Episode 8: Beyond Help?
Throughout history, vulnerable young people suffering from trauma have been dismissed as 'beyond help' or simply too badly behaved by the institutions charged with their care.
In this episode of Life Solved we hear how this bias is still denying many the ongoing support needed to overcome childhood disadvantage. Dr Wendy Sims-Schouten explains how her research into history and present-day case notes for vulnerable children has revealed where institutions are failing young people, particularly when it comes to meeting the needs of different cultures. She also explains how different local organisations are coming together to address this.
Dr Sims-Schouten also explains how the Covid-19 pandemic highlighted and exacerbated deficits in existing support services, and tells us about her work to tackle some of these problems in partnership with the government, councils, charities and other researchers in the field.
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Are children ever 'beyond help'?
As a chartered psychologist, Wendy's focus is upon the mental health of children, particularly those in marginalised groups, in care or care leavers. Funding from the Wellcome Trust allowed Wendy to compare historic case notes with those of more recent young people and she was surprised to find the high number of children considered ‘beyond help’ – that is, dismissed in case notes as too difficult to fully engage in support services.
Wendy delved into the ‘blind spots’ that were causing some children to be dismissed in case notes and noticed a gap in understanding when it came to children recovering from trauma.
They are surviving that coping by sharing certain types of behaviours that may not necessarily be perceived as appropriate. But to them, it's a way of coping. It's a coping mechanism.
Misunderstood and vulnerable
Whether a consequence of poor resourcing or a lack of training in the support sector, Wendy’s work has highlighted the long-term harmful effects of giving up on a child as simply badly behaved. Her goal has since been to work directly with support workers, social workers and psychologists to adapt systems and attitudes. It’s her hope that a more nuanced practice will better reach children with behavioural difficulties as a result of traumatic experience.
There's always this group of children who are perceived as beyond help, too difficult, too complex. Their behaviour is all wrong and they're bad children. And those are the children that I'm most passionate about when it comes to supporting them.
Wendy also noticed an absence of these children’s ‘voices’ in case notes. Their wishes, thoughts, feelings and opinions didn’t come across strongly in research, and she suspects that a greater focus on the individual experience will lead to a better-informed support system.
Collaborating for change
This has led her to address what she sees as current issues in the care system via a collaborative network of government, council and local services. The MICE hub – or Mental Health in Childhood and Education Hub - aims to promote research and projects in the fields of mental health and wellbeing for young people. Through discussion, events, conferences and workshops, the project is moving towards a more inclusive debate on how to best support young people’s mental health in our institutions.
In addition to this, the MICE hub is driven by Wendy’s desire to incorporate understanding and sensitivity to different communities and cultures in a safeguarding programme. She says that a sensitivity to different conventions of expression is essential in helping children feel included and supported. This was particularly crucial in helping vulnerable children access school meals during the Covid-19 lockdowns.
Wendy says her work with the Racial Equality Council has opened her eyes to the different cultural requirements that can influence a young person’s experience and opportunities.
Now, Wendy’s framework of research combined with institutional collaboration is to be used internationally to help support the safety of vulnerable people working during Covid-19 conditions.
John Worsey: Thanks for downloading this podcast from the University of Portsmouth. I'm John Worsey, and every episode of this series brings you world-changing ideas and stories from our researchers.
John Worsey: Today in Life Solved, I'm talking to Dr Wendy Sims-Schouten about her wide-ranging research work to better represent and protect vulnerable people.
Wendy Sims-Schouten: By listening to anybody who is in a situation where they're disadvantaged, marginalised, vulnerable, you actually get to learn about their situation and you also get to see different sides of the story.
John Worsey: Dr Sims-Schouten is passionate about seeking out and hearing from marginalised voices.
Wendy Sims-Schouten: The key thing that motivates me is to make the world, and that sounds simplistic, but to make the world a better world for everybody and to be inclusive in the way we approach things.
John Worsey: We'll hear how her work has led her to delve into history and talk to hundreds of people to understand why unconscious bias in our institutions can leave some communities more vulnerable.
Wendy Sims-Schouten: I've done a number of studies with members from ethnic minority communities and I've interviewed them. It's been quite an eye-opener because, of course, as a white person, it's also about getting to know people from a different culture and by, you know, certain things happen when it comes to racism. How it is perceived? What can we do to change these things?
