The incredible vanishing teenager Hard to reach young people and ‘agency neglect’

1. The incredible vanishing teenagerHard to reach young people and ‘agency neglect’ Patrick Ayre email: pga@patrickayre.co.uk web: http://patrickayre.co.uk

9. The complexity of the challenge Young people 14-18 may be • Victims, • Perpetrators • Parents • Any combination of the above but have the same right to be safeguarded as any other child.

10. The background National summary of Serious Case Reviews: “The reviews showed that state care did not always support these young people fully and that they experienced ‘agency neglect’” Brandon and others (2008).

11. The young people Adolescence marks start of serious problems for many children: • Onset of mental health issues • Family conflict • Drug use, offending • Sexual activity • Running away

12. The young people (Brandon and others) • History of rejection, loss and, usually, severe maltreatment • Long term intensive involvement from multiple agencies • Parents: history of abuse and current mental health and substance issues • Difficult to contain in school • Typically self-harming and misusing substances, often self-neglect

13. The young people (Brandon and others) • Numerous placement breakdowns • Running away, going missing • Risk of dangerous sexual activity including exploitation • Sometimes placed in specialist settings, only to be withdrawn because of running away

14. The young people (My experience) • Long involvement, but not always intense • Sometimes few placements, but all wrecked by the young person • Common factor that local services just did not know what to do with them. • ‘By the time of the incident, for many of the young people, little or help was being offered because agencies appeared to have run out of helping strategies’ (Brandon and others, 2008).

15. The response • Reluctance to identify mental illness and suicidal intent (CAMHS) • Failure to respond in a sustained way to extreme distress manifested in risky behaviour (sex, drugs, suicide attempts) • Instead of ‘pulling together’, multi-agency response shows fragmentation, ignoring, responsibility shifting, freezing/inertia and generally avoidant behaviour • Reasons for running not addressed adequately

16. The response • Running away leads to discharge • [More generally, does rejection of services lead to total abandonment?] • Age used as a reason for not imposing services • No proper assessment of competence; allowed/forced to choose; • [Dealing with incidents but failing to recognise patterns]

17. The obstacles • Hard to get a purchase on the system • Wrong children, wrong adults (Ayre, 2000) • Acclimatisation • Lack of off-the-shelf resources • The limited resources are poorly coordinated and integrated • Government targets not child centred or child driven • Different agency agendas and mutual misunderstanding; falling down the gap

18. The solutions? • That’s what we are here to explore! • Biehal (2005) recommends adolescent support teams in the community [but is that enough?] • The complexity of the challenge requires flexible collaborative, individualised responses built around the young person

26. References Ayre P. and Barrett D. (2000) Young people and prostitution: An end to the beginning?, Children and Society 14, 48-59 Biehal, N. (2005) Working with Adolescents: Supporting Families, Preventing Breakdown, London: BAAF. Brandon, M, Belderson, P, Warren, C, Howe, D, Gardner, G, Dodsworth J and Black J (2008) Analysing child deaths and serious injury through abuse and neglect: what can we learn? London: Department for Children, Schools and Families