Emergency care – numbers are not the whole story

picture of Amanda Shaw
Amanda Shaw Guardian

14 February, 2017

Anyone who knows me will tell you that I love statistics.

‘Without data you are just another person with an opinion’ – W. E. Deming [1]

So it was with growing unease that we dutifully recorded each month over the last few years the steady growth in the numbers of children and young people being placed by the state into what is called ‘emergency care’.

In emergency care children are looked after in temporary accommodation by rotating shifts of workers with minimal training, provided mostly by commercial companies. In the popular shorthand they have become known as ‘kids in motels’ although their ages vary and the places in which they reside include bed and breakfasts, caravan parks and short-term rentals.

We have frequently reported, and Commissioner Nyland’s investigations reached the same conclusion, that emergency care is very unsuitable for children. It does not and cannot support their psychological needs and social development and potentially places them at greater risk of abuse.

There are now nearly 200 children and young people living under such arrangements so we need to get the numbers down – yes?

Well, yes – but with a very strong proviso.

Finding a suitable alternative placement is much more than just finding a bed. In a complex calculation, the child or young person’s age, gender, cultural identity, maturity, previous experiences, psychological state, personality and disabilities all form part of the planning. A placement in home-based or residential care must have the best chance to make them feel safe, secure, accepted and support them to reach their full potential. As well, a good placement has to consider not just the best for the child or young person being placed but, equally importantly, what is in the interests of those who already live in that placement.

Getting this right has consequences for the safety, happiness and wellbeing of the children and young people being placed, not just now but for the future and perhaps for the rest of their lives.

In the past we have seen efforts to ‘get the numbers down’ lead to children being placed into unsuitable home-based or residential care placements. They were often hastily planned and executed, poorly matched and ignored the views of the children.

We need to acknowledge the community and media pressure on the new Department to ‘get the numbers down’ but the safety, wellbeing and interests of children and young people must come first. A number of matters coming before the Office’s Advocates recently have raised my concern that an emphasis on ‘getting the numbers down’ is once again coming at the expense of good placement matching. Placement options are being discussed that appear very unsuitable, that children and young people do not want and that may place them at risk.

There is also some evidence that children and young people in settled circumstances are being shuffled among the residential care houses in order to create places. There is a dilemma in taking action for the greater good – making more placements within the same resources available – while not losing sight of the individual’s rights, wellbeing and, importantly, their voice.

South Australia already has the highest average number of placement changes per child in Australia and we have previously documented the negative effects of forced placements changes in reports and in young people’s own words.

There is no shortcut to creating suitable quality care placements in foster care, relative care and residential care. It will take time, resources and sustained effort but creating suitable alternatives is the only acceptable way to reduce the numbers in emergency accommodation.

In the end it will be the stories of the children and young people behind the statistics that will be the evidence of our success or failure.

1 William Edwards Deming was a notable American management innovator and champion of evidence-based decision making. Wikipedia

This article also appears in the February 2017 edition of the Guardian’s Newsletter.

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