At the Front Door Child Protection Reporting in a Changing Policy and Legislative Context Submitted for the degree of Doctor of Philosophy 2018 Sadhbh Whelan Supervisors: Dr Helen Buckley & Professor Trevor Spratt School of Social Work and Social Policy, Trinity College Dublin Declaration I declare that this thesis has not been submitted as an exercise for a degree at this or any other university and it is entirely my own work I agree to deposit this thesis in the University’s open access institutional repository or allow the Library to so on my behalf, subject to Irish Copyright Legislation and Trinity College Library conditions of use and acknowledgement _ ii Summary Irish child protection and welfare services have been subject to a range of recent policy and legislative change underpinned by a significant increase in reporting rates over the last ten years This study set out to explore a sample of current child protection and welfare reports made to statutory services and provide important insights within this context of change and increased pressure In doing so, it has filled a gap in empirical research by providing a robust and detailed analysis of the types of concern reported, the source of reports and the initial responses made A case study methodology was utilised and focused on the intake system, the ‘Front Door’, of one administrative area of Tusla, the Child and Family Agency, during Q1 2015 A mixed methods design was used and quantitative and qualitative methods employed to gather and analyse data on all reports received during the time period under study To supplement this data a focus group and in depth qualitative interviews were carried out with eight practitioners from the area By providing comprehensive statistical data and the perspectives of those who operate the system, the study shows how far reform in Ireland has synchronised with current international models of service delivery To this end, the findings are discussed in the context of Irish and international literature on child protection systems, referral and re-referral, reporting trends, decision making, filtering and thresholds This study argues that while Irish child protection and welfare services strive to foster a ‘welfarist’ and children’s rights approach, the ‘forensic paradigm’, endemic within many Anglophone countries, continues to endure; evidenced by an aversion to risk and increasing proceduralisation within the system Key findings from the study showed how practitioners behind the Front Door struggle to address the range of need evidenced in reports The data demonstrate that the largest proportion of reports are made by lay referrers Yet, the way that the intake system is formalised ultimately privileges professional reporters and could be seen to deter families and members of the public from seeking the assistance they require The findings also illustrate that, while a significant proportion of reports are referred forward to the next stage of an initial assessment, a high rate of attrition ultimately prevails Analysis of the types of reports that are re-referred within a relatively short period indicates that certain difficulties, for example, children's mental health and behavioural problems, fall between service gaps Paradoxically, reports made by 'protective' parents about their children appear less likely to receive an assertive response than those made by others The child protection intake system operates according to a set of standard business processes which were developed to structure service delivery and promote a consistent response The current study shows that it responds effectively to reports representing clearly defined ‘abuse’ cases amenable to a straightforward classification of ‘child protection’ However, a substantial proportion of the iii difficulties being reported, classified as ‘welfare issues’, relate to parental capacity and family functioning The latter are more likely to be complex and multi-faceted and require case by case deliberations in order to make a decision about the next step to be taken The research illustrates the challenges involved in achieving this in an environment characterised by high levels of demand, low resources, time constraints and limited information Decision making at the Front Door, both in terms of the categorisation and outcome in cases was revealed in this study to be a very subjective task, guided more by ‘sense making’ strategies than by any official guidance or policy afforded by the statutory agency Localised practice norms were also found to influence thresholds in a context of high pressure and varying levels of service availability By revealing, through the statistical analysis of intake records, the full extent of concerns reported to services, the links between the nature of child harm and vulnerability, the sources of reports and the likely early decisions made, this research should enable policy makers and service planners to make evidence based projections This will be particularly important in the context of upcoming legislation on mandatory reporting The study has also illustrated some weaknesses behind the Front Door, particularly in its apparent capacity to respond to certain