Example Essays - Social Work Essays
An exploratory study into the experiences of women using the Home Start service.
Laing (1971) maintains that problems in the family create problems in the wider society. There has, however, been a largely 'laissez-faire' attitude to family policy (Harding, 1996) whereby agencies respond to identified family needs.
This requires the co-operation of both statutory and voluntary organisations such as Home Start. There is little evidence, however, as to how effective this kind of working actually is, especially as voluntary projects have to justify their existence and may thus make claims that are not easy to substantiate (Shinman et al, 1996).
Home Start began with an initial project in Leicester more than thirty years ago. It is now a national organisation comprising some three hundred projects. National Office provides a link and support for the various neighbourhood voluntary projects. Home Start was formed to give help and advice to mothers with young children, particularly those who were away from family and friends. The organisation provides a place where mothers and young children can get together and individual projects will sometimes have days out and other activities.
Home Start trains its volunteers to help families dealing with specific problems such as mothers with post-natal depression, parenting problems, and those who just can't seem to manage or who feel themselves to be isolated. Volunteers will visit parents in their homes and can offer friendship and practical help to those families with at least one child under the age of five. This paper will look at identified sources of stress experienced by some mothers. It will also look at the role of volunteers in providing practical help and support. Finally it will attempt to establish what effect this may have on families and whether it may be said that this works in the long term.
Reasons for Referral
Home Start projects and volunteers do some work with children who are deemed to be at risk but they are only a small part of the case load. The largest number of referrals and calls for help are for mothers who are lonely and are finding it difficult to cope. This may be because they are disabled, or have children who are disabled, or they may be new to the area and unused to coping without family help (Oakley et al, 1998). Families are also likely to be referred if they are living in poverty and in some cases if domestic violence is suspected. Mothers who have children with behaviour difficulties may also be referred and in some cases they just need to hear that there are others whose children behave in the same way. Referrals are usually made by social workers and by health visitors but not all of them will abide by the referral.
Children and Care in the Community
The Tory Government of the 1980s and early '90s introduced a marketing approach to health and social welfare and this saw a corresponding growth in the number of voluntary organisations who offered to provide support in the community. Fox-Harding (1996) argues that cutbacks in benefits payments and in the welfare state generally has resulted in increased familial responsibility e.g. other family members looking after children while their mother works. However, those who do not, for whatever reason, have such a family structure are often referred to voluntary parenting initiatives such as Home Start for advice and support. since the 1989 Children's Act local authorities and voluntary organisations are required to collaborate in assessing children's needs and providing support where needed.
However this inter-agency co-operation does not always involve effective working relationships and this can result in children's needs being overlooked (Sutton, 1995). Oakley et al (1998) maintain that the necessity of such organisations to compete for funding may sometimes lead to an overstatement of the benefits such support might bring.
Mothers
Many of the mothers who are referred to Home Start have problems coping with their children and quite a few of them are referred for depression, either post-natal depression or the mild depression associated with a young mother on her own all day with toddlers. Mothers who use Home Start often have non-supportive partners, some of them are lone mothers who have little social contact and may attend drop-in centres to have some contact with other mothers, or in some cases to get time for themselves.
Many pressures can affect the quality of family life-poverty, isolation, relationship breakdown or bereavement, as well as disability, mental and physical ill health and multiple births. The stress of coping with these problems can prevent even the most committed and loving parents from giving their children the start in life that they deserve (Homestart, 2003:5).
Oakley et al (1998) state that the service is aimed generally at women and that most women who use Home Start are referred by their health visitor and some by their G.P. They say that being socially isolated is one of the most common reasons for referral and that child behavioural difficulties are also a reason for referral. Health professionals tend to see social support as the main reason for referring to organisations such as Home Start. Genuine child protection concerns or women with severe depression would be referred to a statutory authority or for counselling/psychiatric advice.
The level of help a woman receives will depend on whether there is an available volunteer in her area, if not, then it will be limited to attendance at the drop in centre. If a woman needs some support at home because of a lack of support structures, or because she is depressed and finding it difficult to cope with a new baby and there is no volunteer available then she may have to go on a waiting list. It is arguably the case that it is in this type of situation that families can fall through the net and the collaboration between agencies to ensure the family's and particularly the child's welfare goes wrong. While Home Start will inform health visitors and GPs once a referral has been taken up, if they cannot then provide the appropriate help, mothers can quickly become disillusioned (Oakley et al, 1998).
Volunteers
The majority of volunteers are women with children of their own. A few of them however, are fathers who befriend lone fathers. They can both offer advice and a friendly ear for someone who needs to talk. They will deliver and collect a child from school if the parent is unwell and will sometimes get shopping or baby sit so that a parent can have sometime to themselves (Homestart, 2003).
Sometimes there are problems if a volunteer does not meet with the expectations of the person who has been referred. In their study Oakley et al (1998) found that some volunteers needed someone to listen to them and that was not helpful. One woman reported that her child did not like being collected from school by someone she did not know well and that this adversely affected the child's behaviour. Homestart's website and literature presents the success stories where mothers (and fathers) describe their volunteers as good friends. Although volunteers do undergo some training much of their usefulness to parents in crisis is borne out of their own experience.
