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Early intervention models of practice for better outcomes for children and young people

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Presentation on theme: "Early intervention models of practice for better outcomes for children and young people"— Presentation transcript:

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2 Early intervention models of practice for better outcomes for children and young people
Prevention, Partnership and Family Support Programme and Adverse Childhood Experiences

3 Tusla Services The Child and Family Agency’s services include a range of universal and targeted services: Child protection and welfare services; Educational welfare services; Psychological services; Alternative care; Family and locally-based community supports; Early years services; Domestic, sexual and gender-based violence services.

4 Policy Context

5 High Level Policy Statement on Supporting Families
Policy Context High Level Policy Statement on Supporting Families

6 First The First 5 Strategy sets out how to develop a system of integrated, cross-sectoral and high-quality supports and services –an effective early childhood system – that will help all babies and young children in Ireland to have positive early experiences. The family is considered throughout First 5 across all areas given its critical role in supporting positive experiences for young children.

7 Adverse Childhood Experiences
Children who are routinely exposed to situations such as domestic violence, mental ill health, alcohol and other substance misuse problems in their homes experience a negative impact which can last well into adulthood. These chronic stress situations are called Adverse Childhood Experiences (ACEs) and are often associated with poorer outcomes for children in educational attainment, employment, involvement in crime, family breakdown, and a range of health and wellbeing measures.

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9 Intergenerational cycle of harm
There is increased awareness of the impact of intergenerational cycle of harm on families and Adverse Childhood Experiences (ACEs). As the numbers of adverse experiences increase in utero and in the first 2 years of life the risk for negative health outcomes increases and the impact on the child’s developing brain and other biological systems. (Faculty of Public health Medicine).

10 Harvard Center on the Developing Child- Improving Outcomes
Recent advances in the science of brain development offer us an unprecedented opportunity Understanding how the experiences children have starting at birth even prenatally affect lifelong outcomes can be combined with new knowledge about the core capabilities adults need to thrive as parents and in the workplace

11 The Biology of Stress and Science of Hope
Support responsive relationships for children and adults Strengthen core life skills Reduce sources of stress in the lives of children and families

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16 Resilience Secure base / sense of security and attachment Self-esteem
Self-efficacy ‘I HAVE………….…people I trust and love’ ‘I AM……………………..a loveable person’ ‘I CAN…………find ways to solve problems’ Grotberg, E. (1997) ‘The international resilience project.’ In M. John (ed) A Charge against Society: The Child’s Right to Protection. London: Jessica Kingsley

17 Prevention Partnership and Family Support

18 What is PPFS? Greater participation of children and families
New Structure low, medium and high prevention services commissioned based on need, evidence and participation And arranged with all partners into localised Child and Family Support Networks Implementing Meitheal and parenting support approaches Workforce, learning and development Enhanced public awareness and communication l

19 Tusla’s Early Intervention and Prevention System
17 Area Managers 17 Senior Managers for PP&FS & Steering Committees linked to Children & Young People Services Committees Each of the 17 areas divided into local Child & Family Support Networks with Coordinators

20 What is Meitheal? Meitheal is a national early intervention practice model to ensure that the needs and strengths of children and their families are effectively identified, understood and responded to in a timely way so that children and families get the help and support needed to improve children’s outcomes and to realise their rights. Meitheal – A National Early Intervention Practice Model for all agencies working with children, young people and their families (2013, p. 1) Trainer Note: Meitheal is an old Irish term that describes how neighbours would come together to assist each other in the saving of crops or to carry out other tasks. In this context, Meitheal is a National Practice Model to ensure that the needs and strengths of children and their families are effectively identified, understood and responded to in a timely way so that children and families get the help and support needed to improve children’s outcomes and realise their rights. It is a multi-agency approach that can be used across all child and family services. NOTE: During the Meitheal process, if child protection concerns emerge then the Children First national guidance and legislation should be followed.

