PA0081

Written evidence submitted by Birmingham SEMH Pathfinder

  1. About us

The Birmingham Pathfinder provides intensive, sustained and relational support for families facing serious disadvantage, through schools.

Most of our work takes place in the Northfield district in the south of Birmingham. We are currently supporting 343 families through 35 primary and secondary schools and a large FE college.

The Pathfinder is a collaborative project sitting across the schools, Birmingham Children’s Trust and the voluntary sector.

  1. Our approach

Our approach developed from the following problem statement, as experienced in practice by the Pathfinder’s founder, a frontline social worker:

Families experience multiple challenges

Services fail to respond promptly and effectively

Needs escalate to crisis point

 

Many families face serious interconnected social problems (and resultant trauma) including DVA, inadequate housing/homelessness, SEND, poverty and financial vulnerability, substance misuse and mental ill health.

 

Children’s anxiety and distress about these familial challenges often manifests as behavioural issues at school including reduced attendance.

 

 

Too often the services that are meant to support people are disconnected, siloed, crisis-focused and short-term (and hard to access in the first place).

 

Schools may not understand children’s behaviour as communication and resort to behaviour management approaches (including eventually exclusion). 

 

Families feel judged and patronised and relationships with services including schools break down

 

 

Problems are not prevented or resolved but escalate.

 

Children’s potential and the wellbeing of families are damaged.

 

Costly crisis interventions become necessary including children’s social care, primary healthcare, criminal justice etc. 

 

 

 

 

Instead, we want to see the following, and suggest this would maximise attendance:

Children

 

Families

Schools

 

All children thrive in settings which are trauma-informed, nurturing and inclusive.

 

If problems occur, caring and relational expert help is on hand to resolve challenges before they escalate.

 

 

 

Families feel confident that schools understand their children’s needs and will support them effectively.

 

They know that help will be available at an early stage from a trusted person if they encounter challenges they can’t resolve.

 

They are part of networks of mutual support and action with other families, sharing experiences and strategies for self-help.

 

 

Schools are trauma-informed and inclusive, with an understanding of the social context of children’s lives.

 

They have strong relationship with families.

 

Schools can call on an ecosystem of expert advice and support if they need help to support a particular child/family with SEND and/or other issues

 

The Pathfinder approach is based on the principle that sustained trusting relationships are the foundation of any work to identify and address challenges and difficulties. We also believe a holistic and flexible approach is needed, which can engage with the full complexity of people’s lives.

  1. How we operationalise this

School-based Pathfinder workers provide direct support to children and families, making the most of the relational potential inherent in the 11 years children are in school.

In turn these school-based workers are supported by a core team of multi-disciplinary experts who mentor, train and advise them, and co-work the most complex cases. The also provide direct access to specialists (in early years, domestic abuse, housing, substance misuse, benefits and debt, SEND etc).    

This means schools develop expertise, confidence and capacity for skilled, trauma-informed, values-driven support for families, and this becomes part of their normal practice. Expert advice is always on hand through the core team.

 

  1. Our evidence

In 2021 Social Finance conducted an independent rapid evaluation of the Pathfinder approach. They found that:

•The Pathfinder significantly reduced fixed-term exclusions from mainstream schools 

•The Pathfinder reduced referrals to Children’s Social Care

•The Pathfinder reduced how many children and young people need a social worker

 

The qualitative element of the research found a broad range of benefits including improved family engagement with schools and statutory services, improved attendance at school, families being able to meet their basic needs, prevention of escalation of issues to crisis point, improved physical and mental health and overall greater resilience, autonomy, and wellbeing.

 

Wider literature

There is much existing research that supports relational, holistic approaches like the Pathfinder. In a literature review as part of the evaluation, Social Finance concluded “the importance of multi-disciplinary and holistic interventions, connecting entire families and schools, is noted throughout the literature as having strong potential for improving outcomes for children and families with complex needs. The need for a joined up approach to support vulnerable families is vital”.

  1. Your questions

Our response to your questions is informed by our frontline experience and the evidence we have around the efficacy of multi-disciplinary and relational approaches like the Pathfinder. 

We have concentrated on the first two questions as these speak more closely to our expertise.

a)      The factors causing persistent and severe absence among different groups of pupils.

We know most about disadvantaged children and those with SEND.

Our experience is that there is always a social/familial context to persistent and severe absence, linked to the serious and interconnected challenges the families we work with face.

These contextual factors may include practical reasons good attendance is difficult, for example parental ill health (both mental and physical) and/or disability, difficulties managing a plethora of appointments with various professionals, distance from school etc. 

Case study

 

Andy is a single dad of four children.

