Mental Health Awareness Week 2019
It’s Mental Health Awareness Week, and this year’s theme is Body Image – how we think and feel about our bodies. Body image issues and mental health problems of all kinds can affect all of us, at any age, at any time. 
One in eight 5-19 year olds have a clinically diagnosed mental disorder. Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems.
‘Body image’ is a term that can be used to describe how we think and feel about our bodies. Our thoughts and feelings about our bodies can impact us throughout our lives, affecting, more generally, the way we feel about ourselves and our mental health and wellbeing.
An important key to promoting children’s mental health and feelings about themselves is to understand the protective factors that enable children to be resilient when they encounter problems and challenges. Resilience is linked to self-esteem and confidence and a belief in own self-efficacy and ability to deal with change and ability to adapt and being able to have a range of problem solving approaches.
These tips will give you some pointers on how to improve self-esteem:
- Keep a top-10 list of things you like about yourself: Things that are not related to how much you weigh or what you look like. Read your list often.
- Remind yourself that true beauty is not skin-deep: Look at yourself as a whole person, beauty is a state of mind and not a state of body.
- Surround yourself with positive people: It is easier to feel good about yourself and your body when you are around others who are supportive and who recognise the importance of liking yourself just as you are.
- Clothes: Wear clothes that are comfortable and that make you feel good about your body.
- Body image and the media: Reduce your amount of social and media access. Be aware of images, slogans, or attitudes that make you feel bad about yourself or your body and remember that these images may have been edited by Photoshop.
- Do something nice for yourself: Do something that lets your body know you appreciate it. Take a bubble bath, make time for a nap or find a peaceful place outside to relax.
Mental Health Services in Brighton & Hove
See here for a list of Mental Health Services for Children & Young People in Brighton & Hove.
Training
The LSCB offer training for Children’s Services staff to explore the way parental mental health difficulties can impact on the lives of children and young people. The day session explores how they can work together to create better outcomes for families. The aim is to promote effective working together across agencies when working with families where a parent or carer has a mental health problem.
See more about the event and how to book a place here.
Event – Body Image: How we think & feel about our bodies
Join the mental health charity Mind to explore the impact of body image on mental health and wellbeing through interactive activities, short films, information and friendly conversations. Take part in body collage and positive body image pledges.
Come and say hello: Friday 17 May, 3-6pm in Wellsbourne Health Centre, Whitehawk
Read the body image report by the Mental Health Foundation
Read a blog from Mental Health Foundation CEO Mark Rowland on this year’s theme
Sources:
Children’s Society: Body Image
NHS: Mental Health of Children and Young People in England, 2017
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1. Universal
Has needs met within universal provision. May need limited intervention within the setting to avoid needs arising.
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2. Early Help
Has additional needs identified within the setting that can be met within identified resources through a single agency response and partnership working.
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3. Early Help Partnership Plus
Has multiple needs requiring a multi-agency coordinated response.
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4. Specialist Services to address Acute & Chronic need
Has a high level of unmet & complex needs, or is in need of protection.
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Child developmental needs
- Good attendance (above 90%)
- Meeting developmental & learning milestones
- Has emotional well-being
- Ability to protect self and be protected
- Resilient and able to adapt to change
- Physically healthy
- Age-appropriate self care & independence skills
- Ability to express needs
× Good attendance (above 90%)
× Good attendance (above 90%)
× Meeting developmental & learning milestones
× Meeting developmental & learning milestones
× Has emotional well-being
× Has emotional well-being
× Ability to protect self and be protected
× Ability to protect self and be protected
× Resilient and able to adapt to change
× Resilient and able to adapt to change
× Physically healthy
× Physically healthy
× Age-appropriate self care & independence skills
× Age-appropriate self care & independence skills
× Ability to express needs
× Ability to express needs
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Child developmental needs
- Absence/truancy from school
- Statistics show a direct link between under-achievement and absence below 90%
- Regular attenders make better progress, both socially and academically
- Regular attenders find school routines, school work and friendships easier to cope with
- Regular attenders find learning more satisfying
- Regular attenders are more successful in transferring between primary school, secondary school, and higher education, employment or training
- Incidence of absence/missing from home
- Persistent poor behaviour in school
- Behaviour is impacting child’s ability to learn.
- Behaviour is impacting child’s relationships with peers and with adults in school.
- Behaviour is impacting child’s access to education (frequent removal from classroom, including internal exclusion).
- Risk of social exclusion
- Poor relationships
- Language and communication difficulties
- Disability or additional special educational needs
- Have a significantly greater difficulty in learning than the majority of others of the same age
- Have a disability which prevents or hinders them from using the facilities generally provided in mainstream schools or colleges.
- Children’s Disability Service at Seaside View Child Development Centre Integrated services for children and young people with SEND including health, education and social care
- Brighton & Hove Inclusion Support Service School-based support for children and young people with SEND
- Community Mental Health and Wellbeing Services Mental health services for children and young people with and without SEND
- Difficulty in achieving in education
- is significantly slower than that of their peers starting from the same baseline
- fails to match or better the child’s previous rate of progress
- fails to close the attainment gap between the child and their peers
- widens the attainment gap
- Potential for becoming Not in Education, Employment or Training (NEET)
- increased levels of absence or truancy
- low levels of prior attainment
- behavioural or social difficulties
- chaotic family background
- offending or at risk of offending
- in care/care leaver
- young parent
- Slow in meeting developmental milestones
- Schools and parent/carers can access supportive health and wellbeing information through NHS Choices, or contacting the appropriate HCP 5-19 team
- Missing health checks/immunisations
- Minor health problems
- Contact NHS Choices for information about managing minor health problems. If worried about an urgent medical concern, call 111 and speak to a fully trained advisor.
- Where to go for: Health
- Early signs of offending/anti-social behaviour
- School disruption
- Missing from education
- Missing from home
- Coming to police notice
- Coming to the attention of Community Safety Team
- Family breakdown
- CAMHS referral
- Poverty/deprivation
- Underage sexual activity
- Early signs of drug/alcohol misuse
- Promote improved educational outcomes for vulnerable pupils who may be involved in substance misuse
- Offer advice and consultation to school staff, including drug coordinators, on substance misuse management issues.
- Provide individual support at a targeted level for young people who may be engaged in substance misuse, this will include supporting young people who are at risk of exclusion or who are returning from exclusion
- work with families and other agencies to support the young person.
- Poor self-esteem
- Low level emotional & behavioural issues that may be linked to attachment and/or emotional development delay
- Young carers
- the family have little or no support network around their health or caring roles, including through friends, family and professionals
- the young carers is doing multiple inappropriate tasks, such as personal care, budgeting or precociously mature, emotional support
- there is a significant impact on the young carers school attendance and attainment
- there is a significant impact on the young carers mental or physical health
- Bullying
- Advice for Schools: Preventing and tackling bullying
- Safety Net
- Bullying UK
- Brighton & Hove City Council’s leaflet for parents, which includes advice for talking to the school about the problem as well as ways to support your child.
- Children who have previously been in Care, and children living away from their birth parents e.g adopted children, Special Guardianship Orders, Kinship Care.
- Priority School Admission – please contact School Admissions
- Pupil Premium Plus payments made to support their school in meeting their additional needs (as long as the parents or carers have informed the school of their status) – discuss with your class teacher at school
- Assessment for Special Guardianship or Adoption Support needs: This entitlement extends to Children and their carers if subject to an SGO or child arrangement order / Residence Order. For Adopted children, the child, the parents, and any siblings of the child in the adoptive family are entitled to assessment of their adoption support needs. These assessments are additional to any other assessments of the child’s needs and development.
- Therapeutic Support – The Adoption Support Fund is a fund provided by the Department of Education which exists to fund specialist therapeutic assessments and therapy for children who are adopted from care, or who were in care and are now subject to a Special Guardianship Order. The fund offers up to £2500 per year for specialist assessments of therapeutic needs and up to £5000 per year for therapy. Unfortunately those children subject to child arrangement orders or residence orders are not eligible for this funding. Those children who are subject to SGO but were not previously in care are also not eligible for this fund.
× Absence/truancy from school
Attendance less than 90%.
Good attendance is important because:
Parents & carers have a responsibility to make arrangements for the education of their children either at school or “otherwise”. Education “otherwise” includes being taught at home by a parent or private tutor. They must provide an education that is efficient, full-time and suitable for their child’s age, skills and capability, taking into account any special needs that the child may have. For more information on Elective Home Education in Brighton & Hove please visit here
Brighton & Hove Educational Psychology Service have developed a tool to support understanding why children are persistently absent from school. This is called the ATTEND Form and is available for all schools to use to problem solve the situation with their Educational Psychologist.
× Absence/truancy from school
Parents can be signposted to information on NHS Choices to ensure their child is well enough to attend school.
× Incidence of absence/missing from home
An indicator of a child being at possible risk of exploitation is linked to children beginning to go missing from home, with their whereabouts unknown.
× Incidence of absence/missing from home
× Persistent poor behaviour in school
Persistent poor behaviour, where the child does not respond to the standard school behaviour policy (including use of consequences)/reward measures by school and parents/carers:
Schools take a staged approached, based on their Behaviour Policy, which might include setting up a support plan and undertaking a review of child’s learning needs and consideration of whether the child needs to be recognised as SEN.
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× Persistent poor behaviour in school
× Risk of social exclusion
Social exclusion is “a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of a society as a whole” (Pierson, 2002).
People who are socially excluded do not have access to the same institutions, services and social support networks that most people in a society take for granted. Although poverty is usually the main cause of social exclusion, there may be other contributing factors, such as racial discrimination or low educational achievement.
× Risk of social exclusion
× Poor relationships
The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond. If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Health Visiting Service for further support / advice. Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator).
× Poor relationships
× Language and communication difficulties
Pre-school
Children’s speech and language will be routinely reviewed at the 27 month health review. Those identified with difficulties will be offered interventions through the Healthy Child Programme 0 – 19 team, Children’s Centre team and specialist Speech and Language Therapy or Seaside View Child Development Centre as appropriate
School-age
If a child has language or communication difficulties all referrals to S LT are made through school. Schools can refer directly Sea Side View. HCP team 5-19 can make direct referrals to Sea Side View.× Language and communication difficulties
× Disability or additional special educational needs
Many children will need extra help with their learning at some point, but this does not necessarily mean that they have a Special Educational Need or Disability (SEND).
Children and young people have SEND if they:
Special provision must be made for children and young people with SEND. Sometimes this may only be for a short time and sometimes support will be needed for the whole of someone’s life.
Read more about how schools and other educational settings support children with SEND here
Identifying and assessing special educational needs and disabilities (SEND)
If you are concerned about your child’s health or development, you should speak to a professional who works with you or them in the first instance. Depending on your child’s age or circumstances, this might be a health visitor, nursery worker, teacher, social worker or your GP.You can also contact Amaze, the local SEND Information, Advice and Support Service, for advice around diagnosis and assessment.
If your child is at school or nursery, there are certain set processes for assessing their needs and the support that may help them. Find out more about how schools and other settings must support children and young people with SEND here
Where there are shared concerns about a child or young person’s developmental progress, they may be referred for assessment through the following services:
The assessment process might involve seeing different specialist services or being seen in more than one place, for example at the Seaside View Assessment Centre or school or nursery.
