Public Services Committee
Oral evidence: The role of public services in addressing child vulnerability
Wednesday 30 June 2021
Members present: Baroness Armstrong of Hill Top (The Chair); Lord Bourne of Aberystwyth; Lord Davies of Gower; Lord Filkin; Lord Hogan-Howe; Lord Hunt of Kings; Baroness Pinnock; Baroness Pitkeathley; Baroness Tyler of Enfield; Baroness Wyld; Lord Young of Cookham.
Evidence Session No. 18 Virtual Proceeding Questions 134 - 138
I: Lauren; Sheridan.
The Chair: Welcome to both of you. Thank you for joining us. My name is Hilary Armstrong and I chair the Public Services Select Committee in the House of Lords. I know people have talked to you about what that is all about. My colleague Baroness Tyler will lead this next session, where we are going to hear from you.
Q134 Baroness Tyler of Enfield: Welcome to both of you. My name is Claire. I am part of this committee. Our role is to look at how public services are helping vulnerable children, and to try to come up with ideas and recommendations for improving that. We have listened a lot to people, but by far the most important people we listen to are those with lived experience, because we really need to hear their voice and hear what it is like in their own words. We are very grateful to you for doing this.
These are completely private conversations, and it is entirely up to you what it is about your personal experience or your work that you want to share. We recognise that that can be tough at times. Perhaps you could introduce yourselves. Particularly from the work you do as volunteers, could you say something about what life is like for vulnerable children who are experiencing difficult times at home?
Lauren: The thing we thought when we saw the questions beforehand is that there is no one experience of vulnerable children. That phrase “vulnerable children”, in a way, can be a bit misleading. There are certainly children with specific vulnerabilities and specific problems at home, but every family unit, regardless of the underlying challenges it faces, will undergo tough times. The experiences are also varied, depending on the support they have had from services.
For example, one young person talks about school being their me time, which heavily implies that she is experiencing issues at home, if school is her space. You can infer from that comment that, because she has this me time at school, it is not a wholly terrible experience. The key takeaway is that public services have a huge impact on children who have vulnerabilities in specific areas, either positively or negatively. It is our responsibility as people in positions of power in these services to ensure that they are always doing the best for the children. I will just hand over to Sheridan briefly, and then I will come back to a few more points on this question, if that is all right.
Baroness Tyler of Enfield: That is fine. Sheridan, would you like to share something of your experiences?
Sheridan: The first thing that I thought of, thinking about children and their experiences, is the major link between the school environment and the home environment. If you do not get that support from your house, being in school, as a safe place, and experiencing that security is a really major thing. That was prevalent through what I have seen and experienced.
Children feel like they have to adapt to school and to services, but the school needs to adapt to the children’s needs, not the other way round. School, from the children’s perspective, is seen more as a risk than an opportunity to learn and broaden their experience and knowledge. It is also a challenge to catch up, for example if you have a setback, especially with mental health. Even if you are getting that type of support within school, it takes you back. It is a back-blow to the race that is the school curriculum. We heard one of the quotes: “Education should look beyond the subjects and at what is happening in the young people’s lives to focus on the support.”
Q135 Baroness Tyler of Enfield: That point about the school being me time is incredibly important. Thanks for emphasising that. You both talked primarily about children’s experiences with schools. Is there anything you would like to add about their experiences, particularly if they are having a really tough time at home, in relation to their own physical and mental health?
Lauren: It is very interesting. One of the key points in regard to the effect it has on physical and mental health is whether these physical and mental health problems are picked up and can be targeted. I will quickly pop back to schools, and I promise I will move on. I just wanted to flag that, although some people are home schooled, school is almost a completely universal service in terms of comprehensive education, so it has a responsibility to pick up these issues and to provide the support that children need. It is one of the very few services that everyone, regardless of what is happening at home, is coming into contact with daily. I know they are under a lot of pressure, but teachers are in a unique position here to help, to assess the risks of vulnerable children and to provide support.
You mentioned mental health. Mental health problems—[Inaudible.]—can be treated much more effectively. We found in our research that, as has been in the news a lot, there are huge waiting lists. One young person we spoke to had been in hospital after a suicide attempt and still had to wait five months to receive counselling. By that point, they had got to the most extreme position possible with mental health problems. I know the next question is on barriers, so I will try not to cover it too much, but whether they can get help with their physical and mental health problems is also dependent on whether they have parents who can support in accessing it.
The other thing to raise is how things can have a knock-on effect. If you are having problems at school and you feel like you are falling behind, this can impact your mental health, which can further impact your grades. Your mental health might be impacted by problems at home, which then impact your grades, which then impact your mental health, in the same way that, if your family is receiving benefits and then the benefits are stopped, this puts pressure on you. Then it impacts your mental health.
You cannot really take mental and physical health in isolation. You have to think about both how the young people can access support and how available it is, but also the underlying causes and how that links up to other aspects of public services, as well as the responsibility that public services have generally and their role in picking up these problems when and if they occur.