John Worsey: And critically, we'll hear how she's bringing people together to create change and a fairer, safer society.
John Worsey: Dr Wendy Sims-Schouten is an Associate Professor in Childhood Studies in the School of Education and Sociology at the University of Portsmouth.
Wendy Sims-Schouten: I keep coming across those children who consistently miss out on support. Children, for example, who are in care, care leavers or children who are perceived as, you know, their behaviour is too bad, they're beyond help. And that sort of got me into looking into mental health perceptions, historic mental health perceptions, and current perceptions around mental health and wellbeing in children.
John Worsey: Her studies span a broad spectrum of the areas that make up and can influence childhood experiences from wellbeing to education and sociology to psychology and history. She works with charities in the UK and abroad, as well as with Portsmouth City Council to put research into action.
Wendy Sims-Schouten: When it comes to practises around children, there are a number of things that could improve, such as multidisciplinary practises, teamwork.
John Worsey: As a chartered psychologist, Wendy's focus has been on the mental health of children.
Wendy Sims-Schouten: I was fascinated by some of the experiences of children when it comes to early trauma, attachment, school experiences such as bullying. I lived in Amsterdam at that point and I was awarded some funding to do research around children's care in Greece and Finland. So I lived in both countries for about six months and found out a lot about local childhood, interdisciplinary practises around childhood and wellbeing in different countries in Europe. So following this, I embarked on a PhD in psychology. I looked at early care, again day-care practises to support children. And slowly but surely got into research with a focus on the psychology of childhood, specifically in relation to, for example, bullying, wellbeing and childhood supporting disadvantaged and marginalised groups such as children in care and care leavers.
John Worsey: Safeguarding and wellbeing have always been at the heart of Wendy's research. But she became more curious about children and trauma when she was working in an adult mental health unit in the Netherlands. Wendy says that challenging historical biases and institutionalised blind spots has helped to uncover barriers to helping vulnerable people today.
Wendy Sims-Schouten: I was lucky enough to get funding from the Wellcome Trust to look at historic archives of children who were taken into care in this country in the Victorian times by the Children's Society, which was called the Waifs and Strays society at the time, and comparing this with current practises. And again, I saw that certain practises with certain very vulnerable children, they are sort of the same now as they were in the past. So we still have this narrative that although we like to talk about mental health, we like to support vulnerable children, there is always this group of children who are perceived as beyond help, too difficult, too complex. Their behaviour is all wrong and they're bad children. And those are the children that I'm most passionate about when it comes to supporting them. And I'm also interested in changing practises around those children. So improving the knowledge of psychologists, social workers when it comes to engaging with those children, but also being aware of their own perceptions.
John Worsey: Yes.
Wendy Sims-Schouten: Because sometimes you've worked in practice for a really long time, you almost become a little bit institutionalised and sometimes it's really hard to see the sort of maybe even unconscious bias you have towards certain children and families and I'd like to change that.
Wendy Sims-Schouten: It's not necessarily good enough to say that practitioners sometimes could be better at doing practice. Sometimes they simply don't have the means. So if there are funding cuts, if there are not enough resources, if there are not enough practitioners, or if there's not enough training, then the practitioners also become vulnerable groups themselves because they have to work with the limited means they have.
John Worsey: Wendy's historic research found that in records dated between 1881 and 1918, a shocking 46% of case notes suggested children were, in quotation marks, 'beyond help'.
John Worsey: The concept of giving up on a vulnerable child because of their behaviour after trauma is in itself deeply sad. But more concerning was what Wendy found in her research between 2015 and 2018, when she interviewed vulnerable care leavers.
Wendy Sims-Schouten: About 50% said they were 'beyond help'. The only way to change it is by centralising their voices. It is the narrative that you can see in their case files, because the heartbreaking thing is that the case files that I analysed – historic case files – there were lots of letters from those children. The were letters talking about their experiences and asking for somebody to understand them and to-- to see what was going on with them. So their voices are there. And of course, in the current situation, again, it's about centralising the voices of those people, which I've found that it has been quite empowering because by listening to young people, by listening to anybody who is in a situation where they're disadvantage, marginalised, vulnerable, you actually get to learn about their situation and you also get to see a different side of the story.
