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Islington Think Family Service. Islington Think Family. What is Think Family? Partners What we’ve done so far Challenges and benefits What next?. What is Think Family?. Background: Families at Risk Review Stats – national/local A Think Family approach What it looks like in Islington.

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islington think family
Islington Think Family
  • What is Think Family?
  • Partners
  • What we’ve done so far
  • Challenges and benefits
  • What next?
what is think family
What is Think Family?
  • Background: Families at Risk Review

Stats – national/local

  • A Think Family approach
  • What it looks like in Islington
partners
Partners
  • Family Action
  • NHS Islington
  • Mental Health Foundation Trust
  • Children’s Social Care
  • Islington Families/EPIC
  • Community Service Volunteers (CSV)
  • All agencies working with children, adults, families
what we ve done so far
What we’ve done so far
  • Audit- safeguarding and mental health
  • Staff team/extended Pathfinder
  • Piloted a model
  • Developed a WFA tool
  • Direct work with families
  • Direct work with Young Carers
  • Indirect work – consultation/training
  • DCSF – national conference and consultation
  • Independent Parent Consultation
  • Mapped Social networks of our partnering agencies
challenges
Challenges
  • Different risk thresholds, legislation, separate guidance on policy and practice.
  • Expectation that referrer remains involved
  • Anxieties – expertise, professional trust, loss of autonomy
  • Resistance to change
  • Team cohesion
  • IT/database
  • Change in political agenda
benefits
Benefits
  • Inclusive approach – engaging whole families and children and young people
  • Small case loads
  • Intensive outreach
  • Enthusiasm and commitment to achieving better outcomes, joint working etc.
  • MDT approach-’multi heads/ideas’
  • CSV (Rachel J)
  • High Intensity young carer work(YC pathfinder)
csv think family volunteers
CSV Think Family Volunteers
  • Based on CSV’s successful Volunteers in Child Protection (ViCP) projects
  • Aim was to integrate volunteer support into TAFs, WFAs and exit plans for families
  • Rigorous recruitment, selection and training procedures and ongoing monitoring and support
  • Now expanded to include referrals from TF partners – CIN, CMHT and CAMHS teams
  • Development of a Think Family plan for each match using key TF impact areas
csv think family volunteers9
CSV Think Family Volunteers
  • Benefits:
  • High level of interest in volunteering – 308 enquiries and 83 applications from members of the public
  • Positive feedback from current matches and strong stats from pre-existing projects e.g. 0% re-referral rate for families with CP plans in Bromley
  • Fits in well with current government’s national agenda (Big Society etc) and winner of 2010 Charity Awards
  • Capacity to provide more intensive support for longer than most statutory services (2hrs a week for 6mths)
csv think family volunteers10
CSV Think Family Volunteers
  • Challenges:
  • Establishing the need within a service and clear referral routes with partner agencies
  • Boundaries of the volunteer role and service
  • Matching volunteers to families and managing both parties expectations
  • Timescales of the service – making an impact and evaluating outcomes
young carers
Young Carers

A child or young person (under 18) who is caring out significant caring tasks and assuming a level of responsibility for another person, which would usually be taken by an adult”.

Definition provided by Department of Health (1995)

qualitative differences in the reasons for caring
Qualitative differences in the reasons for caring.
  • Mental Health
    • Instability in family patterns
    • Difficulty understanding about the illness and fantasies about the illness.
    • Emotional availability of the parent
    • Hyper vigilance
    • Stigma

-- Long-term illness

-- Separation due to hospital stay

  • Physical Disability
    • Physical strain on the young person
    • Strain on their health/recreation time due to on going tasks
    • Parent may be able to be more available emotionally.
    • Stigma
  • Substance Misuse
    • Impact of parents change in mood and behaviour patterns
    • Vigilance
    • Stigma – leading to lack of communication within the family and outside the immediate network.

-- Stigma attached to some illnesses (e.g. HIV)

-- Fear of bereavement

-- Lack of understanding of the illness

impact on young carers
Impact on Young Carers
  • Emotional burden of caring affects physical and mental wellbeing
  • Lack of positive or consistent role models may affect choices in regard to healthy eating/physical activity/sexual activity/use of drugs and alcohol
  • Missing school/dropping out early
  • Falling behind in school work
  • High Instances of Bullying and isolation
  • Challenges to parent/school relationship
  • Lack of social opportunities
  • Lack of consistent boundaries
the young carers service response to the needs
The young carers service response to the needs
  • Recognition of the role of being a young carer
  • Provision of social opportunities and respite via groups and outings and residential trips.
  • Family events and groups
  • Child friendly explanation of illness/disability (inc FAB and KTW)
  • Key person to talk to about life experiences and any worries
  • Linking families with services to improve outcomes
  • Facilitating families to use their own resources and wider family to reduce the role of the young person (FGC’s)
messages from children an young people
Messages from Children an Young People
  • Introduce Yourself
  • Give as much information as you can
  • Tell them what is wrong with their parent
  • Tell them what is going to happen next
  • Talk and Listen to them
  • As them what they know and what they think
  • Tell them it is not their fault
  • Don’t ignore them
  • Keep on talking to them and keep them informed
  • Tell them if there is anyone they can talk to

