The impact of Covid-19 on children and families

This post offers observations about the impact of Covid-19 on children and families, the current challenges facing commissioners and providers in meeting needs and how they are responding, and some suggestions on the future direction for commissioning. It has been prepared by IPC Principal Consultant, Clare Dodwell.

Whilst the government has issued guidance and some additional funding for children’s social care services and other agencies that provide intensive and specialist support to children and families with a statutory plan; there has been relatively little attention given to the early help services that work with thousands of families to tackle emerging issues and problems early on.

We think that the landscape of early help deserves more consideration if we are to avoid a scenario where the indirect consequences of the Covid-19 lockdown results in family needs being picked up late, when they have become complex and chronic, more damaging to children’s life chances and more costly for society as a whole. Emerging data suggests that referrals to children’s social care have fallen by as much as half since the Covid-19 lockdown (Local Government Chronicle, 23 April). Faced with the immediate crisis in adult services, local authorities have inevitably prioritised the needs of older people and those with underlying health conditions. Families who are ‘not known’ to children’s social care but had been benefitting from open access, early intervention provision (stay and play drop ins at children’s centres, for example) have become out of touch now that these services are closed.

What is the impact of Covid-19 on children and families?

The majority of children and young people are thought to be at lower risk of developing serious symptoms or dying from Covid-19 than adults and older people.

Nonetheless, there are some key challenges that are likely to be impacting many families, threatening those that were already struggling to function well and tipping many more into a fragile position. Risk factors include:

Poverty – the economic impact of Covid-19 is hitting hard and despite government funding schemes, many people’s livelihoods are at risk. It is likely that many more children will be growing up in hardship as their parents face job losses and falls in earnings. More families may not be able to provide basic necessities to keep their children safe and well, like housing, food, clothing and technology like laptops, now essential for learning at home.

Mental health and wellbeing – Research is revealing that many parents and children are likely to be experiencing a deterioration in mental health and wellbeing at this time (Transforming Mental Health and the Academy of Medical Sciences, 2020). The huge uncertainty around employment/income, as well as the day-to-day pressures of being together 24/7 under the same roof and trying to home school children is causing an increase in stress and anxiety amongst parents. Children and young people are coping with major changes in routine and the loss of normal activities like meeting friends, going to youth clubs, libraries, sports and leisure activities and playgrounds. This can result in feelings of loneliness and isolation, and an increase in stress, anxiety or low mood.

Family conflict – the new stresses in the home may at worst lead to an increase in abuse. We know from research (Harold, 2018) that exposure to prolonged intense arguing can be as damaging to children as exposure to actual violence. There are many reports that domestic abuse is increasing – the UK’s largest domestic abuse charity, Refuge, recently reported a 700% increase in calls to its helpline in a single day.

A decrease in protective factors which help to mitigate these risks in ‘normal times’ include:

• The closure of universal services like schools and nurseries that provide pastoral as well as practical help. Although there is still some provision for vulnerable children and the children of key workers, the closure of schools and nurseries means that the vast majority of children and young people are not able to benefit from the watchful eyes of staff who are trained to spot problems early on and offer support.
• The reduction in other services like health visiting, the service that carries out face to face child development checks at key points between birth and age five, and can provide early support has been stripped back, with staff being re-deployed into nursing roles. Other ‘open access’, early help services like drop ins and stay and play sessions at children and family centres have been suspended. Likewise, the role of grandparents and extended family as part of a network of wider support has been curtailed by the need for shielding and social distancing.

What are the implications for the delivery of early help at the current time?

Early help aims to promote and protect health and wellbeing, working with family members to enhance their strengths and develop protective factors that will prevent their needs from escalating. It means both intervening early in a child’s life as well as early on when problems start developing. What we know from our reviews of the research (Institute of Public Care, 2016) is that early help is most effective when it includes elements such as:

• Joined up, multi-agency working which incorporates statutory as well as voluntary and community and private sector organisations
• Whole family approaches, often delivered in the family home on an intensive basis over a sustained period
• Trusting relationships between professionals and family members, built up through active listening, non-judgemental attitudes and open communication
• Strengths-based and solutions focused interventions
• Targeted approaches (targeting individual families or vulnerable communities)
• A focus on supporting improvements in parent functioning and parenting
• Services and interventions that are evidence-based, and where there has been a high degree of fidelity to the specified methodology