Read a detailed overview of identifying special educational needs for all age groups from GOV. UK.
× Disability or additional special educational needs
× Difficulty in achieving in education
Schools should review a child’s learning needs, in accordance with the SEND Code of Practice. A pupil has special educational needs and disabilities (SEND) where their learning difficulty or disability calls for special educational provision, namely provision different from or additional to that normally available to pupils of the same age.
Schools should make regular assessments of progress for all pupils. These should seek to identify pupils making less than expected progress given their age and individual circumstances. This can be characterised by progress which:
Where progress continues to be less than expected the school, should assess whether the child has SEND.
For some children, SEND can be identified at an early age. However, for other children and young people difficulties become evident only as they develop.
Persistent disruptive or withdrawn behaviours do not necessarily mean that a child or young person has SEND. Where there are concerns, there should be an assessment to determine whether there are any causal factors such as undiagnosed learning difficulties, difficulties with communication or mental health issues. If it is thought housing, family or other domestic circumstances may be contributing to the presenting behaviour a multi-agency approach, supported by the use of approaches such as the Early Help Assessment, may be appropriate. In all cases, early identification and intervention can significantly reduce the use of more costly intervention at a later stage.
× Difficulty in achieving in education
× Potential for becoming Not in Education, Employment or Training (NEET)
Young people up to the age of 16 are required by law to be in full time education. Young people aged 16-18 are required to be participating in some form of education, training or employment with training.
Young people who are not fully engaged in school may be at increased risk of becoming NEET at age 16. It is important to identify these young people early, before they disengage from education, so that help can be put in place to support them. Some indicators that a young person is at risk of becoming NEET may include, but is not limited to:
Schools have a duty to ensure that all young people on their roll are engaged in an appropriate curriculum and have access to the right support to enable them to achieve. Level 2 single agency support should be sought from the school in the first instance.
Every school must ensure that pupils are provided with independent careers guidance from year 8 to year 13.
× Potential for becoming Not in Education, Employment or Training (NEET)
× Slow in meeting developmental milestones
Pre-school
Children will routinely have their developmental milestones assessed by way of ASQ-3 assessment at their 9-12 month and 27 month health reviews. If a child is attending an Early Years setting they will be offered an ‘Integrated Review’ incorporating findings from the ASQ-3 domains with the Early Years Foundation Stage development assessment categories. If a child requires support that is additional to, or different from their peers a SEND Support Plan should be put in place. Children identified as slow to meet their milestones may be referred to the appropriate specialist services, for example, Seaside View Child development Centre, including BHISS Early Years Team.If there are concerns regarding speech, language and communication then a referral should be made for Speech and Language Therapy for Children. Children can be reviewed using ASQ -3 assessments at any time from the age of 1 month. This can be accessed by contacting the Healthy Child Programme Team (Health Visiting Service) for their geographical location.
School-age
School-age children who are not meeting their developmental milestones and not progressing in school should be discussed with the Special Educational Needs Coordinator to see if additional assessments or support is required.All Children in their reception year are offered a vision and hearing screening test by the 5-19 Healthy Child Programme team. If the child is identified as having a possible concern they will be referred to an orthoptist or audiologist with parent/carer consent.
If there are subsequent concerns about a child’s vision or hearing this should be discussed with the child’s parent/carer to check whether they are already seeing a specialist. If they are not already being seen by audiology or an optician parent/ carers should be advised to seek a free eye assessment. Special Educational Needs Coordinators can make a referral to audiology directly from Year one onwards.
If there are concerns about a child’s fine or gross motor skills schools should refer to and liaise with their link therapist. Parents can get further support and advice from their School Nurse, or ask their GP for a referral to audiology.
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× Slow in meeting developmental milestones
× Missing health checks/immunisations
Babies are offered regular health and development reviews until they are two years old to make sure their development is on track and support parents & carers. The reviews are usually done by health visitors in the home, or they may take place at a GP surgery, baby clinic or children’s centre
Children are offered a range of vaccines from the age of eight weeks to 14 years. Deciding not to vaccinate a child puts them at risk of catching a range of potentially serious, even fatal, diseases. For more information on the NHS Vaccination programme see here
× Missing health checks/immunisations
× Minor health problems
× Minor health problems
× Early signs of offending/anti-social behaviour
Early signs of offending or anti-social behaviour may include:
It is important to note that early signs of offending/ASB are often also symptoms of trauma or exploitation
Diversion scheme- Adolescent Services:
Children and young people (aged 10-17) who are arrested for a criminal offence and admit guilt are referred to the Diversion scheme, unless the police make an immediate disposal such as a community resolution. All referrals are from the Police, and the decision-making is via a joint panel with Police, YOS and other services as appropriate.
An assessment is undertaken by Adolescent Services with the child or young person and family/ carers, with input from any involved professionals and the case is then referred back to the panel for a decision. If an alternative outcome is agreed (or potentially a caution), Adolescent Services offer a voluntary programme to address offending related issues and risk or safeguarding issues in liaison with other agencies as appropriate.
The purpose is to divert young people from the criminal justice system and if successful, they will complete their programme without getting a criminal record. The programme may include work on offending behaviour, restorative justice (e.g. mediation) substance misuse sessions, family work, sessions with the Police Officer (e.g. knife crime) or services such as CAMHS. The length of the programme would be agreed at the start in relation to risk and need and although this would not usually be longer than 3 months they may be able to offer longer term intervention where required.
If the young person re-offends, they can be referred back to the Diversion panel, provided they admit the offence. The decisions are made on the seriousness of the offence and harm to the victim, the victim’s perspective (where known), the young person’s circumstances and the context of the offence and related risk and safeguarding issues (e.g. if offending is related to CSE or other forms of exploitation). The primary aim is to prevent further offending by offering a package based on the young person’s needs.
× Early signs of offending/anti-social behaviour
× Underage sexual activity
The age of consent for sex in England and Wales is 16 for both men and women. The age of consent is the same regardless of the sexual orientation of a person and whether sexual activity is between people of the same or different gender.
It is an offence for anyone to have any sexual activity with a person under the age of 16. However, Home Office guidance is clear that there is no intention to prosecute teenagers under the age of 16 where both mutually agree and where they are of a similar age.
It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust.
The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity.
Schools and other agencies will / may have a confidentiality policy which clearly dictates what information they will pass to interested parties in relation to under age sexual activity if the young person is aged 13 years and above.
Young people can access their Sexual Health clinic or a Sexual Health Outreach Nurse for contraception, STI testing, treatment and information through sexual health and contraception clinic (SHAC). Trained youth support practitioners are available at a range of community venues and can provide confidential information, advice and signposting. Young people can access free condoms, chlamydia testing and pregnancy testing from a range of community settings.
Some secondary school offer support and advice with regard to sexual health to young people at a weekly drop in run jointly by School Nurse and Youth Worker .
Free Emergency Hormonal Contraception (EHC) is available from Pharmacies across Brighton & Hove. Please phone the pharmacy before attending to ensure the trained pharmacist is available to dispense the EHC. Young people can also access free EHC from their GP or local sexual health clinic. Details can be found here
× Early signs of drug/alcohol misuse
Alcohol and substance misuse services are offered to young people.
Level 2 (targeted) services are available to support children and young people via ru-ok?. These services work to reduce and mitigate the risks to young people and those considered vulnerable. Youth projects in Brighton and Hove offer prevention support to young people around substance misuse. The targeted service will:
Referrals to the service will be accepted from professionals and young people themselves.
Young people should be referred when a substance related incident occurs and where there are concerns that they are becoming involved in regular absence or are displaying changes in behaviour, due to substance misuse. Young people’s consent must be gained for the referral and confidentiality and need for safeguarding should be addressed..
Drinkaware have a definition of the early signs of alcohol misuse and the ‘Talk to Frank’ website offers a definition of the early signs of drug misuse
× Early signs of drug/alcohol misuse
× Poor self-esteem
Self-esteem should be viewed as a continuum, and can be high, medium or low, and is often quantified as a number in empirical research. When considering self-esteem it is important to note that both high and low levels can be emotionally and socially harmful for the individual. Indeed it is thought an optimum level of self-esteem lies somewhere in the middle of the continuum.
Socially children with low self-esteem can be withdrawn or shy, and may find it difficult to have fun. Although they may have a wide circle of friends they are more likely to yield to group pressure and more vulnerable to being bullied.
Living with low self-esteem can harm your mental health, leading to problems like depression and anxiety, and as they get older children may rely on health harming behaviours, such as smoking and drinking too much, as a way of coping.
Research has also shown that low self-esteem has to linked to an increased risk of teenage pregnancy. Read more
× Low level emotional & behavioural issues that may be linked to attachment and/or emotional development delay
Certain individuals and groups are more likely to develop emotional and behavioural problems than others. One in ten children and young people (aged 5-10) has a clinically diagnosed mental health disorder. Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems.
An important key to promoting children’s mental health is understanding the protective factors that enable children to be resilient when they encounter problems and challenges.
Resilience is linked to self-esteem and confidence, a belief in own self-efficacy and ability to deal with change and ability to adapt and being able to have a range of problem solving approaches.
Brighton & Hove Educational Psychology Service support schools with understanding attachment through their Attachment Aware Behaviour Policy Guidance which evidences the importance of whole school approaches on children’s attachment needs.
× Low level emotional & behavioural issues that may be linked to attachment and/or emotional development delay
× Young carers
A Young Carer is a young person under 18 who has a responsibility for caring for a relative (or very occasionally a friend) who has an illness or disability, including some-one with mental health or substance misuse problems. For many young carers, caring can lead to feelings of pride and help develop additional skills. However, caring can also lead to a variety of losses for the child, and have a negative impact on their mental or emotional health, and/or educational attainment and attendance. It can also have an impact on friendships and social activities.
All agencies in contact with young carers should consider if they are in need of support services in their own right, and / or whether the family might benefit from additional support. A key way to ensure the young carer’s responsibilities are minimised is to ensure that the ‘cared for’ is accessing relevant services. This might include Adult Social Care, GP’s, Amaze, The Parenting Team or and wellbeing support.
See The Carers Hub Website for further information and to make a referral. Following a referral The Young Carers Coordinator/ITF Family Coach can ensure that the right support is offered to the family through relevant information and advice, and / or targeted support through The Young Carers Project, who support young carers aged 6 and over.
A Early Help Strengthening Families Assessment and Plan can be completed if the Young Carers Coordinator/Family Coach identifies the following:
A Team Around the Family Meeting may be set up, or an Integrated Team for Families, Youth and Parenting Services Family Coach allocated, where the threshold is met.
The local authority should consider whether any provisions of the Children Act 1989 or The Children and Families Act 2014 and The Care Act 2014, should be applied. Depending on the extent and effect of caring responsibilities, the young carer may come within the definition of a Child In Need under Section 17 of the Children Act 1989.
× Bullying
Bullying is a common form of deliberately hurtful behaviour, usually repeated over a period of time, where it is difficult for the victims to defend themselves. It can take many forms, but the three main types are physical (e.g. hitting, kicking, theft), verbal (e.g. racist or homophobic / religious remarks, threats, name calling) and emotional (e.g. isolating an individual from social activities, cyberbullying).