Barnardo’s (2007)

referral
Referral

The referral for the family was received from Islington Children’s Social Care who advised that Ms A had a diagnosis of Depression and is Agoraphobic. Ms A was being assessed by the Mental Health Crisis Team following an incident where she drank a bottle of rum and was having suicidal thoughts.

family history
Family History
  • Long history of Depression
  • Experience of being in care
  • Experience of physical abuse, emotional abuse, neglect and sexual abuse as a child
  • Experience of Forced marriage
  • Several past relationships that featured domestic abuse, most recently with B’s father which she fled to London as a result of
  • History of alcohol misuse
  • Family isolation/disownment
  • History of minimal engagement with services
  • Several past suicide attempts as well as a history of self-harm
other professionals working with the family
Other Professionals working with the Family

Social Worker

Think Family Key Worker/ Young Carers Worker

Learning Mentor from B’s School

Substance Misuse Support Worker

Family Therapist

Mentor for Child

Young Peoples Drug and Alcohol Service

Adult Psychologist

identified need
Identified Need
  • B was identified as a young carer as a result of A’s mental illness, substance misuse and physical ailments
  • Exploration around the seriousness of A’s Suicidal thoughts
  • Support around A’s alcohol misuse
  • A had not discussed any issues around Mental Illness or Substance Misuse with B therefore he had no age appropriate understanding of his mother’s difficulties
  • There were concerns regarding the impact of A’s moods and mental health on B
  • A had no support for herself regarding her mental illness and identified this as a need
  • Emotional Support for A and support around understanding impact of mental illness, substance misuse B’s caring role and her relationship with her partner at the time on B
  • A had a history of minimal engagement and then disengagement with services
  • B was very unconfident, experienced bullying and isolated himself with his peers at school
  • B’s school attendance was erratic and he was often late
support provided
Support Provided
  • Regular communication between all professionals to ensure a co-ordinated approach to provide holistic approach of work with the family
  • Psychological Assessment and referral to Adult Psychology for CBT
  • FAB Group and access to other Young Carers Groups
  • Weekly home visits to offer emotional support and to discuss other areas of support with A
  • A was met with weekly to offer emotional support and to discuss some of the practical difficulties that she was having regarding other professionals and family members throughout the work
  • B attended the FAB group to look at and address some issues around parental substance/alcohol misuse.
slide23
One to one support sessions were provided to B around his mother’s mental illness and substance misuse, his young caring and how all these things connected.
  • Family Therapy Sessions were attended regularly by A to explore her feelings around her ex-partner and how they related to her mental health, emotional well-being and the impact of this on B.
  • A and her ex-partner attended several sessions of Family Therapy together to discuss their relationship and think about how this impacts on B
  • B completed a course in an Art Group at School and Graduated from the group. He expressed that he liked the group and had fun in it.
positive outcomes for a
Positive Outcomes for A
  • A engaged well with all support provided
  • The Crisis Team closed her case
  • A has been able to be very honest with Think Family around her mental health and different aspects of her life that which has allowed a flexible method of working.
  • A visits her GP on a regular basis who monitors her medications, which she takes as prescribed.
  • A has said that she feels that B has calmed down and is now more manageable in relation to his behaviour.
  • Following Family Therapy A began to explore her feelings around her ex-partner and how they related to her mental health, emotional well-being and the impact of this on B. This resulted in a decision to end the relationship consequentially allowing her to move forward in other aspects of her life
slide25
A reduced her social isolation by becoming more involved with the school
  • As a result of the regular emotional support A informed of an improvement in her self-confidence
  • A felt well supported in Team around the Family Meetings where she had previously felt attacked by professionals
  • A has advised that she has not drunk alcohol to excess since May 2010
  • A has a future appointment date for her initial sessions of CBT
positive outcomes for b
Positive Outcomes for B
  • B has been able to meet other young carers through the FAB group and other groups
  • B has had the opportunity and openly discuss issues around alcohol misuse, mental health and young carers
  • B now has an age appropriate understanding of mental health and substance misuse and how it relates to his family/mother.
  • B’s school attendance improved and instances of lateness reduced
  • Through support from the social worker, school and young carers worker B is feeling more confident in addressing bullying and has advised that he is no longer being bullied
  • B is reported to be better able to make positive peer relationships
  • B is listening more at home and is able to better verbalise his feelings/emotions
  • Awareness that his mother is getting the appropriate support that she needs
the final phase
The Final Phase
  • Reflection, Monitoring and Evaluation
  • Volunteer service- Taking forward the TF approach
  • Taking forward the audit recommendations
  • Maintaining corporate and political profile
  • Linking with other pathfinders and similar services-national findings
  • Applying the principles of Think Family in times of austerity
  • Taking forward Carers pathway
  • Launch of joint protocol/joint training.
outcomes
Outcomes
  • 51% of cases decreased risk level by 1 level, 22% by two levels, 15% stayed the same (London continuum of need)
  • 23% contained plus DV plus substance use and young carer.
  • 59% of parents where on CPA
  • Therefore multi-stressed families in high need- we had set out to be early intervention/universal
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