Clearly, the disruptions to normal services and ways of working at the current time mean that it is difficult to deliver early help in some of the ways described above which require close and regular contact between workers and families, and commissioners and providers are experimenting with new approaches at pace, currently. These might include drawing on local community assets and networks, building on the ‘social protection model’ that advocates linking families to communities in ways that widen circles of safety and connection (Featherstone, 2020) . Others are embracing the use of virtual and digital methods of delivery (Institute of Public Care, 2020), although early research has highlighted some challenges and risks associated with these methods which need to be borne in mind (Early Intervention Foundation, 2020).

Responses from the Sector

Conversations with commissioners provide a flavour of what is happening around the country. In London, for example, one local authority is pressing ahead with plans to launch a new open-access service for children and young people to support their mental health and wellbeing. The contract for the service had been awarded before the pandemic, and commissioner and provider are working together closely to develop on-line methods to provide wellbeing coaching to children and young people in the borough who self-refer. Making sure that ‘word gets out there’ about the new service is vital and a lot of effort is being put into promoting the service through formal and informal communication channels to reach those that need it most. What is not yet known is the extent to which trusting relationships between the workers and young people can be effectively established through online contact.

Another local authority in the South West of England with a well embedded early support offer has been proactive in finding ways to keep this going during lockdown. Whilst referrals into their Early Help Hub have decreased, informal contacts from individuals seeking help for friends and neighbours has increased. In one case, a phone call by a neighbour resulted in the offer of a nursery place to support a family not known to children’s social care who were struggling. Community development workers who are part of locality early help teams have proved to be invaluable in linking families to community support. Likewise, Money Matters advisors have been able to help families facing financial problems, including issuing store cards and providing debt advice. Young people experiencing poor emotional and mental health are ‘loving the new technology’ that Targeted Youth Support workers are using to keep in touch. Regular auditing of Covid-19 support plans that have been put in place with families at all levels of need, are helping to reveal where the gaps might be and enabling staff to seek solutions. Data is already showing an increase in the take up of education and early years provision, following negotiations with schools and nurseries to make their lockdown provision available to a greater range of children that would benefit from it.

Next steps: suggestions for children’s commissioners

These are just a couple of very recent examples of how commissioners and providers are working together to respond flexibly and quickly to changing needs as the Covid-19 pandemic continues. More generally, we think there are a number of things that commissioners can do to strengthen invaluable early help services:

Identify and plan for emerging need, for example bereavement support for families who have lost love ones to the virus; an increase in demand for mental health and wellbeing support as children, young people and families experience anxiety and fear about the uncertainties that lie ahead.

Make better use of data to identify vulnerable groups locally. The newly published ‘local area profiles of child vulnerability’ are one source; others include Joint Strategic Needs Assessments (JSNAs) and child health profiles.

Systematically gather and collate observations and data – both quantitative and qualitative about new services, pathways and approaches that are being developed at this time, for example virtual and digital innovations, to help inform decisions about whether they are effective and worth carrying on with

Strengthen relationships with the voluntary and community sector, recognising the significant contribution they make to meeting the needs of children, young people and families – develop long term partnerships built on trust and respect rather than short term contracts.

Review the market – are there sufficient suppliers to meet predicted need Develop useful communication tools for engaging with providers such as commissioning strategies and market position statements and proactively shape the market in readiness for re-designing services post Covid-19.

References

Early Intervention Foundation (April 2020) Covid-19 and early intervention: evidence, challenges and risks relating to virtual and digital delivery.

Featherstone (April 2020) Social work with children and families in the pandemic. Research in Practice.

Harold (2018) Interparental conflict and youth psychopathology: an evidence review and practice focused update, The Journal of Child Psychology and Psychiatry, Volume 59, issue 4

Institute of Public Care (2016) Evaluation of the Integrated Family Support Service in Newport.

Institute of Public Care (May 2020) Providing arms length, digital support for vulnerable young people

Transforming Mental Health and the Academy of Medical Sciences (April 2020) Survey results: understanding people’s concerns about the mental health impact of the COVID-19 pandemic