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------------------- Marie ANAUT Professor Psychologist ------------- University of LYON-2 FRANCE

«  Care for children: a matter of institution »? April 20 2007 Brussels --------------------- "Desinstitutionalisation in France, a good practice ?". ------------------- Marie ANAUT Professor Psychologist ------------- University of LYON-2 FRANCE. European research.

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------------------- Marie ANAUT Professor Psychologist ------------- University of LYON-2 FRANCE

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  1. « Care for children: a matter of institution »?April 20 2007 Brussels--------------------- "Desinstitutionalisation in France, a good practice ?" ------------------- Marie ANAUT Professor Psychologist ------------- University of LYON-2 FRANCE

  2. European research • Data from 2 research programs : • Program “Daphne” U.E. • WHO Regional Office for Europe (OMS) General Coordination : Univ. Birmingham • Research with 9 European partner countries => comparative studies

  3. Phase 1: "Number and characteristics of children less than 3 years living in sanitary et social institutions, at risk of arms" ------------------------------------ Study of modalities to take care of children (relationships, life conditions…) Phase 2: « Study of children les than 5 years, leaving institutions or moving from placement " ------------------------------ => Study of trajectories of each children leaving institutions (relational characteristics, families aspects…) Methodological aspects Institutions :residential social care - children’s homes for children less than 5 years; Modality :Visiting the institutions, interviews, directly observations and questionnaires…

  4. Data of General research (1) • 31 countries compared :23 500 children ( under 3 years) placed in institutions during more than 3 months • Population of under 3 years : 18 million => Average : 13 children for 10 000

  5. Data of General research (2) • The European countries of the study : U.K. (univ. Birmingham : Kevin BROWNE) coordinator ; Denmark, France, Greece, Poland, Hungary, Romania, Czech Republic, Slovakia, Turkey.

  6. FRANCE : Nationals Characteristics • General political aspects => to privilege placement of children less than 5 years in foster families But : • Lack of foster families • Some children less than 5 years in institutions in order to not separate them from their sibling(s). • Structures of “emergency placements": • Sometimes children stay in emergency placement institutions more than 3 months, sometimes for 1 year… • Not enough institutions for mother and child…

  7. Institutions analysed:from Rhône-Alpes area 7 institutions in phase1 and 4 in phase 2 --------------- 80 Questionnaires in phase 1 45 Questionnaires in phase 2 : 25 children with "social problems" 20 children with "handicap situation"

  8. The INSTITUTIONS of the STUDY (FR) • Little Institutions "pouponnière“for > 40 children (babies) : • Possible stay for some Mother and Child • Children social case (less than 3 years) • Children with disability (0-3 years and more) • Big institutions with sub-structures : • Emergency Placement • "Pouponnière" (0-3 years) : 52 children in 4 units. • Mother and Child homes : 42 mothers and 42 children • Children homes unit for : 4-12 years et 12-18 years • Medical Specialised Institutions : • Children in handicap situation (polyhandicap…)

  9. STUDY in PHASE 2: Children less than 5 years leaving or changing from institution… in France

  10. Characteristics of children placed in institutions • Majority of children in “emergency placement" • 90% of children in “judiciary placement" • Some children hospitalised before the placement • A few children placed with her mother • A few children waiting for adoption.

  11. Causes of admissions in institutions • Causes of placement (by order of frequency): • 1) Negligence / careless • 2) "Abandonment" (in fact and/or to be adopted) • 3) Psychiatric problems of their parents • 4) Maltreatment • 5) Violence in family

  12. Before admission in institution • In a large majority children were leaving in biological family • Family Context : poverty, socio-educative and psychological inadequacies, social isolation problems.

  13. Characteristics of biological families • A lot of single parent families and/or separated parents • Many families with very feeble financial income (poverty) • Violence in the family • Alcoholism, drug addiction • Mental illness (psychiatric problems)

  14. Duration of placement in institution • Duration of the stay very variable : from 2 months => to about 12 months • Legal duration for children who are waiting for being adopted is : 2 months (minimum). • Children with disability stay longer than others in institutions.

  15. Criterion of decision for leaving or changing from institution ? • Medical, social and psychological evaluation for the child and his family • Collective decision by multidisciplinary staff of Social Services (ASE: Aide Sociale à l’Enfance). • Juridical decision (by Judge) for “juridical placements", after ASE’s proposition or from an other service. • Preservation of relations with siblings.

  16. Children’ orientation after leaving institution ? • 1) Placement in Foster Family : 61 % • 2) Return to biological family (mother and/or father) : 25% • 3) In care to relatives (grants-parents…): 11% • 4) National adoption : 3%

  17. Children followed up after de-institutionalisation ? • Children who return with their parents or relatives are almost all followed by social services "in natural context" (AEMO). • Children in care of foster families are followed by social services (by ASE). • Often social workers keep changing, a second service replace the first. • In case of new placement (F.F.), family links with natural family are preserved (parents & siblings).

  18. Practices to be improved ?(1)(cf. attachment theory) • Privilege mother and child’s links by increasing homes or units for “mother and child“ • Promote “emergency foster families" for children less than 3 years • Systemise children’s “life story book" (photos, transition objects…) • Preserve stability of links between child and relatives (nanny, nursery or school, neighbour …)

  19. Practices to be improved ? (2) - Reduce the duration of the children’sstayin institutions : => less than 3 months for all children • Reduce the period for family’s evaluation and take a decision more quickly for the children’s orientation => Use and/or create tools of evaluation… • Carry out medical and psychological assessment more systematically : => Appraise the specific needs of children => Estimate relatives and family resources => Reviewofcommunity and alternatives service’s resources

  20. Practices to be improved ? (3) • Growing public awareness of consequences of early separations with care givers. • Estimate the possibility to develop new services (day care…). • Make the medical and social staff sensitive to attachment theory… • Training… => The 10 steps of good practices

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