasgow says there is unlikely to be any response at all to Caley and Kirsty’s current situation.

“All this young mum needs, really, is a consistent, kind, supportive relationship through which she can talk about both her practical needs and concerns in order to be the best mum she can be, and some of the emotional challenges she might have around her adult relationships,” she says.

“She needs a relationship, not a service. A relationship, not a process. She doesn’t need to be sucked into a system which only looks at her through the lens of risk.”

On Human Rights Day last week, Sturgeon reaffirmed her commitment to incorporate the UNCRC into Scottish law and policy next year, but with so much commitment and ambition already not being met by practice on the ground, will it make any difference to Kirsty?

According to Glasgow, it’s about rebuilding whole systems around a new approach.

“We have great legislation, great policy and all we need to support children like Kirsty and her family,” she says.

“The gaps are in the resources in being able to implement it properly, and then the leadership in the system being brave enough to say there are some things we’ve been doing for a long time that don’t work within a GIRFEC context. 

“What do we need to shift in a system that was built primarily before GIRFEC, particularly the child protection, care system and hearings system? We need to think differently about these pre-GIRFEC things, and how can we shift towards something that works for all children and their families.”

Meanwhile Caley still faces a difficult Christmas, and Kirsty heads towards an uncertain new year.