Wendy Sims-Schouten: So one of the care leavers, for example, I interviewed in Portsmouth and he was I think in his early 20s, and he explained how he felt that Big Brother was watching him. He had been in care all of his life, children's homes, foster care. And now he was a father and he felt that social services were looking at him because they were thinking, well, you've been in care, so there's no way you're going to be a good dad. So he felt that he didn't have a voice. So, again, it's about centralising their voices and feeding it back to-- to practitioners through training, different sessions that-- workshops. And that's made a difference because there's a number of things that I've done either in Portsmouth or abroad, for example, I've done some work in Egypt, working with people in Canada. It's about changing practises and creating awareness of-- of particular children needs and also where practice goes wrong.
John Worsey: When Wendy talks about centralising voices, she aims to hear individual experiences and prioritise those in approaches to caregiving. By seeing the person at the heart of the experience we can better relate to and address their vulnerabilities.
John Worsey: Wendy says that an understanding of different communities and cultures should all be a part of the way care and safeguarding are approached by institutions.
Wendy Sims-Schouten: Members from ethnic minority communities may have different needs, may have different cultural values, may have different ways of expressing themselves. So all of these things need to be taken into account. And it's-- it's simple things. For example, I was working in a school where a mixed-race girl had experienced severe bullying. Because of that, her behaviour had escalated and the school had excluded her. So I got involved. I did a number of training sessions with the teachers, because it turned out they had not had any diversity, inclusive practise training. So together with the Chair of the Racial Equality Council and a ethnic minority representative from the police, we did some training in the school, which was quite exciting. And we learnt quite a lot about lack of understanding things that, you know, bullying, racist bullying, how that's being perceived by people.
Wendy Sims-Schouten: All of that needs to be discussed and other things. Touching somebody-- somebody's hair. It is quite a common practise, you know, a child who's got afro hair, it seems to be quite tempting for some people to touch their hair. That can be quite upsetting. It can be quite personal. And again, there is sometimes a need to explain to teachers and practitioners that, no, it's not good enough, it's not appropriate to touch somebody's hair. And then sometimes the response from teachers will be, yeah, but they only touch her hair because they like her. But it's still not appropriate. It's still-- So there's certain things, certain practises that need to be discussed and changed because there is this unconscious bias or lack of understanding.
John Worsey: Wendy thinks the multidisciplinary nature of mental health and wellbeing means that when services are stretched, individual practitioners sometimes don't have all the resources they need to fully deal with an individual's issues at an early stage. I wanted to understand more about why it was so important to intervene as soon as possible in potentially traumatic situations.
John Worsey: What sort of ways does that kind of trauma in childhood manifest itself in later years?
Wendy Sims-Schouten: Yeah, the sort of general sense is when it comes to trauma, mental health, mental health issues, generally, when the child has experienced trauma, you start to see the more serious mental health issues from age 14 onwards, which could be a whole complex range of issues. Depression, anxiety, sometimes diagnosed, sometimes undiagnosed, which again, can be a bit tricky because diagnosing children, teenagers is quite hair and sometimes a little bit hit and miss. And also the sense of not being able to-- to work or hold a job or stick to education. And again, you can see this in certain behaviours as well, because if you've experienced trauma in your life, whether it's trauma through the trauma of your parents because your parents have been in the care system and has had a tricky life. Or whether it's trauma because of something you've been exposed to, I mean, children even have trauma from being bullied. Bullying is quite extreme. It can have long-lasting mental health implications. So you learn certain forms of dealing with this.
Wendy Sims-Schouten: And there's quite a lot of interesting research around the work by Michael Ungar. Who is a Canadian Professor who is quite interesting on this front. The notion that if you've had trauma, then your way of dealing with this could be percieved as inadequate. But it still is a way of showing resilience, but equally refer to this as disordered resilience. And as such, this child may be perceived as not very well behaved, but it may simply be the only way for them to survive. So they are surviving, they're coping by showing certain type of behaviours that may not necessarily be perceived as appropriate. But to them, it's a way of coping. It's a coping mechanism. So it's also, again, how we perceive resilience. Resilience can be disordered, but it could be the only way that that person can cope.
John Worsey: Yes.
John Worsey: So how does Wendy think we should be approaching a new intervention for vulnerable young people? She leads the MICE hub, the Mental Health and Childhood Education hub that organises events and creates a platform for conversation between government, local governments, councils, charities and academics on these issues.