One lone father said that he had spent eight months struggling before he was referred to Home Start that his volunteer had also experienced lone fatherhood and shared experiences that prevented the father from making some of the same mistakes (Homestart, 2003). Some families have felt so much better that they have begun a group in their own area. This was the case for a deaf couple who were having a difficult time but later felt that their involvement with Home Start had totally changed things for them (Homestart, 2004).
However it is part of the ethos of Home Start to promote themselves as an effective component in supporting families and in preventing family breakdown. Certainly some parents do speak of feeling happier in themselves and thus coping better. Oakley et al (1998) do raise the question of how far these projects are as effective as they present themselves. While they would argue that they do effect people's lives positively, and the stories represented in Home Start literature would tend to support the view that in some cases they do have a positive effect there is no way of gauging whether this is long term.
Organisations such as Home Start do provide a support service where statutory services are lacking but as some commentators argue families referred to Home Start may also be accessing statutory support. Even with statutory support however, it is not easy to measure the long term effects of any support/intervention as once a crisis is over such support is no longer deemed necessary, not just by the person who has been referred, but by the service providers to whom they are referred. Oakley et al (1998) found that some of the women in their study reported that being involved with Home Start had not helped them at all or had given them other problems while around a quarter of those involved in the study reported some positive change.
Organisations are not always aware how great the non-take up of referrals might be and this can have a significant effect on the number of people who it is claimed have benefited from the service. Oakley et al (1998) argue that organisations such as Home Start do not take kindly to being objectively evaluated and that this made it difficult because it was seen in pejorative terms. Statutory organisations will often buy in the services of voluntary organisations and may also refer to them but in many cases this does not involve effective collaborative working and so it is difficult to ascertain whether all the money that is allocated for children's needs is well spent. A London Professor of Child Psychology has written of such initiatives that:
there is some evidence to suggest that beneficial changes to children's behaviour, and parent's levels of stress and self-esteem result from participating in parenting programmes. Nevertheless, a considerable number of questions remain to be answered about the outcomes of parenting programmes. These include the question of whether specific short and long-term benefits are gained by children, parents and families from which approaches (Davis, H and Day, C. no date or page no).
Conclusion
Home Start projects are starting up in all parts of the country and a pilot scheme is testing out projects at an international level There are many different funded projects, Camden Family Service Unit operated for one year helping Chinese families who had children with mental health problems. It is unfortunate that there is no sustainable core funding for such small projects because accessing such a project can mean that families are then able to access other services that they might otherwise not have used. Certainly projects like Home Start are filling a gap in service provision and in some cases families will have easier access to other services.
Oakley et al (1998) demonstrate that there are significant problems in assessing how effective these projects are on a wide scale, some of this is due to the fact that there is no clear estimate of those families who are referred but then fail to take up the referral. Referral records are not a good way of assessing this because although they keep a record of referrals they fail to account for those who do not act on that referral. There is also concern at government level over the rising cost of such services. The authors quote the Audit Commission of 1994:
At present some 2 billion a year is spent on services provided by community childhealth and social services authorities, but little is known of their impact (Audit Commission 1994:1 quoted in Oakley et al, 1998:20).
The Commission found that only twenty five percent of authorities operated effective co-operative working partnerships that monitored the progress of those families who accessed parenting support initiatives such as Home Start. Pugh et al (1994) found that this did not just apply in the voluntary sector but was evidenced across all family welfare and support services. There was a dearth of evidence on which to base the effectiveness of such services and to plan for future service delivery. Organisations such as Home Start do provide a service that some parents have found effective. Their various web-sites do highlight successful cases, and these are also commented on in yearly reviews. How far these examples may be generalised remains, however, a difficult question. Certainly there needs to be some sort of yard stick by which agencies and funding bodies might be able to measure such effects over a period of time
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Bibliography
Davis, H. and Day, C. A Framework for the development of parenting initiatives http://www.cpcs.org.uk/research8.asp
for commissioners and purchasers of family support
Fox-Harding, L. 1996. Family, State, and Social Policy. Macmillan, Basingstoke.
http://www.home-start.org.uk/site/document/Home-Start%20Annual%20Review%202004
http://www.home-start.org.uk/site/document/report2003.pdf
http://www.mentalhealth.org.uk/page.cfm?pagecode=PIBFPSSD
Laing, R.D. 1971 Self and Others. Penguin, Harmondsworth
London.
Oakley, Rajan, and Turner1998. Evaluating parent support initiatives Health and Social Care in the Community 6(5), 318-330 319
Pugh G., Deth E. & Smith C.1994 Confident Parents, Confident Children. National Children's Bureau, London
Shinman S.M. 1996. Family Health and Home-Start: information
Home-Start UK, Leicester.
Sutton P. 1995 Crossing the Boundaries: A discussion of
Children's Services Plans. National Children's Bureau,
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