Ms Ang Bee Lian, 27 June 2017
There has been a lot of interest in preventive work, and especially so in the area of early intervention. One of the challenges of early intervention work is to effectively direct resources towards areas where it makes a difference. To understand the challenge better, it is necessary to know what these efforts and interventions are trying to prevent in the causal relationship. Although there are always intermediary factors that will complicate the link, thinking critically about causality is important to ensure proper resource allocation and interventions. So what are some useful concepts that will help when we are thinking about early intervention? Let’s take a look at this in the context of child welfare.
In the case of families with young children, we should begin with thinking about the struggles faced by families who are known to the social service system. For these families, we want to offer better and early support so that they will not need child welfare services. And for those who require welfare services, we want to ensure that they do not need more serious interventions down the line. Thinking this way helps to link the work across the children and family social services. It also helps in thinking about the outcomes that we want to see when we work with these families.
From Data to Outcome
We often want to keep track of the children in vulnerable families who are embedded in case files, living in group homes, lingering in various forms of care outside of their families and who are part of the social service data system. The challenge then is to ensure that such information and data become statistics that can help us to reduce the number of children in care or the number of children experiencing neglect, abuse and harm. In essence, how can we develop the ability to use these data to drive decision-making? How can we build discipline in good assessment, good case planning and good follow-up to derive good outcomes for children?
A Stable Child Welfare System
Core to systems thinking is the deployment of the correct interventions systematically. The choice of intervention is based on a proper understanding of evidence and not just an assumption that any intervention that is early is good and preventive. Intervention should be based on a causative relationship no matter how difficult it may be to determine the link. Thereafter, having oversight and demanding adherence to good practice is crucial to ensuring good outcomes. The difficulty with compliance in such systems is the ongoing calls to deviate and experiment with something “untestedly” different. It is important to ensure that the system itself is stable to work with these families and to better protect children.
Intervening early for Vulnerable Families
Most families, with support from friends, neighbours and colleagues, are able to cope with crises and respond in a way that avoids disaster. However, families plunge into instability when they are not able to respond this way. Instability potentially brings with it many undesirable outcomes such as "evictions, addiction, domestic violence, abuse, and neglect" (Tierney, 2016)1. This is especially so in the case of vulnerable families who usually already present themselves with some of these problems.
What these families really need is intervention when they were beginning to struggle, when they still had a job or when the children were not yet at risk of being abused or irregular at school. While these families are often below the radar for detection, they are not outside our radar and can be detected early if we tune up the sensitivity in the system. Early intervention can possibly stave off more serious or drastic interventions.
Efforts in early intervention usually show good outcomes. These efforts usually work on a high trust basis as they involve sharing of information between partners such as schools and community agencies about families that are showing early signs of distress. The challenge then is the responsiveness of those who are able to work with such families as they often require the person helping to pull together access to resources through creative strategies and justifying the access. These early intervention efforts require a certain amount of regular "coaching, connections to community resources, access to treatment, and a steady presence in sometimes chaotic households" (Tierney, 2016)1. There is no one specific way or standard of intervention for such circumstances because they may not fit neatly into the standard criteria. They require the person who is helping to have tenacity to stay with the uncertainties and ambiguity inherent in such circumstances.
The good part of such work or early intervention is that the help arrives at the earliest signs of trouble, the support is injected long before things get so dire that statutory intervention has to be activated (Tierney, 2016)1. Using this approach, there are opportunities for partnerships to step forward to support family stability and to avoid state intervention.
Through the expansion of child care centres in Singapore, access to child care is less of a problem for children from disadvantaged circumstances. Child care is important as it provides a critical source of support for the parents and children. Let’s imagine a family in crisis with a parent who has lost his or her job. The whole family is under stress. The parent, perhaps a single mother, is desperately trying to find another job, while figuring out how to pay rent and to feed the children, doing everything possible to make sure the crisis doesn’t escalate. The children are under stress, scared and needing reassurance and stability.
The stories of such families could play out differently if they had access to support that could stabilize them and keep things from escalating into a major crisis. Often, child care is least on the mind of the parent as cost is involved. In the case of a single mother, she would often have the children in tow as she scrams to find employment. However, child care can be a critical source of support in times like this. The stabilizing effect of child care cannot be under estimated as the child can continue to go to a stable, loving place. The caregiver could help the child to work through his/ her fears to prevent him/ her from acting out so that the parent can focus on managing the crisis with the comfort of knowing that her child is safe.
The initial results from efforts such as the Circle of Care by the Lien Foundation and the Kids Start Programme testify to the value of child care as a critical stabilising measure. A caseworker, be it in the form of a social worker, case manager or coordinator, plays a significant role in linking the parent to resources that can help her with her various problems. In such situations, child care can mitigate the deterioration of instability in other parts of the child’s and family’s life.
However, child care in isolated instances could also ironically contribute to destabilising a family situation. Take the situation where a family can no longer afford child care, or a child is taken out of child care because of a child’s acting out or misconduct. The loss of care disrupts the equilibrium and increases tension and stress in the home. In such situations, quick access to a caseworker or social worker can help the family to access help and resources.
Focusing on ensuring that child care is affordable and accessible to vulnerable families and enabling early intervention can play a crucial role in stabilizing the lives of families, and especially single mothers. Such efforts can strengthen the web of support for families in trouble and help prevent them from becoming families in crisis.
1 Tierney, M. M. (2016). From Family Data to Neighborhood Outcomes. Stanford Social Innovation Review. Retrieved from https://ssir.org/articles/entry/from_family_data_to_neighborhood_outcomes
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MS ANG BEE LIAN
Director-General of Social Welfare