The damage inflicted by bullying is often underestimated and can cause considerable distress to children to the extent that it affects their health and development. In the extreme it can cause Significant Harm, including self-harm.
There are many reasons why children bully others, and they might not even realise that what they’re doing is bullying. Peer pressure plays an important part in bullying, and children may bully because they want the approval of others. On the other hand, they might bully others because they feel powerless – perhaps because they’ve been a victim of bullying, or they have suffered inconsistent parenting, or lacked warmth and care.
In Brighton & Hove Safety Net’s services are designed to support the mental, physical and emotional well-being of children and young people aged 8 –13 (and sometimes 7-year-olds) across the city. The service works with children, families, schools and neighbourhoods, building communities where children know they have the right to feel safe and adults are actively involved in protecting them from harm.
The council’s Community Safety Casework Team can provide support in some cases of bullying or prejudice-based incidents (hate incidents) as per the leaflet for parents in the link. Please note that the email address to contact the team has changed to communitysafety.casework@brighton-hove.gov.uk
× Bullying
× Children who have previously been in Care, and children living away from their birth parents e.g adopted children, Special Guardianship Orders, Kinship Care.
Children who were previously in care and are now living in adoptive families or with family and friends under special guardianship or child arrangement orders will be living with the impact of the circumstances and experiences which led to the need for them to leave the care of their birth parents.
Many of these children can struggle to respond to usual parenting approaches and strategies because of their past experiences of neglect, abuse and trauma. They have learned their own strategies to feel safe; these don’t always work in their new families and this can present significant challenges to their new parents and carers. This can also mean that some interventions will be less successful for these children than they are for children who are growing up with the parents they were born to and haven’t experienced repeated changes of primary carer.
All children placed with Special Guardians from care, and all children adopted from care are entitled to:
If a family would like an assessment of their support needs (which is required in order to access the Adoption Support Fund), they should make contact with:
The Brighton and Hove Adoption Team at: Adoptionhelpline@brighton-hove.gov.uk 01273 295455
The Brighton and Hove Family and Friends Team at: Famfriends@brighton-hove.gov.uk 01273 295694
× Children who have previously been in Care, and children living away from their birth parents e.g adopted children, Special Guardianship Orders, Kinship Care.
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Child developmental needs
Despite intervention at 2, there is evidence of continuing and escalating need:- Persistent absence from school
- Statistics show a direct link between under-achievement and absence below 90%
- Regular attenders make better progress, both socially and academically
- Regular attenders find school routines, school work and friendships easier to cope with
- Regular attenders find learning more satisfying
- Regular attenders are more successful in transferring between primary school, secondary school, and higher education, employment or training
- Persistent absenteeism is linked with increased risk in relation to child sexual exploitation, criminal exploitation and a decrease in life opportunities that can have long term impacts into adulthood.
- Missing from school/ home regularly with no explanation
- Fixed Term exclusions/no school place
- Social exclusion
- Poor relationships
- No access to universal services / “Hidden Children”
- Fathers
- Disabled parents
- Parents of teenagers
- Black, Asian and minority ethnic (BAME) families
- Asylum-seeking parents
- Homeless or peripatetic families
- Rural families.
- Significant disabilities
- Keyworkers
- Nursery nurses
- Occupational therapists
- Paediatricians
- Physiotherapists
- PRESENS
- Psychologists / Counsellors
- Social workers
- Specialist health visitors
- Specialist nurses
- Speech and language therapists
- NEET (Not in Education, Employment or Training)
- Developmental milestones not being met due to persistent parental failure/inability
- Chronic/recurring health problems
- Additional resources to support a child or young person’s health and well-being can be found here
- Pan Sussex Safeguarding Procedures: Fabricated or Induced Illness
- Regular missed appointments affecting developmental progress
- Teenage pregnancy
- Drug/alcohol misuse impacting negatively
- Risky sexual behaviour (e.g. unprotected sex)
- Offending / anti-social behaviour resulting in risk of entering Youth Justice System
- Emotional / mental health issues
- There are two commissioned services at this level;
- Information for professionals and other referrers on Children & Young People’s Mental Health & Emotional Wellbeing Services in Brighton & Hove
- Children & Young Peoeple, and parents, can go online to www.findgetgive.com
- Mental Health & Behaviour Advice for Schools
× Persistent absence from school
Attendance less than 90%.
Good attendance is important because:
If the child or young person has an ongoing health problem they can be referred to the 5-19 Healthy Child Programme following discussion with parent/ carer/ young person. Each school has a named School Nurse and schools have the referral form.
Children Missing Education may help identify children who are not only missing from school but are also missing from home. There may also be a further link for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence. For additional guidance see “The right to choose: multi-agency statutory guidance for dealing with forced marriage” Foreign and Commonwealth Officer 2008.
× Persistent absence from school
Parents can be signposted to information on NHS Choices to ensure their child is well enough to attend school.
× Missing from school/ home regularly with no explanation
Children who are missing invariably place themselves at risk. The reasons for their absence are varied and complex and cannot be viewed in isolation from their home circumstances.
Sometimes children go missing with their families to evade contact with professionals. If a child is missing in this context professionals should consult Children and Families who Go Missing Procedure
Every ‘missing’ episode should attract proper attention from the professionals involved with the child and those professionals must collaborate to ensure a consistent and coherent response is given to the child on their return and that parents and carers are supported appropriately.
Children Missing Education may help identify children who are not only missing from school but are also missing from home. There may also be a further link for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence. For additional guidance see “The right to choose: multi-agency statutory guidance for dealing with forced marriage” Foreign and Commonwealth Officer 2008.
If staff are concerned that trafficking or sexual exploitation may be the reason for underlying prolonged or repeated periods of absence, then contact should be made with the Front Door For Families. Additional information and guidance is available from,Trafficked Children Procedure and within ‘Safeguarding Children Who May Have Been Trafficked‘ HMSO 2011.
× Missing from school/ home regularly with no explanation
× Fixed Term exclusions/no school place
There are 2 kinds of exclusion – fixed period (suspended) and permanent (expelled).
Fixed period exclusion: A fixed period exclusion is where a child is temporarily removed from school. They can only be removed for up to 45 school days in one school year, even if they’ve changed school.
If a child has been excluded for a fixed period, schools should set and mark work for the first 5 school days.
If the exclusion is longer than 5 school days, the school must arrange suitable full-time education from the sixth school day, e.g. at a pupil referral unit.
Permanent exclusion: Permanent exclusion means your child is expelled. The local council must arrange full-time education from the sixth school day.
The school or local council must tell parents and carers about any alternative education they arrange. It is a parent or carers responsibility to make sure their child attends.
× Fixed Term exclusions/no school place
× Social exclusion
Social exclusion is “a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of a society as a whole” (Pierson, 2002).
People who are socially excluded do not have access to the same institutions, services and social support networks that most people in a society take for granted. Although poverty is usually the main cause of social exclusion, there may be other contributing factors, such as racial discrimination or low educational achievement.
At Early Help Partnership Plus level the extent of a family or child’s social exclusion is being evidenced through the child or family’s behaviour that is beginning to show a negative impact on the development of the child and upon their life chances.
× Social exclusion
× Poor relationships
The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond
If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Health Visiting Service for further support / advice.
Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator).
The impact of early experiences of poor relationships and often the resultant levels of low or high self-esteem can result in high levels of anxiety and potential conflict in the context of friendships and intimate relationships as a person grows and develops.
× Poor relationships
× No access to universal services / “Hidden Children”
In 2001 the National Family and Parenting Institute (NFPI) conducted a national mapping of family services in England and Wales (Henricson et al., 2001). One of the key findings was that availability was patchy across the country, but take-up of services by parents tended to be low across the board (with the exception of targeted services).
Some specific groups of parents were less likely to access services than others, in particular:
A parallel survey by NFPI of parents (NFPI, 2001) found the majority had concerns that could be helped by services, and that just over half wanted more information about child development and sources of help. The findings indicate the need for a wide range of parenting and family support services. Read more
× No access to universal services / “Hidden Children”
× Significant disabilities
The Integrated Children’s Development & Disability Service works with children who have a range of developmental needs. The team includes
× Significant disabilities
× NEET (Not in Education, Employment or Training)
Young people up to the age of 16 are required by law to be in full time education. Young people aged 16-18 are required to be participating in some form of education, training or employment with training.
Brighton & Hove City Council has a duty to promote the active participation in education and training of all young people in Brighton & Hove, including ensuring all 16-18 year olds have an offer of an appropriate place in post -16 education or training, tracking process from pre to post-16 learning and identifying those who are not participating.
Many young people who are NEET will be so for a short period of time. However, there are some NEET young people who will have significant and complex barriers and may need intensive support from a range of specialist agencies before they are ready to re-engage in learning or employment. Brighton & Hove City Council has a responsibility for young people’s participation and NEET reduction and co-ordinates support for young people who have disengaged from learning.
× NEET (Not in Education, Employment or Training)
× Developmental milestones not being met due to persistent parental failure/inability
If there is a concern about a child or young person’s speech, development or motor skills that is felt to be attributable to the care the child has been receiving then call the Front Door For Families on 01273 290400 who will be able to advise how best to support them and access an assessment if necessary.
If you are concerned that a child is not thriving because they have a Special Educational Need or Disability (SEND) – then please see further information here
× Developmental milestones not being met due to persistent parental failure/inability
× Chronic/recurring health problems
School-age Children and young people can be referred to the 5-19 Healthy Child Programme School Nursing service where there are concerns about a child or young person’s health. If they have a complex need or a long term health condition School Nurses can work together with the child/young person, parent/carers, schools and the health professionals who are involved in their care, to help them get the support that they need.
The child/ young person can be referred to the School Nurse following discussion with parent/ carer/ young person. The School Nurse teams are based in 0-19 Healthy Child Programme Teams.
There is also a group of children that present with perplexing/medically unexplained symptoms (perplexing presentations). Perplexing presentations may include cases of functional disorders (conditions with a psychological cause of the symptoms) and those cases that medical professionals are unable to explain based on their clinical assessment and medical investigations. Rarely in some of these cases, symptoms are being reported to gain support that may not be required or recommended by health and education professionals. This group can include cases where a parent is exaggerating symptoms, mis-reporting or mis-understanding conditions. Fabricated or induced illness in a child is a condition whereby a child suffers harm through the deliberate action of her/his main carer and which is duplicitously attributed by the adult to another cause
× Chronic/recurring health problems
× Regular missed appointments affecting developmental progress
Neglect is the most common form of child maltreatment in England. Neglect can be defined from the child’s perspective as their right not to be exposed to inhuman or degrading treatment (HRA. Article 3)
Neglect in the early years can have a longstanding impact across the whole spectrum of children’s development and throughout their life span. Early intervention and support for families where neglect is identified is therefore of utmost importance in ensuring children are protected from harm.
Neglect is rarely life threatening but can be when it happens in combination with other forms of maltreatment. Neglect has the potential to compromise a child’s development significantly, across multiple domains. Effective interventions can help neglected children and young people recover from impairment which is why regularly missing appointments to receive such help and support is a concern.
× Regular missed appointments affecting developmental progress
× Teenage pregnancy
Pregnant teenagers are entitled to the same support and information as all pregnant women and will be under the care of their GP and Midwife.
Schools should make a referral to EOTAS so that girls can get home tuition for 18 weeks.
