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UK Joint Social Work Conference
9th July 2008
Christine SmartChildren’s Rights Director - Cafcass
Dean Coe, Lois O’Neill and Ylber NezirajYoung People’s Board Members - Cafcass
Presentation by Sarah Woodhead
Outline
• Why did we hold the event?
• What were the benefits to Cafcass?
• About the day…
• The Report
• Quotes from the Participants
• The Findings
Why did we hold the event?Young People’s Board investigation consideration
An opportunity to address other key areas relating to health, with event structured to:
Find out young people’s opinions on health and healthcare provided
Identify success in existing support and service provision
Identify gaps and commission and provide services in the future
Inform young people, improving understanding in key health and lifestyle area
Final deliverable: report highlighting findings
What was the benefit to Cafcass?
See it from the young person’s perspective
• To be better able to influence the care plans for a child in proceedings in future.
• To recognise the health issues that need to be addressed for children in care whilst planning for their future.
• To be better informed of the collaborative partnerships of those involved in the life of a child in care.
• An opportunity to listen to the needs, wishes and feelings of children in care.
About the day…
When - Wednesday 20th February, 2008
Where - National Space Centre, Leicester
Who attended – Young People aged 12-18, either in care or recent care leavers
About the day… (cont’d)
The Consultation was split into three parts:
• Focus Groups – to encourage discussion of issues
• Question Cards – to record views and experiences
• Information Stations – to provide leaflets and access to further sources of advice and guidance
Topic Areas
• Smoking
• Alcohol
• Drugs
• Emotional and Mental Wellbeing
• Relationships and Sexual health
• General Health
• Healthy Eating
About the day… (cont’d)
The Question Cards:
• One for each topic area
• Multiple choice / short written answers
• Hand in Question Cards at the Information tables
The Report
Following the event, all information gathered from questionnaires and focus groups was processed by an external consultant.
In collaboration with the Cafcass CR team, a final report will be drawn.
This report will be made available to the services / carers who attended the event prior to publication VIA the Cafcass web-site in July.
This will also be officially published and distributed through ADCS and other key partner agencies involved in the care of looked after children.
Respondents
Table 1: Type of Care Arrangement
Residential care homes
Alternative arrangements(mostly foster care, afew care leavers)
0
10
20
30
40
50
60
Frequency
Male Female
Gender
Table 2: Number of Respondents by Gender
Table 3: Number of respondents by ethnicityPakistani
Asian Other
African
Caribbean
Black Other
White & Asian
White & Black African
White & BlackCaribbeanMixed Other
‘‘English’’
Irish
Other
The Findings
“The health and wellbeing day in February 2008 at the National Space Centre provided a tremendous opportunity to capture the voices of looked after children and young people”
“The majority of them appear to be doing well in many ways. The majority of them do not smoke”
“Peer pressure emerges in the research as an important factor in people starting to smoke, drink and take drugs. It appears to be especially important for girls and young women”
Alcohol
Table 4: Weekly Alcohol Consumption of Respondents Who Drink
No. drinks per week
Frequency Per cent
1-5 21 75
6-10 7 25
Total 28 100
Table 5: Age started alcohol consumption
Age Frequency Per cent
<6 1 2.4
6-8 1 2.4
9-11 7 17.1
12-14 28 68.3
15-17 4 9.8
Total 41 100.0
Table 6: Reasons for starting drinking
Reason Frequency Per cent
Peer pressure 14 34
Liked the taste 8 20
Nothing else to do 5 12
don’t know 7 17
unhappiness/depression
2 5
It was available 1 2
Other 13 32
Total 41 *
* some respondents gave more than 1 reason therefore percentages do not add up to 100
Issues for consideration
Advice and support should be available for young people who wish to reduce their alcohol consumption Someone that young people can trust to discuss issues relating to alcohol with would be helpful Peer pressure is an important factor in influencing people to start drinking. Effective intervention in this area may be useful, especially directed towards helping girls and young women
•Over half young people in care drink alcohol and many started at a very young age
•Nearly half the sample answered the questionnaire on
whether alcohol affected their daily lives.
•Young people drink for many different reasons
As a focus group participant said:
‘People get drunk because their friends are doing it – peer pressure.’