Andy has a chronic bladder condition since childhood which impacts on sleep and his confidence to be away from his flat for long periods of time. This had led to the children being regularly late or absent from school because of difficulties with morning routine.

 

Andy had been in care as a child and so was his father. This has impacted on his emotional and psychological wellbeing and means he has a mistrust of agencies, including school, health and other statutory services. This led to him not seeking/accepting help.

 

All of the above has meant the relationship with school has become strained.

 

 

They also include other factors, for example significant stress and overwhelm within families (especially when trying to manage the process of gaining appropriate support for children with SEND), trauma, bereavement, debt, anxiety caused by environmental factors such as poverty and homelessness and lack of support networks. 

These contextual factors are felt by children and impact on their own mental health. In some cases, children do not want to leave parents at home while they go to school because they are worried about them.

Case study

 

Melanie is a single mum of three children (Jessica at primary school, Izzy at secondary school and Zak at college).

 

The children’s dad passed away from cancer in the family home in 2021. The family have not accessed any counselling about this.

 

Izzy has not attended school since before lockdown, she suffers with anxiety and won’t go out without Melanie. She is also closed off from speaking to anyone about her feelings. Melanie also suffers with mental health issues - currently she takes medication to help her cope.

 

Both girls have sleeping issues - Jessica will only sleep in Melanie’s bed since her dad died and Izzy does not a have good sleep routine.

 

Zak has low attendance at college. Melanie feels this is due to him lacking in confidence in his English ability and she thinks he may suffer from dyslexia.

 

Melanie is in a lot of debt and struggling to pay for essentials since the children’s dad died. 

 

 

Our experience of supporting families with children with SEND is that this is an additional factor, often interrelated with other factors.

Implicit in all the above is a structural/systemic element to absence, which is about the immense stress experienced by parents (who have often already experienced trauma in their own early lives), because of poverty (worsened by the cost of living crisis) and inadequate housing/homelessness. If a public health approach was taken to this, and families lived in decent conditions with an adequate income, many expensive social harms (including poor attendance at school) would be prevented.

Case study

 

Tina and Rob live with their four children in a two-bed high-rise flat.

 

The oldest child, Rosa, has additional needs (ASD, ADHD, ODD & OCD). Sharing a room impacts on her ability to regulate her behaviour, which in turn impacts on her parents and siblings due to the overcrowded conditions.

 

Both parents have serious mental health issues. Tina is diagnosed with anxiety, depression and EUPD (emotionally unregulated personality disorder) and Rob has a CPN for anxiety, depression and bi-polar disorder.

 

 

Attendance issues can be seen as a red flag for families who may be experiencing intolerable stress and who need support, rather than a discrete issue that can be addressed on its own.

b)      How schools and families can be better supported to improve attendance

We strongly believe that without a good and trusting relationship with a family, vitally important contextual factors can never be understood and resolved.

Our model is adaptive, trauma-informed, strengths-based, delivered by the school workforce and surrounded by a multi-agency ecosystem of advisors, counsellors and supporters. This approach means the children and families’ needs, experiences and perspective are centred within a relational model of support. At its heart is a desire to understand the wider context of a family and empower them to use their strengths to overcome barriers affecting their lives.

We coproduce solutions and strategies with families, that are meaningful to them and therefore more likely to work. We have found that sometimes very simple things can help, but they need to make sense within the context of the family and will not work if they are imposed.

We suggest it is unhelpful to add another professional with a narrow remit to the army of other professionals with narrow remits who are often already involved with families facing multiple challenges. We know families often experience a ‘revolving door’ of involvement with services over many years. The revolving door experience can lead to mistrust of professionals; it can lead to re-traumatisation as families retell their difficult case histories (‘assessment fatigue’); and it does not allow for a deep enough relationship to make lasting change.

We also think punitive approaches are unlikely to help and may irreparably damage relationships with the school. In our experience, it is better to build a good relationship with a family and use this as the conduit for support, strategies (as above) and if necessary and when appropriate, challenge.

It is also important that schools are inclusive and trauma-informed places.

In summary:

-          Persistent absence is almost always a result of complex contextual stresses and strains within a family.

-          Sustained, trusting relationships are the only way to uncover and understand these deeper issues. They enable workers to coproduce effective strategies with families.

-          It is not helpful to have multiple professionals involved for the short term, and with narrow remits – this creates assessment fatigue and mistrust.

-          With the right support (such as that offered by the Pathfinder) the school workforce is well-placed to build trusting relationships with families facing adversity because of the pre-existing long-term relationship between child and school.  

-          The stresses and strains within families that are the root cause of absence (as well as many other social problems) are being exacerbated by structural factors including rising poverty and inadequate housing/homelessness.

 

February 2023

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