In Brighton and Hove all pregnant teenagers are offered the Healthy Child Programme and additional support via the Healthy Futures Team, a city-wide team based at Roundabout Children’s Centre.
Contact sc-tr.healthyfuturesteam@nhs.net – Tel: 01273 666484
× Teenage pregnancy
× Drug/alcohol misuse impacting negatively
The Adolescent Health Service (Ru-ok?) is a service for young people up to the age of 18 who require support around drugs, alcohol or sexual health. Parents/ carers or the young person can self- refer or professionals or schools can refer but the consent of the young person is required.
It offers tier 3 service for young people whose substance misuse is problematic to the degree that it is impacting on their daily life. For example physically, emotionally, or impacting their education, family relationships, or leading to offending, safeguarding or other significant issues.
Young people would have a comprehensive assessment leading to a bespoke care plan, which could include a range of interventions, for example, harm reduction, motivational interviewing, advice and guidance. The service works alongside partner agencies to support young people and their families/ carers.
They also work to prevent and divert young people away from substance use before it has become a problematic. Referrals to the DASH workers (prevention) can come from schools, professionals and young people and their families/cares. 01273 293966
× Drug/alcohol misuse impacting negatively
× Risky sexual behaviour (e.g. unprotected sex)
The age of consent to any form of sexual activity is 16 for both men and women. The age of consent is the same regardless of the gender or sexual orientation of a person and whether the sexual activity is between people of the same or different gender.
It is an offence for anyone to have any sexual activity with a person under the age of 16. However, Home Office guidance is clear that there is no intention to prosecute teenagers under the age of 16 where both mutually agree and where they are of a similar age.
It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust.
The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity.
Schools and other agencies will / may have a confidentiality policy which clearly dictates what information they will pass to interested parties in relation to under age sexual activity if the young person is aged 13 years and above. Alternatively they can access their Sexual Health clinic or a Sexual Health Outreach Nurse for contraception, STI testing, treatment and information through sexual health and contraception clinic (SHAC). Trained youth support practitioners are available at a range of community venues and can provide confidential information, advice and signposting.
Young people can access free condoms, chlamydia testing and pregnancy testing from a range of community settings.
Some secondary school offer support and advice with regard to sexual health to young people at a weekly drop in run jointly by School Nurse and Youth Worker .
Free Emergency Hormonal Contraception (EHC) is available from Pharmacies across Brighton & Hove. Please phone the pharmacy before attending to ensure the trained pharmacist is available to dispense the EHC. Young people can also access free EHC from their GP or local sexual health clinic. Details can be found here
× Risky sexual behaviour (e.g. unprotected sex)
× Offending / anti-social behaviour resulting in risk of entering Youth Justice System
Referrals to the Adolescent Service Youth Offending specialist YO via the Police or Courts.
Young people (age 10-17) who are arrested for an offence and admit guilt are referred to the Diversion scheme. If the Police decide to charge (e.g. not guilty plea or serious / persistent offending), the young person will be summonsed to Court and may receive a community disposal via a Court Order. Young people referred to the Diversion scheme will be assessed and then, if an alternative outcome or caution is agreed, they will be offered a programme (which is voluntary).
The allocated Adolescent Worker will work closely with the young person and the family to address offending related or other issues. The Adolescent worker will collaborate with relevant professionals, such as CAMHS, social worker, psychologist, family worker or others to assess the young person/ family and deliver a targeted programme to meet need. The lead professionals will also liaise with the school or educational provision in planning for the young person.
The diversion programme may consist of a single intervention, such as restorative justice or drugs/ alcohol awareness, or the programme may involve a number of sessions, depending on the offending behaviour and related needs.
× Offending / anti-social behaviour resulting in risk of entering Youth Justice System
× Emotional / mental health issues
Certain individuals and groups are more likely to develop emotional and behavioural problems than others. One in ten children and young people aged 5-10 has a clinically diagnosed mental health disorder. Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems.
An important key to promoting children’s mental health is to understand the protective factors that enable children to be resilient when they encounter problems and challenges. Resilience is linked to self-esteem and confidence and a belief in own self-efficacy and ability to deal with change and ability to adapt and being able to have a range of problem solving approaches.
Research suggests that there is a complex interplay between risk factors in children’s lives and promoting their resilience. As social disadvantage and the number of stressful life events accumulate for children and young people, more factors that are protective are required to counterbalance.
Risk factors can be located in the child, the family, the environment and educational establishment or across all the factors.
Schools can promote pupils mental health and well-being by setting a culture that values all pupils, allows them to feel a sense of belonging and makes it possible to talk about problems in a non-stigmatising way, alongside setting a strong ethos for high expectation of attainment.
× Emotional / mental health issues
(1) Schools Wellbeing Service – Primary Mental Health Workers in all Secondary Schools as starting to be rolled out to Primary Schools and considering how to roll out to Colleges. This is a whole school approach to emotional wellbeing and mental health (1:1 and group work);
(2) Community Wellbeing Service which also a hub for mental health referrals. This is an all-ages service (4+) which enables a family approach where relevant www.brightonandhovewellbeing.org and BICS.brighton-and-hove-wellbeing@nhs.net
Specialist CAMHS referrals should go through the hub (Community Wellbeing) apart from crisis / urgent referrals (Duty Tel 0300 304 0061 which is Mon-Fri until 10pm)
-
Child developmental needs
Persistent/continued/severe:- Chronic persistent absence, permanent exclusions or no school place that risks entry to the care system
- Statistics show a direct link between under-achievement and absence below 90%
- Regular attenders make better progress, both socially and academically
- Regular attenders find school routines, school work and friendships easier to cope with
- Regular attenders find learning more satisfying
- Regular attenders are more successful in transferring between primary school, secondary school, and higher education, employment or training
- Persistent absenteeism is linked with increased risk in relation to child sexual exploitation, criminal exploitation and a decrease in life opportunities that can have long term impacts into adulthood.
- Persistent social exclusion
- Poor relationships
- Complex / multiple disabilities
- Children with a severe learning or physical disability
- Children with a moderate learning disability, where it is assessed that their needs (in terms of challenging behaviour or mental health issues) can only be met through the input of specialist service
- Complex mental health issues affecting development needs, including self harm
- High level emotional health issues and very low self-esteem
- Non-organic failure to thrive
- Inappropriate sexual knowledge / sexualised behaviour for age.
- Harmful Sexual Behaviour / Peer on Peer Abuse
- Sexually abusive, where there is an element of manipulation, force or coercion or where the subject of the behaviour is unable to give informed consent, or
- Sexually problematic, where there may not be an element of victimisation but where the behaviours may interfere with the development of the child demonstrating the behaviour or which might provoke rejection, cause distress or increase the risk of victimisation of the child.
- Teenage parent/pregnancy under the age of 13
- Concerns about exploitation (including sexual exploitation/ abuse, radicalisation; criminal exploitation; gang affiliation)
- See themselves (and are seen by others) as a discernible group, and
- Engage in a range of criminal activity and violence
- Identify with or lay claim over territory (not necessarily geographical but can include an illegal economy territory)
- Have some form of identifying structural feature
- Are in conflict with other similar gangs
- Pan Sussex Safeguarding Procedures: Sexual Exploitation
- Pan Sussex Safeguarding Procedures: Recognising Sexual Abuse
- Pan Sussex Safeguarding Procedures: Children and Young People Who May be Affected by Gang Activity
- Pan Sussex Safeguarding Procedures: Children & Young People Vulnerable to Violent Extremism
- NSPCC: Child Sexual Exploitation
- Department for Education guidance What to do if you suspect a child is being sexually exploited
- Wise Up to Boys
- Brighton & Hove LSCB: Child Sexual Exploitation
- Pan Sussex MACSE (SERAF) form.
- Unprotected, Overprotected: CSE & Learning Disabilities
- DASH: Young Persons Drug, Alcohol & Sexual Health Education Workers
- Where to go for: Sexual Health
- Safe in the City: Preventing Terrorism & Extremism
- If you want advice from the Prevent team regarding concerns about an individual please email Channel.Prevent@brighton-hove.gov.uk
- Advice for Parents & Carers (Tower Hamlets)
- Educate Against Hate
- Child victims of modern slavery or human trafficking
- For further advice, contact the Modern Slavery Helpline – 08000 121 700
- For further information about child trafficking, look at the materials on the ECPAT website – www.ecpat.org.uk
- Unaccompanied minors
- Drug/alcohol use severely impairing development
- Frequently missing from home resulting in self-neglect
- Relationship breakdown between child & parent
- Child has been abandoned and there are no family/ friends options
- Parents are deceased and there are no family/friends options
- Parents are in prison and there are no family/friends options
- Parents in hospital and no family and friend options
- Child whose welfare and development can only be safeguarded through provision of accommodation outside of the family/friend network
- Child is assessed as being beyond parental control and there are no family/friends options
- Meets criteria for secure accommodation
- Child remanded to Local Authority care/custody
- Unaccompanied asylum seeking children who require accommodation
- Eligible & Relevant Care Leavers
- Children and young people whose adoption placement has broken down and there is no family or friend options.
- Offending and in the criminal justice system
- Unexplained / suspicious injury
- Inconsistent history
- History that does not match the physical findings
- Injuries that do not match the developmental stage of the child
- Unexplained or poorly explained death of an infant
- Unexplained apnea
- Ingestion or toxin exposure with suspicious history
- Repeated drug or toxin exposure
- Abandonment
- Children <8 years old left unattended
- Delay in seeking care for a serious injury
- Serious noncompliance with medical care
- Failure to thrive with no medical explanation
- Cold injury
- Parent refusal of medically necessary care (despite medical/cultural/religious differences)
- Unexplained CNS insults resulting in coma, seizures or obtundation
- Skull fracture with suspicious or no history of significant trauma, especially:
- Depressed skull fracture
- Diastatic fracture
- Fracture >3 mm wide
- Complex or multiple skull fractures
- Bilateral skull fractures
- Fracture with associated intracranial injuries
- Evidence of Shaken Infant Syndrome (altered level of consciousness, closed head injury, CNS or retinal hemorrhage)
- Catastrophic injury explained by routine falling
- Subdural hematoma without history of significant trauma
× Chronic persistent absence, permanent exclusions or no school place that risks entry to the care system
Attendance less than 90%.
Good attendance is important because:
Chronic and persistent absence from school or no school place, alongside other identified risk factors that place a child at risk of coming into care, increases the risk of further negative outcomes.
Children Missing Education may help identify children who are not only missing from school but are also missing from home. There may also be a further link for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence. For additional guidance see “The right to choose: multi-agency statutory guidance for dealing with forced marriage” Foreign and Commonwealth Officer 2008.
If the child or young person has an ongoing health problem they can be referred to the 5-19 Healthy Child Programme following discussion with parent/ carer/ young person. Each school has a named School Nurse and schools have the referral form.
Good systemic approaches to persistent absence from school is important (versus within-child) to avoid behaviours becoming pathologized. When the reasons for persistent absence are examined within the system the child is in, the behaviours can often then be seen as fairly normal response to cumulative ACEs/trauma, which require different support systems for the child to move on from.
× Chronic persistent absence, permanent exclusions or no school place that risks entry to the care system
× Persistent social exclusion
Social exclusion is “a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of a society as a whole” (Pierson, 2002).