Alcohol
Smoking
Table 7: Amount of Tobacco Consumption
0
2
4
6
8
10
1.-5 6.-10 11.-20 21-40 71-100 100+
No. Cigarettes per week
Fre
qu
ency
Table 8: Age Respondents started smoking
7 or less
8 to 11
12 to 15
Table 9: Reasons for Starting Smoking
Reason Frequency Per cent
Peer pressure 13 44.8
Boredom 3 10.3
To calm down 4 13.8
Don't know 4 13.8
Other 5 17.2
Total 29 100.0
Table 10: Strategies to help Young People in Care Smoke Less
Smoke less
More information &advice
Support, encouragement& activities
Nothing
Change laws or policy
Other
Issues for considerationHigh proportions of young people wish to stop smoking and assistance should be available to help them The clearest need is for intervention designed to assist young people to resist peer pressure Intervention needs to be targeted at young people from a very early age Support, encouragement and activities should be used to help people stop smoking Information and advice should be available to young people on how to stop smoking Support is needed to alleviate stress felt by looked after children and young people
•Most respondents did not smoke
•Almost a third of young people were smoking between 11 and 20 cigarettes a week
•Most people started smoking while they were between 12 and 15 years of age
•As with alcohol, peer pressure was seen as an important factor in young people starting smoking
One focus group member said, for instance:
‘It’s all around you. If you’re sitting in a park, someone gets out a cig…you want to do the same. You want to be in with the crew.’
Smoking
Drugs
Table 11: Drug Use and Ethnicity
Use Drugs Total
Ethnicity No Yes
‘English’ 43 (89%)
5 (11%)
48
Non-’English’ 26 (84%)
5 (16%)
31
87
Table 12: Types of Drugs Used
0
2
4
6
8
10
Cannabis Amphetamine Glue Ketamine
Drug
Fre
qu
ency
Issues for considerationInterventions should be designed to help people to resist peer pressure
Interventions targeted at young people should incorporate the very young
Providing information through leaflets might not reach everybody, especially the very young
Need to provide activities - ‘something to do’ - as a form of engagement of young people moving on to development
Provide support, advice and information – where it reaches the target audience and where they can access it
Innovative methods may be needed to assist overcoming or preventing drugs use, such as photographs of drugs users showing ill effects, speakers who have experience and knowledge of drugs
Drugs
•The vast majority of young people - 89 per cent answering the questionnaire - said that they did not use drugs. 11 per cent, amounting to ten people, did use drugs.
•Of the ten using drugs, six people started at between 12 and 15 years
old. One started using drugs at less than 7 years old, another between 8 and 11 years of age.
•Some of the focus group attendees said that they were currently taking drugs of different kinds or had done in the past.
•Some knew dealers locally to where they live and perceive them to be making a lot of money. Some have had drug dealers in the family and parents who have been drug users.
One said:
‘My cousin, auntie, and uncle all smoke dope.’
Health and Wellbeing
Table 13: Health and Young People in Care
How healthy are you? Frequency Per cent
Unhealthy 2 2.4
Quite unhealthy 13 15.3
Average 29 34.1
Quite healthy 24 28.2
Healthy 17 20.0
Total 85 100.0
Table 14a: Frequency of Exercise
None
1-2 times
3-5 times
6-7 times
Table 14b: Factors that would Improve the Health of Young People
Frequency Per cent*
More Exercise 53 62
Healthier Food 38 45
More Sleep 30 35
More Fun 18 21
Smoke less 17 20
Drink Less 13 15
Use less drugs 8 9
More information 2 2
* Respondents could tick yes to more than one question and therefore percentages do not add up to 100
Table 15: Awareness of Government Policy On Health for Young People
Yes
No
Table 16: Fruit and Vegetable Consumption
0 5 10 15 20 25 30
None
1 to 2
3 to 4
5 or more
No
. p
er d
ay
Frequency
Table 17: Factors which help people in care eat healthier
Frequency Per cent*
Information and advice 17 27.9
Support, encouragement & activities
7 11.5
Make healthier food available
28 45.9
Other 9 14.7
Total 61 100.0
Table 18: Perceptions of Own Weight
0
10
20
30
40
50
60
70
Underweight Just right Overweight
Fre
qu
ency
Table 19: Body Mass Index
Underweight BMI lessthan 18.5
Ideal BMI 18.5-25
Overweight BMI 25-30
Obese BMI 30-40
The Findings
“Some of the information, advice and support that should be made available should be about eating healthily on a budget and how to cook, what to cook, and how to make cooking an enjoyable experience”
“Groups where young people who have been in care or are in care can get together and support each other would be of great benefit. This could be developed into a full mentoring system, organised by Cafcass”
Issues for consideration
More information, advice and support to be provided – where it reaches the target audience and where they can access it This should be about eating healthily on a budget and how to cook, what to cook, and how to make cooking an enjoyable experience. Wherever possible, make healthier food available
• Many said that young people in general were not very healthy.
• A number of different reasons were given for this: they ate unhealthily; they smoked too much; they drank too much alcohol; and there was too much drug taking. In addition, they were overweight and took too little exercise because of the strength of the influence of computer games and similar machines.