Baroness Tyler of Enfield: The point you make that physical and mental health cannot just be looked at as if they are two completely separate things is so important. Sheridan, before we move on to talking about how easy or otherwise it is for children to access the services they need, is there anything else you wanted to add about the type of health challenges that vulnerable children might be facing in their homes?
Sheridan: I would like to add a little bit about the challenges that come with the vulnerability of children. Even if you have an awareness that you can go and get help, there is the feeling that you need to be in a serious space. You need to let your issues get serious enough to be flagged by social services or to reach a crisis point in order to attempt to try to access services. This can lead to families being in desperate circumstances for longer periods than would have been necessary if they had reached out earlier. That plagues the family with instability, and their mental and physical health will be at risk.
If this part of welfare is not addressed, those aspects, as Lauren said, create a knock-on effect on other aspects of their lives.
Q136 Baroness Tyler of Enfield: That leads us very neatly to the next issue that I wanted to hear your thoughts about. That is really what you think the main barriers or obstacles are that make it difficult for children and families to get the help they need from public services.
Lauren: Systems are very complex. This has especially been noted with the benefits system, but it is true of other aspects of public services. We saw that, increasingly, children in refugee or migrant families are often having to help their parents navigate a very complicated benefits system, because their parents might not have had English as a first language, or they might not be fluent. Even if they are, trying to access benefits requires a certain level of technological skill. This is putting pressure again on young people.
This links to the issue Sheridan mentioned about people waiting for crisis points. One of the things that I found most striking was that young people we spoke to reported feeling as if they were a burden on the NHS, and often waiting until, as we have talked about, they got to a crisis point. It was not until they got to a crisis point that they even felt like they were ill enough or desperate enough to seek help. That was quite an interesting barrier, I found, because it was a bit less tangible.
For personal independence payments and things like that, there are lots of very stringent criteria. One young person said they felt like they were able to access it only because their mum worked with disabled people so was aware of how the form worked, and they were not sure they would be able to do it on their own. Other people reported feelings of shame and stigma when accessing benefits. One young person actually said, “I feel happier without it, even though I am getting less money”, because of the extent of shame and stigma around benefits.
Other barriers include knowing there will be a really long waiting list for mental health support, so just thinking, “What’s the point in going, if I know I’m going to have to wait six months?” and having had a bad experience in the past and feeling like they have been fobbed off. Then young people quite rightly do not really feel like there is any point in going back.
We wanted to stress the issues with safeguarding. It links to one of the first points that came up, when I said that schools have an obligation to try to provide support and pick up on any issues that young people might be going through. They do. I appreciate that the current safeguarding measures are really important, and I am not trying to argue against safeguarding, but there is a feeling among a lot of my friends who have what might be considered safeguarding issues at home that they basically do not want any safeguarding measures to be triggered, so access support only for the issues that they do not think will get them into trouble, as they see it, with social services or trigger any of those safeguarding measures.
I have spent quite a bit of time with friends, working out how we can phrase their issues so we do not trigger any of the safeguarding apparatus, because otherwise they are not going to seek help. Safeguarding is really important, but in a way it makes children feel powerless, because once something is seen as a safeguarding issue it triggers a load of things that have to happen. Suddenly children realise that they are just a risk to be managed and they are not seen as an individual, because—[Inaudible.]
Along with young people feeling like they are a burden, when I was going through the research, preparing for this meeting, I noticed that in our NHS section an entire A4 page of quotes was dedicated to young people recognising the amount of strain NHS staff were under and saying, “Nurses should be paid more”. “The conditions are poor”. “My teachers are not paid enough. I can see that they’re stressed”. That understanding from young people that services are already under stress is making them not want to add to it. It is making them change the support they ask for, to try to fit into the service, as opposed to getting all the support that—[Inaudible.]
Baroness Tyler of Enfield: You have given us a lot to think about there: the complexity, links with the benefit system, safeguarding and services being overloaded. Sheridan, would you like to give us your perspective on what the obstacles or barriers are in seeking help and support?
Sheridan: One barrier that is very important, especially if you are dealing with mental health, is the time limit of support. That is quite a negative thing that I find. I have experienced this from the perspective of my friends being taken into the system and asking for support to do with their mental health, where there is a specific time limit, for example six months or 18 months, to get them into a stable place. Also, when they turn 18 and become an adult, that support seems to diminish. This really had a negative back-throw effect and basically rewrote all the positive things that the support had done for their mental health.
Furthermore, going back to the powerlessness that Lauren mentioned, young people do feel powerless when they are reaching out for support, because they do not feel like their needs have been met properly. We have reports that some young people feel like their dignity was diminished when they went and reached out for the support, as they were not aware of or told what the process of their support would entail, so they felt in the dark. Communication came across as a very important point.