People who are socially excluded do not have access to the same institutions, services and social support networks that most people in a society take for granted. Although poverty is usually the main cause of social exclusion, there may be other contributing factors, such as racial discrimination or low educational achievement.
At Early Help Partnership Plus level the extent of a family or child’s social exclusion is being evidenced through the child or family’s behaviour that is beginning to show a negative impact on the development of the child and upon their life chances.
× Persistent social exclusion
× Poor relationships
The impact of a child being poorly regarded or having their needs ignored by care givers can be felt throughout a person’s life and is a likely cause of future demand on a wide range of services to respond.
If poor relationships are suspected in children aged 5 and under, the family should be signposted to the Health Visiting Service for further support / advice.
Poor relationships in education (with peers and/or with adults) is a key indicator, often manifesting as or described as poor behaviour or bullying (victim and/or perpetrator)
× Poor relationships
× Complex / multiple disabilities
Social care support for disabled children aged 0 to 17 and their families
Which children aged 0-17 can seek support from SCDS?
× Complex / multiple disabilities
× Complex mental health issues affecting development needs, including self harm
Certain individuals and groups are more likely to develop emotional and behavioural problems than others. One in ten children and young people aged 5-10 has a clinically diagnosed mental health disorder. Risk factors are cumulative with children exposed to multiple risks such as social disadvantage, family adversity and cognitive or attention problems being much more likely to develop emotional and behavioural problems.
An important key to promoting children’s mental health is to understand the protective factors that enable children to be resilient when they encounter problems and challenges. Resilience is linked to self-esteem and confidence and a belief in own self-efficacy and ability to deal with change and ability to adapt and being able to have a range of problem solving approaches.
Research suggests that there is a complex interplay between risk factors in children’s lives and promoting their resilience. As social disadvantage and the number of stressful life events accumulate for children and young people, more factors that are protective are required to counterbalance.
Risk factors can be located in the child, the family, the environment and educational establishment or across all the factors.
Schools can promote pupils mental health and well-being by setting a culture that values all pupils, allows them to feel a sense of belonging and makes it possible to talk about problems in a non-stigmatising way, alongside setting a strong ethos for high expectation of attainment.
× Complex mental health issues affecting development needs, including self harm
Specialist CAMHS – referrals should go through the hub (Community Wellbeing) apart from crisis / urgent referrals (Duty Tel 0300 304 0061 which is Mon-Fri until 10pm) and more information from www.sussexpartnership.nhs.uk/brighton-and-hove-CAMHS
× High level emotional health issues and very low self-esteem
Self-esteem should be viewed as a continuum, and can be high, medium or low, and is often quantified as a number in empirical research.
When considering self-esteem it is important to note that both high and low levels can be emotionally and socially harmful for the individual. Indeed it is thought an optimum level of self-esteem lies somewhere in the middle of the continuum.
Socially children with low self-esteem can be withdrawn or shy, and may find it difficult to have fun. Although they may have a wide circle of friends they are more likely to yield to group pressure and more vulnerable to being bullied.
Living with low self-esteem can harm your mental health, leading to problems like depression and anxiety, and as they get older children may rely on health harming behaviours, such as smoking and drinking too much, as a way of coping.
Research has also shown that low self-esteem has to linked to an increased risk of teenage pregnancy. Read more on the Simply Psychology website
× High level emotional health issues and very low self-esteem
× Non-organic failure to thrive
Non-organic failure to thrive is the term used when a child does not put on weight and grow and there is no underlying medical cause for this.
× Non-organic failure to thrive
× Inappropriate sexual knowledge / sexualised behaviour for age.
As children get older, the way they express their feelings about learning about sex changes. Through social media children can be exposed to sexual images at a far younger age. And in more places than ever before, including music videos, websites and social media. So it’s not surprising that sometimes children’s sexual development can seem out of step with their age.
It’s important that we have a good idea of what’s normal sexual behaviour and can also spot the warning signs if something might not be quite right.
For information regarding the 4 stages of development please see: NSPCC: The stages of normal sexual behaviour
× Inappropriate sexual knowledge / sexualised behaviour for age.
× Harmful Sexual Behaviour / Peer on Peer Abuse
Harmful sexual behaviour (HSB) is the umbrella term for those actions that are either:
Children’s sexual behaviour should be thought about as being on a continuum, ranging from healthy, through problematic, to abusive.
Defining what behaviours fit where on the continuum can be a difficult task and should be thought about within the context of the behaviour itself and the developmental situation of the child. A particular behaviour in one circumstance could be harmful whilst in another it may not.
× Harmful Sexual Behaviour / Peer on Peer Abuse
× Teenage parent/pregnancy under the age of 13
Pregnant teenagers are entitled to the same support and information as all pregnant women and will be under the care of their GP and Midwife.
Schools should make a referral to EOTAS so that girls can get home tuition for 18 weeks.
In Brighton & Hove all pregnant teenagers are offered the Healthy Child Programme and additional support via the Healthy Futures Team, a city-wide team based at Roundabout Children’s Centre.
Contact sc-tr.healthyfuturesteam@nhs.net – Tel: 01273 666484
The Age of Consent
The age of consent to any form of sexual activity is 16 for both men and women. The age of consent is the same regardless of the gender or sexual orientation of a person and whether the sexual activity is between people of the same or different gender.
It is an offence for anyone to have any sexual activity with a person under the age of 16. However, Home Office guidance is clear that there is no intention to prosecute teenagers under the age of 16 where both mutually agree and where they are of a similar age.
It is an offence for a person aged 18 or over to have any sexual activity with a person under the age of 18 if the older person holds a position of trust (for example a teacher or social worker) as such sexual activity is an abuse of the position of trust.
The Sexual Offences Act 2003 provides specific legal protection for children aged 12 and under who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity.
× Teenage parent/pregnancy under the age of 13
× Concerns about exploitation (including sexual exploitation/ abuse, radicalisation; criminal exploitation; gang affiliation)
Exploitation can affect any child or young person under the age of 18 years. It is typified by some form of power imbalance in favour of those perpetrating the exploitation and may involve force and/or enticement-based methods of compliance and is often • accompanied by violence or threats of violence. Situations may still be exploitation even if the activity appears consensual, and this abuse may be perpetrated by individuals or groups, males or females, adults or other young people.
One of the key factors found in most cases of county lines exploitation is the presence of some form of exchange (e.g. carrying drugs in return for something). Where it is the victim who is offered, promised or given something they need or want, the exchange can include both tangible (such as money, drugs or clothes) and intangible rewards (such as status, protection or perceived friendship or affection). The fact that the victim is in receipt of something does not make them any less of a victim.
Certain vulnerabilities may increase the chance that a person will be exploited by others. Whilst these factors do not mean that a person will be exploited it is important to recognise the increased vulnerability that some people face.
Sexual Exploitation / abuse:
Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities.
Child sexual exploitation can occur through the use of technology without the child’s immediate recognition; for example being persuaded to post sexual images on the Internet/mobile phones without immediate payment or gain. In all cases, those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economic and/or emotional vulnerability.
Both girls and boys are at risk of sexual exploitation, and it is seriously harmful to children both emotionally and physically. Children and young people often find it very hard to understand or accept that they are being abused through sexual exploitation, and this increases their risk of being exposed to violent assault and life threatening events by those who abuse them.
Radicalisation:
The current threat from terrorism in the United Kingdom can involve the exploitation of vulnerable people, including children, young people and adults with care and support needs to involve them in terrorism or activity in support of terrorism. This can put the individual at risk of being drawn in to criminal activity and has the potential to cause significant harm. This is safeguarding issue. Preventing someone from being radicalised is no different from safeguarding vulnerable individuals from other forms of harm or exploitation.
Criminal Exploitation:
Vulnerable young people may be exploited into criminal activity or violence by other young people or adults who are able to coerce them to do so.
County lines is the police term for urban gangs supplying drugs to suburban areas and market and coastal towns using dedicated mobile phone lines or “deal lines”. It involves child criminal exploitation (CCE) as gangs use children and vulnerable people to move drugs and money. Gangs establish a base in the market location, typically by taking over the homes of local vulnerable adults by force or coercion in a practice referred to as ‘cuckooing’.
Gang affiliation:
Groups of children often gather together in public places to socialise, and peer association is an essential feature of most children’s transition to adulthood. Groups of children can be disorderly and/or anti-social without engaging in criminal activity.
The statutory definition of a gang is: “A relatively durable, predominantly street-based group of young people who:
They may also have any or all of the following factors:
(HM Government: Ending Gang & Youth Violence Report, 2012)
Professionals are advised to avoid applying definitions of a gang too rigorously; if a child or others think s/he is involved with or affected by ‘a gang’, then professionals should act accordingly. Children rarely use the term ‘gang’, instead they used terms such as ‘family’, ‘breddrin’, ‘crews’, ‘cuz’ (cousins), ‘my boys’ or ‘the people I grew up with’.
× Concerns about exploitation (including sexual exploitation/ abuse, radicalisation; criminal exploitation; gang affiliation)
Sexual Exploitation & Abuse:
Criminal Exploitation:
Gangs:
Radicalisation:
× Child victims of modern slavery or human trafficking
Modern Slavery can take many forms including human trafficking, forced labour, criminal and sexual exploitation and domestic servitude.
Children are considered victims of trafficking, whether or not they have been coerced, deceived or paid to secure their compliance. They need only have been recruited, transported, received or harboured for the purpose of exploitation.
Trafficking doesn’t only happen across international borders. A child can be trafficked between counties, cities or even across a city from one address to another.
× Child victims of modern slavery or human trafficking
× Unaccompanied minors
At least half of the estimated 57.4 million people displaced by war around the world are children, and millions of those children have been separated from their families (UNICEF).
Many children have endured unimaginable horrors in an effort to escape from war and conflict.
War can lead to temporary or permanent separation of children from their parents or other adult caregivers. Separation can have a devastating social and psychological impact, as well as making children vulnerable to continued exploitation.
× Drug/alcohol use severely impairing development
Exposure to drugs and alcohol can have an impact across children’s childhoods to the extent that development is severely impaired.
The exposure could be either through their parent/carers own use or though their own.
Foetal alcohol spectrum disorders are a group of birth defects that can happen when a pregnant woman drinks alcohol. Foetal alcohol syndrome (FAS) is the most severe type of the disorder. FAS and other spectrum disorders affect children differently.
The Adolescent Health Service (Ru-ok?) is a service for young people up to the age of 18 who require support around drugs, alcohol or sexual health. Parents/ carers or the young person can self- refer or professionals or schools can refer but the consent of the young person is required
× Frequently missing from home resulting in self-neglect
Children who are missing invariably place themselves at risk. The reasons for their absence are varied and complex and cannot be viewed in isolation from their home circumstances.
Sometimes children go missing with their families to evade contact with professionals. If a child is missing in this context professionals should consult Children and Families who Go Missing Procedure
Every ‘missing’ episode should attract proper attention from the professionals involved with the child and those professionals must collaborate to ensure a consistent and coherent response is given to the child on their return and that parents and carers are supported appropriately.
Children Missing Education may help identify children who are not only missing from school but are also missing from home. There may also be a further link for some children from Black, Asian and Minority Ethnic communities to Forced Marriage or Honour Based Violence. For additional guidance see “The right to choose: multi-agency statutory guidance for dealing with forced marriage” Foreign and Commonwealth Officer 2008.
