1. Young People who are Hard to Help Patrick Ayre Department of Applied Social Studies University of Bedfordshire Park Square, Luton email: pga@patrickayre.co.uk web: http://patrickayre.co.uk

2. “Hard to Help”: The complexity of the challenge Young people may be Victims, Perpetrators Parents Any combination of the above but have the same right to be safeguarded as any other child.

3. The background “The reviews showed that state care did not always support these young people fully and that they experienced ‘agency neglect’” Brandon and others (2008).

4. The young people Adolescence marks start of serious problems for many children: –Onset of mental health issues –Family conflict –Drug use, offending –Sexual activity –Running away

5. The young people (Brandon and others) History of rejection, loss and, usually, severe maltreatment Long term intensive involvement from multiple agencies Parents: history of abuse and current mental health and substance issues Difficult to contain in school Typically self-harming and misusing substances, often self-neglect

6. The young people (Brandon and others) Numerous placement breakdowns Running away, going missing Risk of dangerous sexual activity including exploitation Sometimes placed in specialist settings, only to be withdrawn because of running away

7. The young people (My experience) Long involvement, but not always intense Sometimes few placements, but all wrecked by the young person Common factor that local services just did not know what to do with them. ‘By the time of the incident, for many of the young people, little or help was being offered because agencies appeared to have run out of helping strategies’ (Brandon and others, 2008).

8. The response Reluctance to identify mental illness and suicidal intent (CAMHS) Failure to respond in a sustained way to extreme distress manifested in risky behaviour (sex, drugs, suicide attempts) Instead of ‘pulling together’, multi-agency response shows fragmentation, ignoring, responsibility shifting, freezing/inertia and generally avoidant behaviour Reasons for running not addressed adequately

9. The response Running away leads to discharge [More generally, does rejection of services lead to total abandonment?] Age used as a reason for not imposing services No proper assessment of competence; allowed/forced to choose [Dealing with incidents but failing to recognise patterns]

10. The obstacles Hard to get a purchase on the system Wrong children, wrong adults (Ayre, 2000) Lack of off-the-shelf resources The limited resources are poorly coordinated and integrated Government targets not child centred or child driven Different agency agendas and mutual misunderstanding; falling down the gap

11. The solutions? Biehal (2005) recommends adolescent support teams in the community [but is that enough?] The complexity of the challenge requires flexible collaborative, individualised responses built around the young person Specialist assessment and treatment?