difficulties that present repeatedly It suggests that some reappraisal of the agency's skill mix could usefully take place, but also recommends deeper consideration of the purpose and function of the intake system iv Acknowledgements First and foremost I would like to thank Dr Helen Buckley for her mentoring, supervision and friendship over the last three years and long before Without her support and encouragement I would not have undertaken this PhD and for that, as well as much else, I am very grateful Professor Trevor Spratt became my second supervisor, following Dr Buckley’s retirement, and his input and supervision were very welcome and much appreciated Dr Elizabeth Nixon provided me with much advice and guidance throughout the last three years, as well as an immeasurable amount of moral support, friendship and encouragement, and listened with great patience to my woes as we ran countless miles around north Dublin! Thanks is also due to the School of Social Work and Social Policy, which provided me with scholarship funding in my first year to enable me commence my doctorate, and the Irish Research Council for providing me with funding for my second and third year I am grateful to both institutions for endorsing both the merit of this study and my ability to carry it through to fruition I would like to thank the staff and management of Oaktown who participated in this study They willingly took time out of their busy schedules to meet with me and share their knowledge and valuable insights into Irish child protection and welfare services They also provided me with the administrative support necessary to enable this study to happen I would like to thank my family and friends who have travelled this journey with me and provided me with much needed emotional and practical support Particular thanks are due to Mamie & Mike, Pam & Frank, Mary & Ciaran and Suzanne whose help with child care, particularly over the last year, was invaluable and much appreciated Thanks also to all the Mommies who took the children on countless playdates and brought them to matches to give me time to study I will reciprocate! Jake, Abby and Luke have endured three years of hearing about ‘Mommy’s PhD’ with incredible patience, understanding and good humour, making me even more proud of them than ever A special thank you is also due to Abby who let me take over her bedroom as my office! Barry provided me with endless support and encouragement, helped me to keep things in perspective and never once faltered in his belief that I could and would get this done Lastly, I would like to mention my parents, my Mom who has always supported and encouraged me in everything I and my Dad, who would have been seriously impressed! v Table of Contents Declaration ii Summary iii Acknowledgements v List of Tables xii List of Figures xiv Glossary of Terms xv Chapter 1: Introduction Making a report to the intake system The screening step The preliminary enquiry (PE) stage Carrying out checks The standardisation of child protection and welfare services in Ireland Research on child protection in Ireland and the contribution of this thesis Review of the literature Layout of the thesis Chapter The Child Protection System in Ireland – Evolution and Change 10 Introduction 10 Classification of child welfare systems and the search for a new paradigm 10 The current child protection and welfare system 13 Conflicting discourses in Irish child protection work 15 The search for a universal child protection paradigm 16 Managerialism, bureaucratisation and proceduralisation 19 Conclusion 23 Chapter Referrals and Re-Referrals 26 Introduction 26 Definitions of referral and methodological challenges 26 Who is referring to child protection services? 27 Reason for referral 30 vi Characteristics of the children reported 32 The visibility of the children who are referred 36 Links between the reporter and the outcome of the report 37 Impacts on rates of reporting, rising rates and barriers 38 The education sector and child protection reporting 41 Families and their experience of being reported to child protection services 43 Re-referral to child protection services and methodological challenges 44 Conclusion 47 Chapter Child Protection Reporting and Trends 49 Introduction 49 Child protection and welfare reporting in Ireland and internationally 49 Outcome and categorisation of reports at national and local level in Ireland 52 Child Protection Reporting in Ireland North and South 61 Conclusion 66 Chapter Decision Making, Thresholds and Filtering 67 Decision making 67 Filtering 74 No further action and thresholds 76 Conclusion 78 Literature review concluding comments and development of research questions 79 Chapter Methodology 82 Introduction 82 Research questions 82 Selecting the research methodology and methods – epistemology and ontology 83 A case study of Oaktown child protection and welfare services 85 Mixed methods 86 Access to the research site 88 Ethical considerations 88 Quantitative data collection and analysis 89 vii Qualitative data collection and analysis 90 Limitations and generalizability of the study 95 Conclusion 96 Chapter The Children, the Alleged Perpetrators and the Difficulties Reported 97 Introduction 