If staff are concerned that trafficking or sexual exploitation may be the reason for underlying prolonged or repeated periods of absence, then contact should be made with the Front Door For Families. Additional information and guidance is available from,Trafficked Children Procedure and within ‘Safeguarding Children Who May Have Been Trafficked‘ HMSO 2008.
× Frequently missing from home resulting in self-neglect
× Relationship breakdown between child & parent
Relationships may break down between parents and carers and the children they are responsible for. In Brighton & Hove the threshold for coming into care is guided by:
× Relationship breakdown between child & parent
× Offending and in the criminal justice system
A child can be convicted of a criminal offence and sentenced in the Youth Court from the age of 10. Children or young people who plead not guilty at Police interview will be charged to court if there is adequate evidence. Prior to conviction, the Adolescent Service (Youth Offending (YO) worker) would attend Court and provide advice and guidance to young people and families. The service will work with young people on bail programmes (prior to conviction) or throughout remand periods but otherwise would complete assessments of young people and make recommendations to the Court following conviction.
The young person would be allocated a YO worker at the point of sentence and this person will complete the assessment, plan and work with the young person and parents/ carers until the Order is completed. The YO worker will assess the risk of harm, risk of offending and highlight any safeguarding concerns and advise the Court on sentencing as appropriate. The YO worker will collaborate with involved professionals (e.g. social worker, R-U-OK, CAMHS), working as a part of a multi-agency service to meet the needs of the young person and family.
The Adolescent Service holds responsibility for young people subject to all Court Orders under criminal justice and child welfare legislation and therefore has dual responsibility for public protection and safeguarding in YOS cases.
× Offending and in the criminal justice system
Contact the Youth Offending Service at brighton-hove.yos@brighton-hove.gov.uk
× Unexplained / suspicious injury
Unexplained or serious injury should be suspected when a physical injury correlates to:
Historical Findings
High-Risk Presentations
Neglect
Head injury
There is also a group of children that present with perplexing/medically unexplained symptoms (perplexing presentations). Perplexing presentations may include cases of functional disorders (conditions with a psychological cause of the symptoms) and those cases that medical professionals are unable to explain based on their clinical assessment and medical investigations. Rarely in some of these cases, symptoms are being reported to gain support that may not be required or recommended by health and education professionals. This group can include cases where a parent is exaggerating symptoms, mis-reporting or mis-understanding conditions. Fabricated or induced illness in a child is a condition whereby a child suffers harm through the deliberate action of her/his main carer and which is duplicitously attributed by the adult to another cause.”
-
Family & Environment
- Positive relationship between parents
- Stable & affectionate relationships with caregivers
- Housed, good diet and kept healthy
- Supportive networks
- Access to positive activities
- Positive sense of self and abilities
× Positive relationship between parents
× Positive relationship between parents
× Stable & affectionate relationships with caregivers
× Stable & affectionate relationships with caregivers
× Housed, good diet and kept healthy
× Housed, good diet and kept healthy
× Supportive networks
× Supportive networks
× Access to positive activities
× Access to positive activities
× Positive sense of self and abilities
× Positive sense of self and abilities
-
Family & Environment
- Children of prisoners/ parents subject to community orders
- Low income affects achievement
- Parental conflict and risk of relationship breakdown
- Concerns about possible domestic abuse
- become aggressive
- display anti-social behaviour
- suffer from depression or anxiety
- not do as well at school – due to difficulties at home or disruption of moving to and from refuges.
× Children of prisoners/ parents subject to community orders
Children affected by parental imprisonment may experience a severe disturbance to family life, including prolonged separation from a parent, and possibly intermittent and traumatic contact through prison visits. The sudden loss of a parent will upset the attachment between the child and both their parents, increasing levels of stress, anxiety and depression, and may manifest in behavioural problems.
Many families feel ashamed by the stigma associated with imprisonment, and so will not ask for support, and may encourage their children to keep the situation a secret. The remaining parent may find themselves facing added financial pressures due to the loss of a wage, a change to benefit entitlements and additional costs including childcare and travelling to visit the prisoner. Children may also face additional challenges such as supporting their parent, coping with bullying and reconciling conflicting emotions such as grief and anger.
For more information for families coping with a parent in prison please see the Family Information Service Factsheet
× Children of prisoners/ parents subject to community orders
× Low income affects achievement
Research studies advise that children in lower-income households tend to fare less well in school and to have worse health than their better-off peers. However, it is not clear how far this is due to differences in financial resources and how far it is due to other household factors (e.g. levels of parental education or parenting approaches). This uncertainty leaves room for considerable difference of opinion about solutions. A review of available research demonstrated that household income directly correlates with the level of children’s achievements.
× Parental conflict and risk of relationship breakdown
Conflict between parents is a normal part of relationships. However, when the conflict is frequent, intense and poorly resolved, it puts children’s mental health, education attainment and long-term outcomes at risk.
This can result in poorer academic outcomes, negative peer relationships and psychological difficulties shown as aggression, anxiety, depression, withdrawal, fearfulness and even suicidality. It can also affect risk-taking behaviours such as smoking, drug use and early sexual activity (EIF).
BHCC define Harmful Parental Conflict as: “Relationship distress and/or destructive behaviours between parental figures; involving aggression, non-verbal conflict or the ‘silent treatment’, lack of respect and emotional control and lack of resolution. Power is balanced and there is no consistent pattern of victim and abuser.”
According to estimates, 11% of all children have parents in a distressed relationship (DWP). In a recent survey 70% of children said their parents getting on well is one of the most important factors in their happiness. (Source: Children’s Society)
Relationship difficulties are often seen as a private matter and families tend to only seek help when they are in crisis. Asking them can give parents permission to speak openly about their difficulties.
Parental conflict can harm children’s outcomes regardless of whether parents are together, separated, or biologically related to the child such (i.e. blended or foster families).
Family breakdown is not a single event but a process that involves a number of risk and protective factors that interact in complex ways both prior to and following family relationship breakdown. The interrelated factors to consider include; parental conflict, the quality of parenting and of parent-child relationships, parents mental health, financial hardship, repeated changes in living arrangements, including family structure.
Separation can be a time of high emotions and increased conflict between parents, including accusation and counter accusations, particularly when involved in the legal process. Speaking to both parents is crucial when working within the Whole Family approach.
It is almost always in a child’s best interest to maintain contact with both parents, if safe to do so.
Even if children feel relieved when their parents separate, most children will still feel some loss and grief (NSPCC).
× Parental conflict and risk of relationship breakdown
× Concerns about possible domestic abuse
It is often difficult to tell if domestic abuse is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children who witness domestic abuse may:
The presentation of the following characteristics might be a sign that a child is being abused. The list is not exhaustive and may include a combination of the following, or none. However if you are worried that a child may be exposed to domestic abuse it is good to be alert to the signs of a child being; withdrawn, suddenly behaving differently, anxious, clingy, depressed, aggressive, having problem sleeping, eating disorders, wetting the bed, soils clothes, takes risks, misses school. changes in eating habits, obsessive behaviour, nightmares, using drugs and alcohol, self-harm, thoughts about suicide.
Living in a home where there’s domestic abuse is harmful. It can have a serious impact on a child’s behaviour and wellbeing. Parents or carers may underestimate the effects of the abuse on their children because they don’t see what’s happening. Children witnessing domestic abuse is recognised as ‘significant harm’ in law. Read more
The effects of exposure to domestic abuse can continue into adulthood. Often, once children are in a safer and more stable environment, most children are able to move on from the effects of witnessing domestic abuse.
× Concerns about possible domestic abuse
-
Family & Environment
- Housing tenancy at risk
- Self-referrals are accepted from young people over the phone
- Referrals from professionals are also welcome
- Priority is given to Brighton & Hove City Council Housing Departments, Children Services, as well as any partner organisations listed on the Brighton & Hove housing or accommodation pathway
- They aim to acknowledge referrals within 24 hours if the client is in crisis or within 48 hours for standard support
- To request a referral form please send an email or call – see email address and phone number given below.
- Where to go for….
- Brighton & Hove Young Peoples Outreach: BHYPOutreachSupport@homegroup.org.uk or 07464 926 546
- Harmful parental conflict and/or relationship breakdown
- Transient families
- Domestic abuse & coercive control
- become aggressive
- display anti-social behaviour
- suffer from depression or anxiety
- not do as well at school – due to difficulties at home or disruption of moving to and from refuges.
- No recourse to public funds
× Housing tenancy at risk
Being at risk of homelessness or being homeless can be very stressful. If you are at risk of homelessness, it is important to get help and advice at an early stage. This information will help you find accommodation in Brighton & Hove and access other advice services: Brighton & Hove City Council – Housing Options – Help if you are homeless or at risk of losing your home:
Brighton & Hove Young Peoples Outreach is a local floating support service that helps 16- 25 year olds who have become homeless and have been given independent accommodation through the council or through children services. The support offered is person centred and can last up to a year. They work with young people with different backgrounds, needs and circumstances such as young families, care leavers, and young people with little support networks.
How to access the service:
Referral & Enquiry phone number: 07464 926 546
This number is open 8am – 8pm, Mon – Fri (excluding bank holidays)
Referral & Enquiry email address: BHYPOutreachSupport@homegroup.org.uk× Housing tenancy at risk
× Harmful parental conflict and/or relationship breakdown
Conflict between parents is a normal part of relationships. However, when the conflict is frequent, intense and poorly resolved, it puts children’s mental health, education attainment and long-term outcomes at risk.
This can result in poorer academic outcomes, negative peer relationships and psychological difficulties shown as aggression, anxiety, depression, withdrawal, fearfulness and even suicidality. It can also affect risk-taking behaviours such as smoking, drug use and early sexual activity (EIF).
BHCC define Harmful Parental Conflict as: “Relationship distress and/or destructive behaviours between parental figures; involving aggression, non-verbal conflict or the ‘silent treatment’, lack of respect and emotional control and lack of resolution. Power is balanced and there is no consistent pattern of victim and abuser.”
Parental conflict can harm children’s outcomes regardless of whether parents are together, separated, or biologically related to the child such (i.e. blended or foster families).
Family breakdown is not a single event but a process that involves a number of risk and protective factors that interact in complex ways both prior to and following family relationship breakdown. The interrelated factors to consider include; parental conflict, the quality of parenting and of parent-child relationships, parents mental health, financial hardship, repeated changes in living arrangements, including family structure.
Separation can be a time of high emotions and increased conflict between parents, including accusation and counter accusations, particularly when involved in the legal process. Speaking to both parents is crucial when working within the Whole Family approach.
It is almost always in a child’s best interest to maintain contact with both parents, if safe to do so.
Even if children feel relieved when their parents separate, most children will still feel some loss and grief (NSPCC)
× Harmful parental conflict and/or relationship breakdown
CAFCASS Co-parent hub has online tools for during and after separation when making arrangements for children
The Parent Relationships website has sections about separation, co-parenting when separated and addressing relationship difficulties.
EIF – Why reducing parental conflict matters for local government
× Transient families
Children and families who move more frequently between local authorities include homeless families, asylum seekers and refugees, gypsy, traveller and Roma families and families experiencing domestic abuse.
