Social injustice and inequality in the care system Part 1: How professionals can inadvertently make things worse

Psychologists and social workers who see risk rather than need are doing families living in poverty a disservice

Photo by Emma Goldsmith on Unsplash
Sinead Peacock-Brennan

On August 16, the British Association for Social Workers (BASW) and Psychologists for Social Change (PSC) co-hosted an event to highlight social injustice and inequalities within the child protection and care systems.

I work as a clinical psychologist in a service for people with a learning disability and have been an active member of London PSC for three years. At the event, the audience heard presentations based on research and practical experience of psychologists, social workers and people with lived experience of the care system. I agreed to summarise the points that resonated with me, along with some of my own thoughts. 

After the main presentations small groups discussed what they had heard and came together to think about individual and collective action. I've collated our ideas in part 2 of this blog: "We need to be more 'counter', committed and personal". You can read BASW's Eve Wilson's take on the event here and watch a recording of part of the event here.
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What does the research say?
Professor Anna Gupta discussed her research, alongside that of Paul Bywaters, Andy Bilson and Michal Krumer-Nevo. Professor Gupta explained that a child is ten times more likely to be taken into care if they come from an area of high deprivation compared to an area of low deprivation. (Deprivation refers to a community's access, or lack of access, to important resources such as income, education, employment or health). This is also the case for children on a child protection plan, which is drawn up by the local authority and the family after an investigation to keep a child safe or improve their living conditions.

As local authorities have continued to be hit by austerity, there has been an increase in the numbers of children on protection plans, most often for emotional abuse or neglect (the proportion of children in care for physical or sexual abuse appears to stay the same). Despite this increase, a large proportion of children are not being offered any service after the investigation. So, families are labelled as not providing “good enough” care but not “bad enough” to warrant support, a situation that Professor Gupta suggested has contributed to the relationship between services and families feeling increasingly authoritarian and coercive.

What then is driving these differences in the involvement of child protection services? There is no evidence to suggest that parents in Blackpool (an area of high deprivation) love their children any less than parents in Wokingham (low deprivation). Is it down to the differing levels of deprivation?

Professor Gupta talked about the direct and indirect impacts of poverty on children and families – both of which play a role. A direct impact would be the inability to buy food for your family if you do not have access to money. An indirect impact would be the lack of power that people living in poverty hold, blocking their access to roles, rights and opportunities as well as having an impact on the way professionals interact with them.

Poverty was also talked about as a human rights issue, which has a symbolic as well as a concrete impact. As a psychologist, talking about poverty’s symbolic impact was helpful. It gave us space to consider the roles of stigma, discrimination and the “othering” process which takes place between professionals and families living in poverty. Othering is the tendency for humans to believe that the group that they are a part of (this could be any kind of social group from Manchester City supporters to working mothers to practising Christians) is inherently living the “right” way. Practising in a way that does not other families in the care system can be a challenge for professionals. Whether or not individuals consciously other on a personal level, it is inevitable on a structural level - the fact that families are on the radar of the care system communicates that their parenting has been judged and found not to be “right”.

We also discussed the knock-on effect of othering on feelings of shame and humiliation, both of which PSC presented as “austerity ailments” in our first briefing paper. Using this lens to make sense of families’ situations encouraged us to think more about the micro-aggressions families living in poverty face, as well as how professionals can contribute by acting as though the poverty is invisible during their interactions with families.
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How do professionals perpetuate these problems?
Professionals tend to talk about families’ problems in terms of the chances of something bad happening to them. We, as a profession, talk a lot about “risk”. In contrast, other important factors in families’ lives, such as poverty and inadequate housing, are largely absent from our discussions. The material and psychological impact of these factors are not acknowledged when we consider the barriers to the family having a happy or healthy life. This is a pattern that I recognised from my work in mental health services.

The result of formulating problems in this way is that any change or improvement is expected to come from individual members of the family. Help offered to parents is about improving their skills (through parenting classes), or their relationship with their children (through therapy). While both have a place, neither attempt to change aspects of family life at a more basic, social level. Examples of alternatives would be increasing parents’ access to financial resources (support in claiming benefits), or at a community level through access to community resources, peer-support or safe and consistent housing.

Professor Gupta talked of a culture of blame towards parents and a tendency to advocate for “child rescue”, a narrative which again erases the issue of poverty. She illustrated this with a quote from the then Secretary of State for Education, Michael Gove. In a 2013 speech Gove framed families’ situations as being on par with an earthquake or famine, seemingly out of human control and not in any way exacerbated by government policy:

We need to intervene to rescue them from an abusive environment just as determinedly as we would seek to rescue them from the scene of any natural disaster

In practice, this culture of parent blame and child rescue can present itself in the attitudes of people working in family services. Parents are labelled as “uncommitted” when they are unable to attend appointments due to travel costs. Parents become fearful of asking for help, aware that they will be labelled “high risk” or “neglectful”. This is also something psychologists are guilty of, said Dr Christina Trigeorgis, clinical psychologist and PSC member. She reiterated the importance of acknowledging social context in formal reports and ensuring that parental or familial “need” is not constructed as “risk”. Dr Trigeorgis warned of de-contextualizing people’s lives when drawing only from Western, individualised theories of psychology and said that even therapists who work with the relationships between people, groups and organisations can inadvertently narrow their lens to the family level, and fail to consider the wider social and political factors shaping the child or family.

The Unseen Impact
Patricia Bailey from ATD Fourth World UK, a human rights-based, anti-poverty organisation, read out the testimony of Angela Babb - a powerful testament of unequal access to the British education system. Angela outlined the list of barriers to obtaining a travel pass for her children to attend school. Her children’s non-attendance of school was constructed as parental failure, and professionals did not acknowledge the online access, email address, photo ID, and birth certificates which were required to obtain a travel pass. All of which required money which she did not have at the time. Highlighting the often unseen impact of poverty on accessing basic rights, such as education, she commented “please do not tell me that education is free”.

Read about how professionals can do things differently: Social injustice and inequality in the care system Part 2: "We need to be more 'counter', committed and personal"

Author

Sinead Peacock-Brennan is a clinical psychologist based in London.