Targeting Troubled Families
The summer disturbances in the UK’s cities generated intense reflection on the state of family life with the Prime Minister identifying broken and "troubled" families as principal causes of the unrest. He made two commitments to families; a new ‘family test’ which would be applied to all domestic Government policy in future and a pledge "to turn around the lives of the 120,000 most troubled families in the country" because the Government considered the breakdown of family life as a major contributor to the disturbances. In asserting that a minority of chaotic families were linked to far-reaching social disorder, the Prime Minister underlined continuity rather than change in public policy. For the scenario of the “families from hell" who have disproportionate impact on their communities was conjured by the Labour Government, although Prime Minister Gordon Brown put smaller numbers on the problem.
Speaking at the 2009 Labour Party Conference, Brown announced that ‘Starting now and right across the next Parliament every one of the 50,000 most chaotic families will be part of a family intervention project – with clear rules, and clear punishments if they don't stick to them.’
The Family Intervention Project is a home-based intensive family support service aimed at families with multiple complex needs who also present challenging and offending behaviour to their communities. It is delivered by a key worker for periods of around a year and can be accompanied by sanctions for non-compliance such as eviction and the loss of social housing. Initiated by Labour the programme was already scheduled for roll-out by the Coalition before the summer unrest.
The present Government, also like its predecessor, asserts that a relatively small number of families can generate disproportionately high costs to the tax-payer. The Department of Communities and Local Government recently estimated that around £8 billion a year is spent on the 120,000 families that have multiple complex problems such as poor parenting, anti-social behaviour, domestic violence, and substance misuse.
Both Labour and the Coalition Governments have developed mechanics aimed at cutting the duplication in the spending on local services for families with multiple complex needs. For Labour this was the Total Place programme. And under the Coalition from April this year 28 councils and their partners in 16 areas were put in charge of 'Community Budgets' that pool various strands of Whitehall funding into a single 'local bank account' for tackling social problems around this group of families.
A third response by the Coalition is employment-focussed provision for families with multiple problems which is supported through the DWP’s European Social Fund (ESF) Co-financing arrangements. Around £270m for the period 2011-13 will be spent on Work Programme places and helping families with multiple problems.
This seems like generous resource but is it sufficient and can these responses to "troubled" families succeed? And even if they can, is it really so desirable to focus on "troubled" families in this way?
The Community Budgets initiative to pool resources and cuts duplication makes very good sense; and the Family Intervention Project is an evidence-based programme with a reputation for delivery under both Labour and the Coalition. The latest statistics show that that FIPs have more than halved truancy and school exclusion and domestic violence in the families they have been supporting and reduced child protection issues by around a third.
But interestingly the FIP programme is a small scale intervention relative to the scale of the problem that has been identified. Since the inception of FIP as a programme in 2007 it has worked with just over 9,000 families relative to the 120,000 families that have now been identified. This is not unconnected to its costs: the cost of a FIP working with one of the highest need families, including on drug and alcohol and offending issues, is up to £20,000 a year; and at its cheapest it costs £8, 000 a family.
This investment is excellent value for money for the tax payer relative to the costs of the family's behaviour to social services and police, and priceless for the vulnerable families and children concerned and their communities; but it is unclear whether this level of FIP will be rolled out to all 120,000 families.
If so, the Government could have to find up to £2.4 billion in investment. While £2.222 billion (2011-12) and £2.307 billion (2012-13) of early intervention grant is being allocated to local authorities in England this must also fund universal programmes and activities available to all children, young people and families, including children’s centres to which the Government is also strongly committed. It is as yet not clear yet what the impact of the pooled Community Budget monies will be. Private equity investment is a potential option in the future but is currently only in the pilot phase for home-based family support.
And while the ESF monies are welcome these are work-focussed. However, for many of us working with families with multiple complex needs there is a big question mark over whether employment is a realistic goal for them in the short-to-medium term when many of them have mental health, disability and child protection issues, they have skills and literacy issues and unemployment is high.