Wendy Sims-Schouten: You tend to organise an event which is very kindly facilitated at the University and paid for by the University, which is lovely. And we then meet people who invite us to-- to come to their practise and do training, give talks. And so from that perspective, I've been able to link up not just with the council in Portsmouth, but also other councils, charities and Children's Society, for example, which is a national children's charity which operates across the UK. Racial Equality Councils from across the UK. And I was also contacted by Kibble Care and Education Centre, which is a large residential centre for children with the trauma issues in Scotland. So it's that sort of thing where the work is promoted through our events, so through the University, through links with the media, and we then make those links with policy and practise.
John Worsey: This has since led Wendy to giving talks internationally in places such as Egypt and Indonesia. Her passionate work for the UK Racial Equality Council became ever more poignant when the Covid-19 pandemic caused schools to close and many support services to be cut off in 2020.
Wendy Sims-Schouten: Through the Racial Equality Council, we got in touch with a number of children from ethnic minority communities, some of them living in quite severe poverty. So we helped them with food vouchers and so on. But what we also found that certain practices around those children were quite tricky.
Wendy Sims-Schouten: Just to give you an example, that particular girl who I mentioned earlier on, mixed-race girl who had racist bullying at school. She was excluded from the school, we did a lot of sessions at her school to basically train teachers when it comes to understanding cultural diversity and inclusion practice. And she was ready to go back to school when Covid-19 hit. And because of her situation living in poverty, she needed to-- to basically go to the school to get her free school lunch because that was still available even during Covid-19. But she was too scared because of the police presence, because, of course, early on in the lockdown, there were quite a lot of rules about you're not allowed to go out and you're not allowed to do certain things. So there was a lot of fear, especially in ethnic minority communities, about going outside, about getting their food, about being stopped by the police. Because we know that a large percentage of especially black children get stopped and searched by the police regularly, too regularly.
Wendy Sims-Schouten: And so we did sessions, again, with the police, the school, and we managed to make sure that she could go to school safely to pick up her free dinner, free school lunch without feeling too intimidated by potential police presence. So we do a lot of sessions and training around this across the country. And it's just to basically open up the discussion around what is different, what is cultural bias, what is unconscious bias, and is it fair to say it's unconscious bias or are people being racist? And what sort of historical factors play a role here as well? And again, this is of course not just the UK, it's-- it's across the world. So these are the base discussions that need to be opened up. And again, I tend to centralise voices there. I've done a number of studies with members from ethnic minority communities and I've interviewed them. It's has been quite an eye-opener because, of course, as a white person, it's also about getting to know people from a different culture and why certain things happen when it comes to racism. How is perceived? What can we do to change these things? And it's very rewarding. I'm really quite passionate about being part of the Racial Equality Council and also being able to-- to do something around white privilege, which is something that is a thing and it needs to change.
John Worsey: Wendy's work during the pandemic is now leading her to look at marginalised voices from women in Indonesia. Her hope is that by talking to people from deprived communities in Jakarta and Surabaya, she can help develop methods of support in casual and temporary workers to remain safe and healthy during lockdown conditions.
Wendy Sims-Schouten: It has been quite a privilege working with academics over there who have got immense experience working with vulnerable groups. And so we-- there was quite a lot of learning I've done engaging with my colleagues in Indonesia. And it's lovely that they're interested in my framework. I'm-- I'm, basically, I'm a critical realist and I apply specific framework to understanding health and co-production and how people make sense of their own health by looking at their experiences but also looking at what is actually available in society to help them and by looking at particular causal factors. So we're going to sort of mix up my model with their model and expertise and the help to come up with a new model. So it's quite exciting.
John Worsey: Wendy's open collaborations and her approach of getting into the world and talking to real people to understand individual experiences is a critical step towards supporting vulnerable people with complex needs.
John Worsey: You can find out more about Dr Sims-Schouten's work at our research portal online. Just go to port.ac.uk/research.
John Worsey: Next time on Life Solved, we'll be challenging taboo and asking how bereavement and grief impact today's society.
Sukh Hamilton: Giving them the language to be able to express the emotions they're feeling at that moment in time is really important. We don't support children enough in developing that barometer.
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