Furthermore, we have another report from an LGBTQ young person who was being housed, and they felt that it was inappropriate, as they believed that the housing should take them into account and be tailored to them more sensitively, in order for them to feel safe and free in their home.
Q137 Baroness Tyler of Enfield: You have both given us a lot of obstacles to think about. Moving on to the final bit, which is more about solutions, if possible, could you give us examples of services that you feel have worked well for children and their families who are in really difficult circumstances?
Lauren: One of the things that some people were really positive about was this idea of school being a separate place to the home for when young people were struggling. As we have heard, not all school is perfect, and young people were quick to raise criticisms with many aspects of it, but in providing a space, as I have said, away from home for a considerable amount of time, where people were able to build up relationships with peers and teachers, it was to some people very important.
One of the things that I found really striking was a quote from a young person who said, “One teacher gave me a card, which said, ‘You’re the reason I stayed in teaching’”, and that stuck with me. I thought, “Yes, that’s what we want, isn’t it?” We want to create environments and services where both the service provider, the teacher, and the person using the service, the pupil, can build a relationship that benefits both people. As you see from that quote, the teacher stayed in teaching because they got a sense of reward and validation due to the positive impact that they had on that individual.
When we are thinking about how we can improve services and changes we want to make, providing space for those relationships to develop in a way that is beneficial for both parties is key. One of the things to stress is that teachers and NHS professionals are doing it under a lot of strain, and positive relationships should not be a reason not to fund. We have to provide the services, with the funding, with the support, with the time to develop those relationships in depth, so that everyone can come away feeling valued.
One of the criticisms of school was that it was very narrow. It was not taking a person’s whole situation into account. This idea of a holistic approach is something that can be taken into all services. In your first question, you asked, “What is life like for the people you might class as vulnerable in lots of services?” One of the things we raised was that things are interdependent. If you are struggling with benefits and you have a mental health problem, you might struggle at school, which might make your mental health worse. Then, because you do not have enough money, you might struggle to access housing, which again makes the whole thing worse. You might have to move schools.
On the flipside of that, thinking about what works, it is really positive when services talk to each other. Just like when you take one person’s circumstances into account it can build a relationship, when you take their service context into account, get services talking to each other and think about how different things interact, that is really positive. It is about relationships, interdependence, good funding and a holistic look at people’s needs. It is about not following young people into a specific system, be that a curriculum or a benefits set. It is about treating young people as individuals, as Sheridan said, with dignity.
Q138 Baroness Tyler of Enfield: That is brilliant. There is a lot there for us to think about. We are slightly up against the clock now, but would you very briefly like to say anything about the role that you think charities or community groups play? Obviously, it is not all about statutory services.
Lauren: The reason charities and community groups have played such a big role is because we have cut down statutory services. They play a large role in young people’s lives and they are really important. Volunteering for charities and being part of a community is key to our sense of belonging. Basically, charities should not be used as a reason to fund less or not to provide services. This is especially true because some of the young people we spoke to felt cut out of their communities and not able to access or be empowered in community groups and services. There was a real desire for community groups that were not necessarily based around a faith and that were accessible, especially for young people with disabilities.
It can be really positive. One of the things we talked about was young people accessing GP services. When the GPs came into a youth centre, that really increased the uptake of that service. It is about boosting communities, funding services and providing services in such a way that young people can access them.
Baroness Tyler of Enfield: Sheridan, I wonder what examples you might like to give of services you thought had worked well, be it statutory services or charities and community groups.
Sheridan: As an example of a service that was reported to work well, there was a quote from a young person in supported housing: “The supportive workers have made me feel really welcome, supported and staffed me 24/7, so you always have company. You can cook with them, watch a film, et cetera”. I found this example of a young people who feels supported, with a sense of normality and an equal relationship, very important. Rather than a professional and a patient, it was more like a connection.
Furthermore, to lean into the community-based services, it was reported by young people that they feel empowered when they exercise their human rights, for example through LGBTQ talks. They feel like they need more of these, but there is a range of community services, mostly faith-based, and they would like to get the best from those.
Baroness Tyler of Enfield: You have both packed a huge amount into your responses, so thank you so much for doing that, giving these issues a lot of thought and basing it on the insight you get from your volunteering work. Thank you for everything that you are doing there. We are incredibly grateful to you. Getting these insights from you really helps us with our work. Thank you very much indeed.
The Chair: Thank you to Lauren and Sheridan. It is very clear that you have done an enormous amount of preparation, work and thinking through how you wanted to deal with the questions. We are really grateful to you for that, but it means that we may have missed something that you had been ready to say to us. If we have missed anything or if there is anything else that you think of that we should hear about, please let us know. I know that Children England will make sure that you have our contact details so that you can do that.
Can I just say thank you to you? It has been a very valuable session for us. Best wishes for the work that you are doing and for the Young Leaders programme. It really is a very good programme, and I hope that you can both continue to benefit from it and to contribute to it. Thanks very much for spending time with us this afternoon.