Since the PM's announcement in the summer the Government admitted that work will not be an option for all 120,000 families with multiple complex needs. So targeting the Work programme and ESF monies at all these families will not be a good use of public resources.
But setting aside the work focussed monies, even if we were to assume that all the funding streams such as the Early Intervention Grants were adequate is it really desirable that the main focus of resources should be the targeting of a FIPs-style intervention at 120,000 families with multiple complex needs?
The FIPs programme is often mistakenly viewed as an early intervention when it is more properly seen as a crisis intervention: that is intervening at a relatively stage when communities cannot ignore families. This is why it is costly; and by itself it will not prevent the creation of further generation of families with multiple complex needs.
But an issue is that the Government's definition of families with multiple complex needs is hazy. Its rhetoric has defined the "troubled" in troubled families as worklessness or criminal behaviour. The reality is that many families with multiple complex needs are neither fecklessly avoiding work nor presenting any anti-social behaviour to their neighbourhoods. They are simply highly disadvantaged and vulnerable adults and children who are not getting the local social and educational services they desperately need.
Some do need intensive home-based family support along FIPs lines but they need it earlier and without the heavy handed sanctions of FIPs. Parents with mental health issues or learning disabilities want support to better self manage their conditions and disabilities and learn techniques so as to manage their households and children's behaviour and reduce family stress.
The good news is that if such help is given early enough it can be cheaper than FIPs. For example independent evaluation has shown that Building Bridges, Family Action's home support services, can be delivered for a cost of around £4000 per family per year while reducing the need for, and costs of the Care Programme Approach for adults and local authority care for children.
But arguably intervening even earlier before multiple complex needs develop is crucial because the new neuroscience is telling us that children’s life development is hugely impacted by the first years of life.
For example some parental mental health conditions begin, or get worse, in pregnancy. Up to one in six mothers will become depressed before or after the birth of their child with a likely negative impact on the mother-child bonding relationship and their child’s development. Therefore, services which spot and support very isolated mothers-to-be at higher risk of perinatal depression so as to mitigate these risks can potentially do a lot more to avert damage to children than interventions in later life.
Also because they intervene earlier before more costly problems like truancy and children’s conduct disorders develop they are also much cheaper than FIPs – Family Action’s perinatal service costs just £4,000 a year a family - but currently they are not as well-funded.
The focus on FIPs and the most troubled families also neglect the role that well-funded universally accessed children’s centres run along a community hub model can play in identifying disadvantaged children and parents and helping them to prevent problems spiralling by lower levels of multi-faceted support.
Children’s centres are a cost-effective way of delivering the mix of support such families need, from help with parenting and child care and play activities to help with benefits, and job searches. Most importantly they give parents chances to participate in the running of services, form informal support networks with their peers, and build forms of social capital which are likely to make their families active community participants, rather than antagonists.
The Government commitments to intervention in families with multiple complex needs and the achievement of FIPs are to be welcomed. However such rhetoric needs to be less punitive and the needs of the families better defined We also need to see investment in services for a wider range of struggling families which are genuinely early intervention in approach . Worryingly many of these services, including children's centres, are being lost or cut as commissioners are forced to concentrate on their resources on families who present the greatest risks.
There also needs to be more joined-up thinking across Government. The impact of welfare reform which is presently proceeding in Parliament threatens the success of intervention in the most at-risk families. For example if the PM’s "troubled" families are kept on the move by decreasing levels of housing benefit and the welfare benefit cap, Community Budgets will find it difficult to deliver and there will be a limit to how far any investment in a FIP or other intervention can strengthen their resilience and promote the stability of communities.
Overall linking benefits to the CPI rather than the RPI is likely to hurt the spending of all families who depend on welfare as an element of income amidst the present economic crisis.
As the Prime Minister said "If it hurts families, if it undermines commitment, if it tramples over the values that keeps people together, or stops families from being together, then we shouldn’t do it." If his family-friendly approach is to work it must be inclusive of the most troubled families and those who are just struggling, and universal as well as specialist services to families. And it cannot ignore welfare.