• About 60 per cent of the sample responded to the questionnaire on how often they exercise, producing answers that seemed to contradict this view of the general health of young people.
• Half of those answering said they engage in exercise three to five times a week,
• 22 per cent exercising once or twice a week, and
• A further 19 per cent claiming an athletic exercise regime of six to seven times a week. One focus group participant, describing diet and lifestyle in families they were placed with, said, for example:
‘In some families you get addicted to sweets and chocolate and don’t realise you are putting on weight.’
General Health
• Young people seemed very knowledgeable about food and had remembered talks that had been given in school.
• They knew what healthy and unhealthy foods were.
• They said that they knew where to look on the packaging for ingredients, including e-numbers and they knew about the concept of eating ‘5 a day’.
• Moreover, the focus group participants were also aware of the affects of unhealthy food, mentioning high blood pressure, high cholesterol, and risk of heart attack as possible consequences.
• Fast food is clearly a big part of the diet of young people
• Quite a high proportion of young people, however, are eating fruit and vegetables
• The questionnaire revealed that a third of the young people eat three or four portions of fruit or vegetables every day. Another third eat five portions of fruit or
vegetables per day.
• Some people in the focus groups said, however, that young people do not always have a choice about what they eat if they are in a foster home or a children’s residential home.
Healthy Eating
Relationships and Sexual Health
Table 20: Knowledge of where to get information about Sexual health
No
Yes
Table 21: Sufficiency of Information about Sexual Health
No
Yes
Table 22: Sexual health Worries of Young people in Care
Issues young people worry about
Frequency Per cent*
Pregnancy 65 80
Getting girlfriend pregnant 20 24
Getting a STI 52 63
How girl/boyfriend treats them
29 35
*Respondents could select more than one option therefore percentages do not add up to 100
0
10
20
30
40
50
Frequency
Carers Parents HealthClinics
YouthAdvisoryServices
GPs
Table 23: Where Young people go for Sexual health Advice
Table 24: Who Young people talk to for Sexual health/Relationship Advice
Frequency Per cent*
Friends 6 10
Family 22 35
Carer/foster carer 7 11
Counsellor 1 2
GP/Nurse 19 30
Health Visitor 1 2
Social Worker 3 5
Other 14 22
*Some respondents selected more than one answer therefore figures do not add up to 100 per cent
Table 25: How young people would advise others on sexual health
Frequency Per cent*
Don't have sex 5 9
Have safe sex/use condom
32 58
Get advice 7 13
Be careful/don't be silly 4 7
Don't feel pressurised 6 11
Other 1 2
Total 55 100
Table 26: Knowledge of issues relating to sexual health
Being a Parent
0
5
10
15
20
25
30
Nothing A little Loads As much asneed to know
Fre
qu
ency
How the Male Body works
0
5
10
15
20
25
30
35
Nothing A little Loads As much asneed to know
Fre
qu
ency
How the Female body works
05
101520
25303540
Nothing A little Loads As much asneed to know
Fre
qu
ency
Contraception
0
5
10
15
20
25
30
Nothing A little Loads As much asneed to know
Fre
qu
ency
STI
0
5
10
15
20
25
Nothing A little Loads As much asneed to know
Fre
qu
ency
HIV
0
5
10
15
20
25
Nothing A little Loads As much asneed to know
Fre
qu
ency
Pregnancy
0
5
10
15
20
25
30
35
Nothing A little Loads As much asneed to know
Fre
qu
ency
Issues for considerationProvide information and advice on relationships and sexual health – where it reaches the target audience and where they can access it Key objective for policy makers is to get accurate information to young people so that it reaches the target groups effectively and they act upon it As with alcohol, drugs, smoking, advice and information on sexual health needs to reach the very young Information and advice can best be disseminated through workshops to raise awareness, through positive role models, and through talks from young people experienced in relationships, parenting and sexual health issues
• Providing information on sexual health is crucial
•It is very clear from the focus group discussions that many of the young people found talking about sex embarrassing.
• Nonetheless, over 90 per cent answering the questionnaire said that they did know where to get information on sexual health..
• There was some debate about value of sex education in school, however, and clearly, getting sex education right is vital
•Presented with a range of options, which included getting pregnant, getting a sexually transmitted disease, girlfriend getting pregnant, and how their girlfriend/boyfriend treats them, getting a sexually transmitted disease was identified as the second biggest worry for young people, with pregnancy being the top.
As one of the participants in the focus groups commented on sex education:
‘If it was made in a way we’d understand, that we’d enjoy…relevant, interesting, if it’s not we’ll forget about it’.