In Brighton & Hove these families are offered the Healthy Child Programme and additional support via the Healthy Futures Team, a city-wide team based at Roundabout Children’s Centre.
Contact sc-tr.healthyfuturesteam@nhs.net Tel 01273 666484
A parent’s homelessness or placement in temporary accommodation, often at a distance from previous support networks, can result in or be associated with transient living arrangements. There is a risk that the family may become disengaged from health, education and other support systems. There may also be a reduction in previously available family / community support..
Families that move frequently can find it difficult to access the services they need. For those already socially excluded, moving frequently can worsen the effects of this exclusion and increase isolation.
Some families in which children are harmed move home frequently to avoid contact with concerned agencies, so that no single agency has a complete picture of the family.
× Transient families
× Domestic abuse & coercive control
It is often difficult to tell if domestic abuse and/or coercive control is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children who witness domestic abuse may:
The presentation of the following characteristics might be a sign that a child is being abused. The list is not exhaustive and may include a combination of the following, or none. However if you are worried that a child may be exposed to domestic abuse it is good to be alert to the signs of a child being; withdrawn, suddenly behaving differently, anxious, clingy, depressed, aggressive, having problem sleeping, eating disorders, wetting the bed, soils clothes, takes risks, misses school. changes in eating habits, obsessive behaviour, nightmares, using drugs and alcohol, self-harm, thoughts about suicide.
Coercive control is a pattern of behaviour which seeks to take away the victim’s liberty or freedom, to strip away their sense of self. It is not just a person’s bodily integrity which is violated but also their human rights.
Coercive control is not domestic purely in the sense that it occurs at home, technology allows for surveillance wherever a victim is, and often the victim effectively becomes controlled, internalising the rules, adapting behaviour to survive.
Living in a home where there’s domestic abuse is harmful. It can have a serious impact on a child’s behaviour and well-being.
Parents or carers may underestimate the effects of the abuse on their children because they don’t see what’s happening. Children witnessing domestic abuse is recognised as ‘significant harm’ in law. Read more
The effects of exposure to domestic abuse can continue into adulthood. Often, once children are in a safer and more stable environment, most children are able to move on from the effects of witnessing domestic abuse.
× Domestic abuse & coercive control
× No recourse to public funds
Families with No Recourse to Public Funds include asylum seekers and other families whose immigration status may exclude them from mainstream services. This can also include EU nationals who are not entitled to benefits
Families may have been forced from their country of origin under life-threatening situations and lived through very difficult experiences, including separation from close relatives. Their needs can strongly relate to these circumstances and also to the ongoing situation in their country of origin.
Read more: Brighton & Hove Joint Strategic Needs Assessment- International Migrants in Brighton & Hove: Full Report and Infogram
× No recourse to public funds
-
Family & Environment
- Significantly harmful parental conflict and/or relationship breakdown
- Home – Cafcass – Children and Family Court Advisory and Support Service
- The Parent Relationships website has guidance on differentiating between domestic abuse and parental conflict
- Parent relationships
- Suspicion of physical, emotional or sexual abuse or neglect
- Physical Abuse;
- Emotional Abuse;
- Sexual Abuse; and
- Neglect.
- Domestic abuse resulting in child being at risk of significant harm
- become aggressive
- display anti-social behaviour
- suffer from depression or anxiety
- not do as well at school – due to difficulties at home or disruption of moving to and from refuges.
- Homeless Child/Young Person
- Family intentionally homeless
- they have given up accommodation that they could have continued to occupy
- they’ve lost accommodation through their actions which they knew, or should reasonably be expected to have known, would cause their homelessness
- they have made an arrangement with somebody in order to take advantage of the homeless legislation
- Extreme poverty affecting child well-being
- Forced Marriage, Honour Based Violence, Female Genital Mutilation
- FGM – All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reason.
- Forced Marriage – “Where one or both people do not (or in cases of people with learning disabilities, cannot) consent to the marriage and pressure or abuse is used.” The pressure put on people to marry against their will can be:
- So-called Honour Based Violence. A violent crime or incident which may have been committed to protect or defend the honour of the family or community. It is often linked to family members or acquaintances who mistakenly believe someone has brought shame to their family or community by doing something that is not in keeping with the traditional beliefs of their culture.
- Truancy
- Low motivation/withdrawn
- Poor exam results/driven to perform well
- Withdrawn from education for extended periods of time / long holiday to ‘country of origin’
- Not involved in extra-curricular activities, trips, parties, etc.
- Withdrawn from PSHE education
- Other family members reported missing
- History of domestic violence
- Young person reported for other offences
- Threats to kill
- Child protection issues raised previously/on child protection register
- Self-harm/attempted suicide
- Physical or learning disability
- Eating disorders
- Depression/isolation
- Problematic use of substances (prescription and non-prescription drugs, alcohol)
- Other siblings forced to marry
- Family history of undergoing or practicing FGM
- Family disputes
- Has run away from home before
- Excessive restrictions, ‘house arrest’, escorted to school, doctors, etc.
- Older family members have a heavy influence on upbringing
- FGM is believed to be integral to identity
- Not engaging with professionals (e.g. health, education, other)
× Significantly harmful parental conflict and/or relationship breakdown
Significantly harmful parental conflict puts children’s mental health and long-term outcomes at risk when it is frequent, intense and poorly resolved. This can result in poorer academic outcomes, negative peer relationships and psychological difficulties shown as aggression, anxiety, depression, withdrawal, fearfulness and even suicidality. It can also affect risk-taking behaviours such as smoking, drug use and early sexual activity (EIF).
BHCC define Harmful Parental Conflict as: “Relationship distress and/or destructive behaviours between parental figures; involving aggression, non-verbal conflict or the ‘silent treatment’, lack of respect and emotional control and lack of resolution. Power is balanced and there is no consistent pattern of victim and abuser.”
Family breakdown is not a single event but a process that involves a number of risk and protective factors that interact in complex ways both prior to and following family relationship breakdown. The interrelated factors to consider include; parental conflict, the quality of parenting and of parent-child relationships, parents mental health, financial hardship, repeated changes in living arrangements, including family structure.
Separation can be a time of high emotions and increased conflict between parents, including accusation and counter accusations, particularly when involved in the legal process. Speaking to both parents is crucial when working within the Whole Family approach to supporting a child.
× Significantly harmful parental conflict and/or relationship breakdown
× Suspicion of physical, emotional or sexual abuse or neglect
Abuse and neglect are forms of maltreatment of a child. Somebody may cause or neglect a child by inflicting harm, or failing to act to prevent harm. Children may be abused in a family, or in an institutional or community setting; by those known to them or, more rarely by a stranger. They may be abused by an adult or adults or another child or children.
Working Together to Safeguard Children 2015 includes definitions of the four broad categories of abuse which are used for the purposes of recognition:
These categories overlap and an abused child does frequently suffer more than one type of abuse. Read more
× Suspicion of physical, emotional or sexual abuse or neglect
× Domestic abuse resulting in child being at risk of significant harm
It is often difficult to tell if domestic abuse and/or coercive control is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children who witness domestic abuse may:
The presentation of the following characteristics might be a sign that a child is being abused. The list is not exhaustive and may include a combination of the following, or none. However if you are worried that a child may be exposed to domestic abuse it is good to be alert to the signs of a child being; withdrawn, suddenly behaving differently, anxious, clingy, depressed, aggressive, having problem sleeping, eating disorders, wetting the bed, soils clothes, takes risks, misses school. changes in eating habits, obsessive behaviour, nightmares, using drugs and alcohol, self-harm, thoughts about suicide.
Coercive control is a pattern of behaviour which seeks to take away the victim’s liberty or freedom, to strip away their sense of self. It is not just a person’s bodily integrity which is violated but also their human rights. Coercive control is not domestic purely in the sense that it occurs at home, technology allows for surveillance wherever a victim is, and often the victim effectively becomes controlled, internalising the rules, adapting behaviour to survive.
× Domestic abuse resulting in child being at risk of significant harm
× Homeless Child/Young Person
In May 2009, the House of Lords made a landmark judgement in the case of R (G) v London Borough of Southwark which affects how local authorities provide accommodation and support for homeless 16- and 17-year-olds.
Where the young person requires emergency accommodation (level 4) the statutory agency receiving the approach shall accommodate pending any statutory determination of duties owed.
Where a district housing authority accommodate under (4) above or the young person requests an Assessment of Need under Section 17 Children’s Act 1989, the district housing authority shall continue to accommodate pending that statutory determination
Where Children’s Services accommodate under (4) above but the young person chooses to progress under homelessness provisions rather than be accommodated under Section 20 The Children Act 1989:
Children’s Services shall refer the young person to the district housing authority.
× Homeless Child/Young Person
× Family intentionally homeless
A family may be deemed intentionally homeless if one or more of the following is applies
× Extreme poverty affecting child well-being
“Individuals, families and groups in the population can be said to be in poverty when they lack resources to obtain the type of diet, participate in the activities and have the living conditions and amenities which are customary, or at least widely encouraged and approved, in the societies in which they belong.” (Prof Peter Townsend)
Higher levels of child poverty are associated with worse child health outcomes, read more about this in the BMJ Journal here
This report identifies and discusses evidence about the relationship between poverty and child abuse and neglect.
× Extreme poverty affecting child well-being
× Forced Marriage, Honour Based Violence, Female Genital Mutilation
Harmful Practices are forms of violence and abuse which have been committed primarily against women and girls in certain communities and societies for so long that they are considered, or presented by perpetrators, as part of accepted cultural practice. This includes:
Physical (including threats, actual physical violence and sexual violence)
Emotional and psychological (for example, when someone is made to feel like they’re bringing shame on their family).
Financial abuse (taking wages or not giving someone any money) can also be a factor.
Risk Indicators
EDUCATION
AGENCY INVOLVEMENT
HEALTH
FAMILY
× Forced Marriage, Honour Based Violence, Female Genital Mutilation
-
Parents & Carers
- Protected by carers
- Secure and caring home
- Receive and act on information, advice and guidance
- Appropriate boundaries maintained
× Protected by carers
× Protected by carers
× Secure and caring home
× Secure and caring home
× Receive and act on information, advice and guidance
× Receive and act on information, advice and guidance
× Appropriate boundaries maintained
× Appropriate boundaries maintained
-
Parents & Carers
- Inconsistent care arrangements
- Poor supervision by parent/carer
- Poor response to child’s physical, emotional or health needs
- Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences (ACEs)
× Inconsistent care arrangements
Consistency teaches children predictability, and it eliminates the stress, confusion and anxiety that comes from not knowing what might happen or being able to contain inevitable uncertainties.
Children need to feel trust in their parents and care givers. This trust provides important security that shapes the child’s behaviour and emotions. When a child doesn’t feel trust because parents are inconsistent, the child may feel confusion, anxiety and distrust. Inconsistent parenting may even contribute to negative behaviour in children because children may be seeking to illicit predicted responses.
× Inconsistent care arrangements
× Poor supervision by parent/carer
Poor parental supervision often begins at early childhood; however, the consequences of this parenting style might not become obvious until the child becomes a teenager.