97 Biographical information on the children in the sample 97 Sibling reports 98 Detail of the person allegedly causing harm to the child 99 Difficulties reported for the children in the sample 101 Detailed analysis of the difficulties experienced by children in the sample 105 Difficulties reported in respect of parents and families in the sample 110 Primary report type 112 Welfare concern categories 113 Differing perceptions of reporters and intake social workers 116 Conclusion 117 Chapter A Closer Look at the Difficulties Reported for the Children 119 Introduction 119 Exposure to domestic violence and parental conflict 119 Physical abuse 122 Behavioural problems 124 Impact of parental substance abuse 127 Educational difficulties / out of school 129 Sexual abuse and sexualised behaviour 131 Mental health need 134 Conclusion 136 Chapter A Closer Look at the Difficulties Reported for Parents and Families 138 Introduction 138 Lack of parenting skills 138 Significant relationship difficulties 140 viii Misuse of drugs and alcohol 142 Domestic violence 144 Struggling to manage child’s behaviour 146 Mental health difficulties 148 Conclusion 149 Chapter 10 Who is Reporting and What are they Reporting? 151 Introduction 151 Source of the report 151 Source of the report and difficulties reported 155 Source of the report and the age of the children reported 162 Mode of the report 163 Parents’ awareness of the report and reporter anonymity 165 Conclusion 165 Chapter 11 Carrying out checks 170 Introduction 170 Finding from the current study regarding ‘other checks’ carried out 170 Checks carried out – rural / urban context 172 Checks and outcome 172 Carrying out checks – perspective of the interviewees 173 Conclusion 177 Chapter 12 Decisions Making at the Coalface 178 Introduction 178 Primary report type: the perspective of the interviewees 178 Outcome 180 Source of the report and outcome 185 Re-referred children and outcome 186 Link between number of previous intake records and outcome 187 Gender and outcome 188 Age and outcome 188 ix Rural / urban context and outcome 189 Qualitative findings on outcome 189 Conclusion 197 Chapter 13 When and How Decisions Are Made 201 Introduction 201 Time frame for decision making 201 Feedback to reporters 202 How decisions are made 204 Thresholds applied in the process of decision making 207 Responsibility assigned to parents for their children’s safety and welfare 210 The perspective of interviewees on decision-making 211 Conclusion 213 Chapter 14 Re-referral 216 Introduction 216 Re-referred children 216 Number of Intake Records 218 Re-referral and length of time since previous reports 218 The perspective of the interviewees on re-referral rates 219 The perspective of interviewees on the nature and content of re-referrals 219 Data from the intake record forms on re-referral 221 Sources of re-referral 225 Ages of the children who were re-referred 228 Conclusion 229 Chapter 15 Discussion and Concluding Comments 232 Introduction and contribution to knowledge 232 Revisiting the methodology 233 The Irish child protection system and the current policy and legislative context 234 The unintended consequences of bureaucratisation 235 Reporting trends 238 x Appendix Screening & Preliminary Enquiries Chart Source: (HSE, 2009: p.10) 293 Appendix Consent Form Consent Form Is the Front Door Open? Child Protection Reports in a Changing Policy and Legislative Context I _ met with Sadhbh Whelan, PhD Student from the School of Social Work and Social Policy, Trinity College, to discuss the preliminary findings from her research study which is looking at child protection reports that are received by Tusla, the Child and Family Agency I agreed to the discussions being recorded and I am happy for the information and insights I provided to be used to inform the overall findings in this study I am aware that the information I have provided will be treated as confidential, within the limits that have been explained to me, and that all identifying information will be changed in any report, paper or publication arising from this study It has been explained to me that all information, recordings and transcripts, will be stored securely on a password protected laptop and will be destroyed after the requisite period of time in keeping with Trinity College Dublin’s ‘Policy on Good Research Practice’ (2014) Signed Date _ 294 Appendix Interview Schedule Welcome, introductions and consent form Detail of study, consent form, limitation of confidentiality What is your role in Tusla and how long have you worked there? The intake system Can you describe how the intake system operates in your area from the point of receiving a report until a final decision is made on outcome? How you think the intake system is working? What impact you think the system of one ‘Front Door’ is having on service provision? What impact are PPFS and Meitheal having on current service provision in your area? The preliminary enquiry stage What is your opinion of the 24 hour time frame allowed to carry out a preliminary enquiry? Are all preliminary enquiries carried out within 24 hours? Are there any impediments to carrying out a preliminary enquiry within 24 hours? If yes, can you describe what they are? Access to intake services Do you think there should be a drop in clinic at intake for members of the public and others? Is this something reporters / parents would value? What difference would meeting people in person make? Mandatory reporting What is your expectation when mandatory reporting is introduced? 