Relationships and Sexual Health
Emotional and Mental Wellbeing
Table 27: Who Young People go to when Unhappy
Family
Foster carers
Friends
Counsellor
Boy/girlfriend
My room
No-one
Someone else
Other
Table 28: Current Feelings
Feel good about the way you look? Frequency Per cent*
No 44 51
Yes 43 49
Total 87 100
Feel good about how you are doing?
No 49 56
Yes 38 44
Total 87 100
Feel good about the way you feel?
No 45 52
Yes 42 48
Total 87 100
Feel good about future opportunities?
No 44 51
Yes 43 49
Total 87 100
Suffer from anxiety?
No 71 82
Yes 16 18
Total 87 100
Suffer from depression?
No 72 83
Yes 15 17
Total 87 100
Suffer from stress?
No 43 49
Yes 44 51
Total 87 100
The Findings
“Throughout the research, it was clear that many young people became angry and upset if they were seen as a ‘different breed’. They saw themselves as the same as anyone else and being in care had no bearing on whether or not they smoked, or took drugs, or drank alcohol”
“In another recurring theme, young people thought that they would behave differently if they were with their biological parents. Or it might be a variation of this, such as their parents would stop them smoking and they would listen, but they do not listen to their carers, because they are not the ‘real parents’.”
Issues for considerationYoung people would be helped by having someone they could talk to who would listen to them Being treated with respect, especially by social workers, is important Having a stable environment is important Groups where young people who have been in care or are in care can get together and support each other would be very helpful
•The general view in the focus groups was that young people are happy, going to school and meeting up with their friends.
•Sport made young people happy too, especially popular with the boys, naming it
their top activity.
•Nevertheless, some overall themes did emerge. One was people listening and talking to young people.
•Something else that would make young people feel happier is social workers valuing them and treating them with respect, which many thought did not currently happen.
•Again, the issue of people in care being treated differently was raised as being something that causes distress. One focus group participant said:
‘Being in care is a label. Everyone has to be police checked if they are to stay over. This makes life harder. Information about your care status is therefore disclosed. Young people are not happy about this.’
Emotional and Mental Wellbeing
Quotes from Participants
‘It’s about the way you are brought up as to whether you drink alcohol…it’s not just the care system that failed me’.
‘If it is illegal, more people want to do it’.
‘If you ask these questions to someone not in care, you would probably get the same answers.’
‘you are not given support quickly enough by social workers. Therefore, problems with alcohol get worse because the support is not there’.
‘People in care are looked on as being different. It’s wrong. We get all this feedback about how people in care are different from other people. Someone from a perfect background might smoke 40 fags a day.’
‘A lot of young people don’t want to take drugs, but if everybody is taking drugs then a young person will want to fit in.’
‘You’re not any different from anybody that’s not in care.’
‘Telling you is not enough. Instead of giving leaflets, having people speaking to you may help.’
Conclusions
• The findings of this research are important, capturing voices of young people on what their concerns are and issues facing them. • We know from the report that there are many good things to say about these young people.
• We knew that they are relatively happy despite facing what must have been difficult challenges in their young lives.
• We know that most of the them do not smoke, take drugs, or drink to excess.
• We also know that many of them eat fruit and vegetables and that a surprising number exercise regularly.
In addition, we also know that they are young people, like other young people, who face the normal developmental challenges of growing up. Where they are different is that they are not getting the right kind of support when they need it.
This emerges from all of our findings, which suggest that young people in care need:
•Someone to talk to who cares about them and can offer them guidance;
•To know that they are being treated in the same way as other young people, that they are not different because of their background;
•Help to overcome boredom and to find something to do; and
•Help to resist peer pressure. As with many young people in the general population, they start to smoke, drink and experiment with sex and drugs at an early age, so very young people need to be part of the target audience.
A number of factors have been identified that would help.
Firstly, those who are responsible for providing care to children need specific training in how to provide support that helps young people to deal with the normal developmental challenges that they will face, without losing sight of the specialist issues that the young person has to deal with. Training is needed:
•on how to deal with the issue of the young person in care feeling different from the rest of the family;
•on recognising the importance of encouraging young people to take part in activities; on how to decide which food are healthy and which are not;
•on how to provide information on sex and sexual health; and
•social workers would benefit from training in communicating their messages more effectively.
Secondly, the idea of providing safe environments - places that are open and welcoming to all young people, where they can
gather to socialise - would help in the fight against boredom.
“There is also much work to do. Listening to the voices of young people,
encapsulated in this report, provides many pointers to the way forward”
Professor Adrian L James
Department of Sociological Studies
University of Sheffield
Contact Details
Any comments or feedback to:
Christine Smart
0113 394 7493 / 07810 852560
Thank you for listening!