Indications of poor parental supervision in early childhood can be when children experience injuries for which they and parents appear to have no explanation. Teenagers who lack parental supervision are more likely to engage in early sexual behaviour and experiences with drugs and alcohol than children of authoritative parents. The influence of peers is significantly high during the teenage years, and a poor self-image may allow these individuals more susceptible to engage in criminal behaviour or become the subject of exploitation themselves.
In some cases, the problem is complicated by public and professional responses to young people. Sometimes children are considered a source of disorder and their behaviour must be restricted, this may make young people feel angry and unwanted. They are out on the streets because they have nowhere else to turn, and because they are not appreciated at home.
There may be reasons why a parent or carers ability to provide care and supervision has been compromised and professionals need to remain mindful of this wider context when seeking to support a parent improving their ability to keep their child in mind.
Read more: Parental supervision: the views and experiences of young people and their parents
× Poor supervision by parent/carer
× Poor response to child’s physical, emotional or health needs
There is significant research as to how parents and carers responses shape children’s development. The quality of parent-child relationships is significantly associated with: learning skills and educational achievement; social competence; children’s own views of themselves, including their sense of self-worth; aggressive ‘externalising’ behaviour and delinquency; depression, anxiety and other ‘internalising’ problems; and high-risk health behaviours.
Research has found that parenting programmes to support parents have increasingly become a matter of public health. Read more
× Poor response to child’s physical, emotional or health needs
× Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences (ACEs)
There is a growing body of evidence that our experiences during childhood can affect health throughout our lives. Children who experience stressful and poor quality childhoods are more likely to adopt health-harming behaviours during adolescence which can themselves lead to mental health illnesses and higher rates of diseases such as cancer, heart disease and diabetes later in life.
Adverse Childhood Experiences (ACEs) are not just a concern for health. Experiencing ACEs means individuals are more likely to perform poorly in school, more likely to be involved in crime and ultimately less likely to be a productive member of society.
People who experience ACEs as children often end up trying to raise their own children in households where ACEs are more common. Such a cycle of childhood adversity can lock successive generations of families into poor health and anti-social behaviour for generations. Equally however, preventing ACEs in a single generation or reducing their impacts can benefit not only those children but also future generations.
× Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences (ACEs)
-
Parents & Carers
- Parental learning or physical disability, substance misuse, or mental health impacts on parenting
- Inconsistent care arrangements
- Poor supervision by parent/carer
- Poor response to identified needs
- Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences
× Parental learning or physical disability, substance misuse, or mental health impacts on parenting
Substance misuse, domestic violence, learning disability and mental illness, can have a significant impact on children’s welfare .
Research, and in particular the biennial overview reports of serious case reviews (Brandon et al 2008; 2009; 2010), have continued to emphasise the importance of understanding and acting on concerns about children’s safety and welfare when living in households where these types of parental problems are present.
Evidence from the 1995 child protection research (Department of Health 1995a) indicated that when parents have problems of their own, these may adversely affect their capacity to respond to the needs of their children.
In addition to meeting the general needs of parents from disadvantaged backgrounds, it is important to consider the more specialised forms of support required by families in specific circumstances, such as support for parents with mental health difficulties or disabilities, or with substance misuse problems. Good collaborative arrangements are required between services for adults, where the adult is a parent, and children’s services, in particular, where children may be especially vulnerable.
Prevention and supporting recovery is at the heart of this strategy. A ‘whole-life’ approach is proposed in order to break the inter-generational paths to dependency by supporting vulnerable families, providing good quality education and advice, intervening early and supporting people to recover. Relevant agencies are expected to work together to address the needs of the whole person. To prevent substance misuse amongst children and young people (some of whom will have parents who misuse drugs and alcohol)
Read more: Childrens’ Needs & Parenting Capacity
× Parental learning or physical disability, substance misuse, or mental health impacts on parenting
× Inconsistent care arrangements
Consistency teaches children predictability, and it eliminates the stress, confusion and anxiety that comes from not knowing what might happen or being able to contain inevitable uncertainties.
Children need to feel trust in their parents and care givers. This trust provides important security that shapes the child’s behaviour and emotions. When a child doesn’t feel trust because parents are inconsistent, the child may feel confusion, anxiety and distrust. Inconsistent parenting may even contribute to negative behaviour in children because children may be seeking to illicit predicted responses.
× Inconsistent care arrangements
× Poor supervision by parent/carer
Poor parental supervision often begins at early childhood; however, the consequences of this parenting style might not become obvious until the child becomes a teenager.
Indications of poor parental supervision in early childhood can be when children experience injuries for which they and parents appear to have no explanation. Teenagers who lack parental supervision are more likely to engage in early sexual behaviour and experiences with drugs and alcohol than children of authoritative parents. The influence of peers is significantly high during the teenage years, and a poor self-image may allow these individuals more susceptible to engage in criminal behaviour or becomes the subject of exploitation themselves.
In some cases, the problem is complicated by public and professional responses to young people. Sometimes children are considered a source of disorder and their behaviour must be restricted, this may make young people feel angry and unwanted. They are out on the streets because they have nowhere else to turn, and because they are not appreciated at home.
There may be reasons why a parent or carers ability to provide care and supervision has been compromised and professionals need to remain mindful of this wider context when seeking to support a parent improving their ability to keep their child in mind.
Read more: Parental supervision: the views and experiences of young people and their parents
× Poor supervision by parent/carer
× Poor response to identified needs
There is significant research as to how parents and carers responses shape children’s development. The quality of parent-child relationships is significantly associated with: Learning skills and educational achievement, Social competence, Children’s own views of themselves. Including their sense of self-worth, aggressive ‘externalising’ behaviour and delinquency, depression, anxiety and other ‘internalising’ problems, high-risk health behaviours.
Research has found that parenting programmes to support parents have increasingly become a matter of public health. Read more
× Poor response to identified needs
× Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences
There is a growing body of evidence that our experiences during childhood can affect health throughout our lives. Children who experience stressful and poor quality childhoods are more likely to adopt health-harming behaviours during adolescence which can themselves lead to mental health illnesses and higher rates of diseases such as cancer, heart disease and diabetes later in life.
Adverse Childhood Experiences (ACEs) are not just a concern for health. Experiencing ACEs means individuals are more likely to perform poorly in school, more likely to be involved in crime and ultimately less likely to be a productive member of society.
People who experience ACEs as children often end up trying to raise their own children in households where ACEs are more common. Such a cycle of childhood adversity can lock successive generations of families into poor health and anti-social behaviour for generations. Equally however, preventing ACEs in a single generation or reducing their impacts can benefit not only those children but also future generations.
× Historic context of parents/carers own childhood, i.e Adverse Childhood Experiences
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Parents & Carers
- Edge of care
- Child has been abandoned and there are no family/ friends options
- Parents are deceased and there are no family/friends options
- Parents are in prison and there are no family/friends options
- Parents in hospital and no family and friend options
- Child whose welfare and development can only be safeguarded through provision of accommodation outside of the family/friend network
- Child is beyond parental control and there are no family/friends options
- Meets criteria for secure accommodation
- Child remanded to Local Authority care/custody
- Unaccompanied asylum seeking children who require accommodation
- Eligible & Relevant Care Leavers
- Children and young people whose adoption placement has broken down and there is no family or friend options.
- Parental encouragement of abusive/offending behaviour
- Continuing poor supervision in the home
- Parental non-compliance / superficial co-operation
- Inconsistent parenting affects child’s developmental progress
- Private fostering
- Children sent from abroad to stay with another family, usually to improve their educational opportunities;
- Asylum-seeking and refugee children;
- Teenagers who, having broken ties with their parents, are staying in short-term arrangements with friends or other non-relatives;
- Language students living with host families.
× Edge of care
Children may be on the edge of care for a number of reasons. The criteria for accessing care is detailed below:
× Edge of care
× Parental encouragement of abusive/offending behaviour
× Parental encouragement of abusive/offending behaviour
× Continuing poor supervision in the home
Poor parental supervision often begins at early childhood; however, the consequences of this parenting style might not become obvious until the child becomes a teenager.
Indications of poor parental supervision in early childhood can be when children experience injuries for which they and parents appear to have no explanation. Teenagers who lack parental supervision are more likely to engage in early sexual behaviour and experiences with drugs and alcohol than children of authoritative parents. The influence of peers is significantly high during the teenage years, and a poor self-image may allow these individuals more susceptible to engage in criminal behaviour or becomes the subject of exploitation themselves.
In some cases, the problem is complicated by public and professional responses to young people. Sometimes children are considered a source of disorder and their behaviour must be restricted, this may make young people feel angry and unwanted. They are out on the streets because they have nowhere else to turn, and because they are not appreciated at home.
There may be reasons why a parent or carers ability to provide care and supervision has been compromised and professionals need to remain mindful of this wider context when seeking to support a parent improving their ability to keep their child in mind.
Read more: Parental supervision: the views and experiences of young people and their parents
× Continuing poor supervision in the home
× Parental non-compliance / superficial co-operation
Non-compliant behaviour; involves proactively sabotaging efforts to bring about change or alternatively passively disengaging.
Disguised compliance; involves clients not admitting to their lack of commitment to change but working subversively to undermine the process.
× Parental non-compliance / superficial co-operation
× Inconsistent parenting affects child’s developmental progress
Consistency teaches children predictability, and it eliminates the stress, confusion and anxiety that comes from not knowing what might happen or being able to contain inevitable uncertainties.
Children need to feel trust in their parents and care givers. This trust provides important security that shapes the child’s behaviour and emotions. When a child doesn’t feel trust because parents are inconsistent, the child may feel confusion, anxiety and distrust. Inconsistent parenting may even contribute to negative behaviour in children because children may be seeking to elicit predicted responses.
There is significant research as to how parents and carers responses shape children’s development. The quality of parent-child relationships is significantly associated with: Learning skills and educational achievement, Social competence, Children’s own views of themselves. Including their sense of self-worth, aggressive ‘externalising’ behaviour and delinquency, depression, anxiety and other ‘internalising’ problems, high-risk health behaviours.
A 2012 DFE study found that a negative parenting style characterised by more harsh, inconsistent discipline was clearly associated with more severe child antisocial behaviour.
Research has found that parenting programmes to support parents have increasingly become a matter of public health.
Read more:
× Inconsistent parenting affects child’s developmental progress
× Private fostering
A private fostering arrangement is essentially one that is made without the involvement of a Local Authority for the care of a child under the age of 16 (under 18 if disabled) by someone other than a parent or close relative for 28 days or more. Privately fostered children are a diverse and sometimes vulnerable group which includes:
Under the Children Act 1989, private foster carers and those with Parental Responsibility are required to notify the local authority of their intention to privately foster or to have a child privately fostered, or where a child is privately fostered in an emergency.
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Level of assessment
No formal assessment -
Level of assessment
Consider commencement of Early Help Assessment / Pastoral Support Plan -
Level of assessment
Strengthening Families Early Help Assessment and Plan -
Level of assessment
Strengthening Families > Child in Need Plan or Child Protection Conference -
Go direct to Service or search the Family Service Directory for the Local Offer, or call the Family Information Service on 01273 293545
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Consider commencement of Early Help Strengthening Families Assessment.
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Early Help Strengthening Families Assessment & Plan. If you require advice or guidance in respect of the child needs contact the Front Door For Families on 01273 290400
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Contact Front Door For Families on 01273 290400 or if the child is at immediate risk call the Police on 999