295 What impact you think it will have on the volume of reports? How you think the system will manage the expected increase in volume? Preliminary findings Preliminary findings indicate that high proportions of reports in this area are being categorised as welfare (86%) What is your opinion of this finding? What is your opinion of the thresholds being applied at the preliminary enquiry stage? What influences /informs thresholds? Preliminary findings indicate that 62% of reports received in this area were put forward for an initial assessment What is your opinion of this finding? Checking during the preliminary enquiry stage What is the area’s approach / policy to carrying out checks during the preliminary enquiry stage? Should more checking be carried out at preliminary enquiry stage? What difference would that make? Do you think more checking would impact the volume of reports being put forward for IA? Are professionals ever contacted without parental consent? What strategies are used to get around this? What impact has there been from public health nurses no longer being part of Tusla? Difficulties reported What is your opinion of the difficulties most frequently reported in your area? Reporters Preliminary findings indicate that the principal reporters are school personnel, family and Gardai & probation What is your opinion of this finding? What type of difficulties the different sources report? 296 Are there are reporting sources who you would identify as being poor reporters of child protection difficulties? Re-referral Preliminary findings indicate that 67% of those reported were already known What is your opinion of this finding? What kind of difficulties you think are subject to re-referral? Guidance documents What guidelines or policy documents are available to you to help you in your work? To what extent you use / refer to them? Suggestions for change Is there anything you would change about the intake system or anything you can think of that would be of help to intake social workers? 297 Appendix Source of the Report – Breakdown of Reporter Table Source of the report, school personnel Source of the report, school personnel Frequency Valid percent Principal 97 77.0 Deputy principal 13 10.3 School designated liaison officer 7.1 Teacher 2.4 Home school liaison officer 1.6 School counsellor 0.8 School chaplain 0.8 126 100.0 Frequency Valid percent Mother 43 40.6 Father 23 21.7 Grandparent 19 17.9 Aunt 8.5 Sibling 5.7 Uncle 3.8 Cousin 0.9 Parent 0.9 Total 106 100.0 Total Table Source of the report, family members Source of the report, family members 298 Table Source of the report, Gardaí & probation Source of the report, Gardaí & probation Frequency Valid percent Gardaí 75 76.5 Probation officers 9.1 Garda child protection unit 8.2 Juvenile liaison officers 3.1 Garda specialist interviewers 2.0 Garda ombudsman officer 1.0 Total 98 100.0 Table Source of the report, medical personnel Source of the report, medical personnel Frequency Valid percent Medical social worker 60 67.4 General practitioner 15 16.9 Nurse 6.7 Medical staff, sexual assault treatment unit 4.5 Hospital consultant 3.4 Forensic medical examiner 1.1 Total 89 100.0 Table Source of the report, domestic violence services Table Source of the report, domestic violence services Frequency Valid percent Women’s refuge staff member 51 87.9 Voluntary organisation staff member 6.9 Women’s refuge manager 5.2 Total 58 100.0 299 Table Source of the report, voluntary organisations Source of the report, voluntary organisations Frequency Valid percent Children’s organisations 30 54.5 Housing organisations 18 32.7 Disability organisations 12.7 Total 55 100.0 Table Source of the report, mental health services Source of the report, mental health services Frequency Valid percent Mental health social worker 15 30.6 Child and adolescent mental health services 14 28.6 Voluntary organisation 13 26.5 Adult mental health service 14.3 Total 49 100.0 Frequency Valid percent Public health nurse 40 83.3 Psychologist 4.2 School age team 4.2 Speech and language therapist 4.2 Environmental health officer 2.1 Senior medical officer 2.1 Total 48 100.0 Table Source of the report, Health Service Executive (HSE) staff Source of the report, HSE staff 300 Table Source of the report, Tusla staff Source of the report, Tusla staff Frequency Valid percent Child protection social worker 21 46.7 Out of hours social worker 17 37.8 Family support worker 8.9 Education and welfare officer 6.7 Total 45 100.0 Frequency Valid percent Residential care worker 11 57.9 Foster carer 42.1 Total 19 100.0 Frequency Valid percent Anonymous 19 100.0 Total 19 100.0 Table 10 Source of the report, care staff Source of the report, care staff Table 11 Source of the report, anonymous Source of the report, anonymous 301 Table 12 Source of the report, youth services Source of the report, youth services Frequency Valid