Think child, think parent, think family: a guide to parental mental health and child welfare
Putting it into practice - lessons about practice: promising ideas
There were a number of approaches in the sites that seem to be promising in embedding whole-family working in adult mental health and children’s services.
A number of sites undertook relatively quick and low-cost actions, which helped start the process of change. See Practice example 20.
- lunchtime learning sessions
- ensuring that Think Family is included in staff inductions and safeguarding training
- liaison with key staff teams to ensure that practice is supporting a Think Family approach, for example, that Child in Need risk screens are being completed.
These types of action were helpful in raising staff awareness at an early stage of the project. This gave the work a sense of progress and achievement from the start.
Linking with related initiatives
This work is closely linked to a number of other agendas relating to vulnerable adults, parenting, and young carers including:
- Hidden Harm – Hidden Harm strategies are local responses to the Advisory Council on the Misuse of Drugs report on the impact on children of problematic drug use by parents. Links were made to this in Northern Ireland and two of the English sites.
- Parenting – There were clear links between this work and local parenting strategies. Some the potential benefits here were threatened following cuts to funding for parenting support.
- Vulnerable adults (PSA16) – This Public Service Agreement aimed to support vulnerable adults, including those with mental health problems, and therefore had links to this work. Again, however, the funding associated with this initiative has been cut.
- Young carers – The practice guidance to the Carers (Equal Opportunities) Act 2004 states that local authorities should have ‘a protocol, shared between adults’ and children’s services, for identifying and assessing young carers.’ A number of the implementation sites made links to their young carers’ strategies.
- In Northern Ireland, the reform of child protection services led by the Reform Implementation Team has also been an important link.
Ensuring that links were made to these initiatives was an important way of sustaining the Think Family agenda after the period of implementation support from SCIE. It also promised to reduce duplicated efforts at a time of reduced resources. See Practice example 20.
Building capacity in the voluntary and community sector
In many of the sites, the voluntary sector provides numerous services to parents with mental health problems and their families. However, the work in Northern Ireland in particular has shown that while this sector provides a valued and trusted service, their systems and processes were not always conducive to effective screening, assessment and onward referral of parents with mental health problems.
Work was started in the region to improve and standardise referral forms and processes, and it appeared that the project improved the capacity of the sector to contribute to a Think Family approach to parental mental health.
Support for voluntary organisations to undertake their safeguarding and screening/signposting roles as effectively as possible was therefore a promising area of practice, particularly given the increased role that the voluntary sector is likely to play in future service delivery. Voluntary organisations need to communicate effectively with each other where more than one organisation is involved with the same family. Statutory services also need to ensure that voluntary and community organisations are well integrated into multi-agency processes to share information and co-ordinate services.
Learning from the sites suggests that the practitioner champions model was a promising way of improving frontline practitioner knowledge and relationships. One site set up a practitioner champions group and the benefits of this group included:
- networking and forming relationships
- learning about the basics of each other’s roles
- clarifying terminology
- highlighting systemic issues to feedback to the project steering group and senior managers.
The progress of the champions group led to the model being introduced in another English site, and Northern Ireland also designate staff as Think Family champions. It was notable, however, that once the champions group had developed a greater awareness about the issues involved in whole-family working, they then found the systems they used, such as assessment forms and practices, unsupportive of their increased enthusiasm for collaborative approaches. This tended to reinforce the sense that senior support is vital so that systems can be altered. See Practice example 3.
Building on the Common Assessment Framework (CAF) and Team Around the Child (TAC) processes
Both the CAF and TAC processes can form a useful basis for a Think Family approach. The CAF is an assessment process for young people with needs which do not meet the criteria for statutory services (Tier 2). The CAF is intended to be a holistic assessment of a young person’s circumstances and needs and, in many areas of the country, is used as the main way of referring a young person for support. Some of the sites identified the potential of the CAF to support whole-family working by encouraging practitioners in adult services to complete CAFs, and by encouraging all practitioners to take a holistic view of the whole family (not just the child) when completing the CAF.
TAC is a process for supporting a child who has additional needs. All the professionals involved with the child meet on a regular basis to plan and coordinate their care. One person is usually nominated the Lead Professional. A similar process is the Team Around the School, in which multi-agency groups of professionals meet to discuss children from particular schools who are raising concerns. Several of the English sites sought to expand the Team Around the Child/School to a Team Around the Family, with professionals who work with the parent also attending.