21 Voices of parents, children and practitioners
UCFRC's research study: Meitheal and CFSN's Process and Outcomes Study

22 Step by Step process Stage 1: Preparation
Considering whether a Meitheal is necessary/introducing it to parents/securing written consent/liaising with Child and Family Support Network Coordinator to initiate the process. Stage 2: Discussion Identifying strengths and needs and desired outcomes/considering appropriate response Stage 3: Delivery Planning and delivering support/monitoring and reviewing progress/ending and closing

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24 All three routes require parental consent
Routes into Meitheal Directly – as a result of discussion between parent and Lead Practitioner When referral under Children First does not reach threshold for SW intervention – family can be diverted Following SW assessment and/or intervention – outstanding unmet need – can be stepped down All three routes require parental consent Trainer Notes: There are three routes though which a family can access support through Meitheal: Directly, as a result of a discussion between a parent and a practitioner, who initiates a Meitheal by completing the Meitheal Request Form and forwarding it to the Child and Family Support Network Co-ordinator. This Request Form involves signed parental consent. When a referral under Children First is deemed not to have reached the threshold necessary for the involvement of the Child and Family Agency Social Work Department but due to outstanding unmet need, that requires child and family services, is diverted, with the consent of the parent, via the Child and Family Support Network Co-ordinator for an Early Intervention Response Pathway. When a referral is accepted to the Child and Family Agency Social Work Department and is deemed suitable for closure either after assessment or after a period of intervention but there is has outstanding unmet need requiring child and family support services, this case can be stepped down, with the consent of the parent, via the Child and Family Support Network Co-ordinator for an Early Intervention Response Pathway. Regardless of the route into Meitheal, parental consent is required before a Meitheal can be initiated.

25 Meitheal Case Study REASON FOR REQUEST
Request by Youth Service as concerned about 17 year old who was 6 months pregnant at risk of homelessness. Living with her mother and her sister who also had two children under 2

26 Meitheal Case Study STRENGTHS AND NEEDS
Young person wanted assistance and good network of supports available Housing – risk of eviction & also concern about housing conditions Parenting capacity and past unresolved trauma in childhood Support to remain in Education

27 Meitheal Case Study DESIRED OUTCOMES
Young person continues in education Housing issues addressed Provision of support to develop parenting skills and access to counselling service TEAM AROUND THE CHILD Dublin City Council, Youth Service, Family Resource Centre, PHN, Family Support, Counselling, MABs

28 Meitheal Case Study SUMMARY OF INTERVENTIONS
Youth Worker agreed to be lead practitioner & obtained consent. Family support to address housing issues Link family to MABS PHN to support mum on basic skills for parenting baby with Family Support Worker to support attendance as appointments arise

29 Meitheal Case Study POSITIVE OUTCOMES
Baby attending crèche & Mum remains in education Young mother (now an adult) moved out of the family home which she did in a planned manner with support Baby has attended all appointments No Child Protection concerns have arisen

30 Meitheal Early Intervention Model Research
The main findings are that Meitheal is improving family outcomes particularly from the perspective of mothers, showing the potential of Meitheal to improve and sustain improvement in outcomes over time. NUIG Child and Family Research Centre: Rodriguez, L., Cassidy, A. and Devaney, C. (2018) Meitheal and Child and Family Support Networks -Process and Outcomes Study. Galway: UNESCO Child and Family Research Centre, National University of Ireland Galway.

31 Maternal well-being was the most significant predictor of family outcomes suggesting that supporting mothers is key to support families. Meitheal was described as empowering by parents and families. They valued being listened to. Challenges remain around the participation of children and young people in Meitheal. Meitheal can have a positive impact on parental attitudes towards help-seeking behaviours and accessing services. Lead Practitioners feel Meitheal is a structured process that can facilitate change in family outcomes and the overall service provision system.

32 Early Intervention models in the community
On January 2019 HSE and Tusla jointly launched their Hidden Harm Strategic Statement and Practice Guide ‘Seeing Through Hidden Harm to Brighter Futures’ European Union’s INTERREG VA Programme, managed by the Special EU Programmes Body -The Multiple Adverse Childhood Experiences (MACE) – Breaking the Cycle Project

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