percent Youth workers 47.1 Counsellor 41.2 Manager 11.8 Total 17 100.0 Table 13 Source of the report, members of the public Source of the report, members of the public Frequency Valid percent Neighbour 12 80.0 Landlord 13.3 Friend 6.7 Total 15 100.0 Frequency Valid percent Social worker 87.5 Employee 12.5 Total 100.0 Table 14 Source of the report, local authority Source of the report, local authority 302 Table 15 Source of the report, drug and alcohol treatment services Source of the report, drug and alcohol treatment services Frequency Valid percent Addiction GP 37.5 Counsellor 25.0 Project worker 25.0 Social worker 12.5 Total 100.0 Frequency Valid percent Self 100.0 Total 100.0 Table 16 Source of the report, self Table 16 Source of the report, self 303 Table 17 Source of the report, other Source of the report, other Frequency Valid percent Social worker from another jurisdiction 20.7 Police from another jurisdiction 17.2 Chairperson child protection hub 10.3 Psychologist national learning network 10.3 PPSN Registrar 6.9 Elected representative’s constituency officer 6.9 Court appointed psychologist 6.9 Designated liaison person, citizen’s information centre 3.4 Designated liaison person, Department of Social Protection 3.4 Elected representative 3.4 Manager learning centre 3.4 Solicitor 3.4 Speech and language therapist, children’s detention school 3.4 Total 29 100.0 304 Appendix Child Difficulties Reported by School Personnel Child difficulties reported by school personnel Frequency Percent** Physical abuse 30 23.8 Behavioural problems 29 23.0 Emotional problems 25 19.8 Educational difficulties / out of school 20 15.9 Mental health 19 15.1 Exposure to domestic violence and parental conflict 17 13.5 Sexual abuse and sexualised behaviour 15 11.9 Neglect 12 9.5 Learning difficulties or intellectual disabilities 10 7.9 Impact of parental substance abuse 6.3 Lack of appropriate supervision 4.8 Sibling violence 4.0 Emotional / verbal abuse by parent 4.0 Inappropriate use of social media 3.2 Child abusing drugs or alcohol 3.2 Difficult child / parent relationship 2.4 Excessive responsibility in the home 2.4 Homelessness 1.6 Negative impact from parental mental health 1.6 Impact of parental separation 1.6 Complex needs or physical disabilities 1.6 Child to parent violence 0.8 Teenage pregnancy and parenting 0.0 Child involved in crime 0.0 Other 4.8 Total 230* *Totals not add up to 126 as reporters could refer more than one difficulty **Percentages not total 100 because values were calculated out of the total number of reports made by school personnel (n=126) rather than the total number of difficulties reported (n=230) 305 Appendix Child Difficulties Reported by Family Members Child difficulties reported by family members Frequency Percent** Impact of parental substance abuse 27 25.5 Educational difficulties / out of school 15 14.2 Emotional / verbal abuse by parent 15 14.2 Behavioural problems 13 12.3 Sexual abuse and sexualised behaviour 12 11.3 Neglect 12 11.3 Exposure to domestic violence and parental conflict 11 10.4 Emotional problems 8.5 Physical abuse 7.5 Mental health 6.6 Child to parent violence 5.7 Child abusing drugs or alcohol 4.7 Learning difficulties or intellectual disabilities 4.7 Difficult child / parent relationship 3.8 Sibling violence 3.8 Impact of parental separation 2.8 Impact of parental mental health 2.8 Excessive responsibility in the home 0.9 Inappropriate use of social media 0.9 Lack of appropriate supervision 0.9 Complex needs or physical disabilities 0.0 Child involved in crime 0.0 Homelessness 0.0 Teenage pregnancy and parenting 0.0 Other 0.0 Total* 167 *Totals not add up to 106 as reporters could refer more than one difficulty **Percentages not total 100 because values were calculated out of the total number of reports made by family members (n=106) rather than the total number of difficulties reported (n=167) 306 Appendix Source of the report and gender of the children Source of the report by gender Gender School personnel Family member Gardaí & probation Medical personnel Domestic violence services Voluntary organisations – children, housing & disability Mental health services Health Service Executive staff Tusla staff Care staff Anonymous Youth services Member of the Public Local authority Drug & alcohol treatment services Self Other 307 Total Male Female % 48.4 51.6 100.0 50.9 49.1 100.0 47.9 52.1 100.0 43.4 56.6 100.0 39.7 60.3 100.0 57.4 42.6 100.0 46.9 53.1 100.0 53.2 46.8 100.0 44.4 55.6 100.0 42.1 57.9 100.0 47.4 52.6 100.0 58.8 41.2 100.0 73.3 26.7 100.0 25.0 75.0 100.0 62.5 37.5 100.0 40.0 60.0 100.0 46.4 53.6 100.0 ... three years and long before Without her support and encouragement I would not have undertaken this PhD and for that, as well as much else, I am very grateful Professor Trevor Spratt became my second... study I will reciprocate! Jake, Abby and Luke have endured three years of hearing about ‘Mommy’s PhD with incredible patience, understanding and good humour, making me even more proud of them... social worker and my more recent involvement in research provided the inspiration for undertaking a PhD in this field A dearth of robust and good quality Irish child protection research was identified