Insight: The trauma of growing up in care

Charlotte Armitage of Who Cares? Scotland. Picture: John Devlin

She says she was lost, lonely and feeling to blame for what had happened to her.

“When I look back I could never have imagined getting out of that hole,” she says. Armitage has attempted suicide five times and self-harmed.

Her world turned upside down at the age of six. Armitage suffered physical and sexual abuse for three years.

When she went into foster care at 15 things got better for a while. “I didn’t feel I belonged. I was treated differently to the others. My foster parents weren’t bad people but they had their own kids and that difference was felt.”

It was a shock when two years after living with the family she was asked to leave. “They told me I was too much. That really drills it into you. How you don’t belong. It was hard to hear that they could feel that way about me. I felt that it must be my fault.”

Armitage became homeless and was offered a caravan ten miles outside her home town. After a short spell in temporary accommodation she was moved to a B&B above a pub with no kitchen or laundry facilities. Visitors were not allowed into her room.

Feeling her mental health dip again she sought the help of a counselling service. “I had suffered with my mental health before and found being in the B&B so traumatic. I knew it was time to get help.” Two days before Christmas she moved into her own flat, aged 18.

Today, Armitage works as a campaigner for charity Who Cares? Scotland. “I found I could use my experience to help change things, make an impact as part of wider movement. I feel connected,” she says.

Asking about her hopes for the future as she strives to get into full time education it’s striking how determined she is despite still dealing with the shadows from her past.

To make up for the lost years in high school Armitage has been doing an apprenticeship and three evening courses alongside a full-time job.

At first she was knocked back from every university she applied to on grounds of insufficient qualifications. Since writing a blog about her efforts one university has offered her a conditional place.

When she describes what it was like to read through her care records obtained recently Armitage says she feels angry.

“Social workers agreed that because I had been abused as a child I couldn’t be trusted to be left alone with boys.” Armitage found a note from a social worker whose assessment was that because she never talked about the sexual abuse this was her memory fading. “That wasn’t the case. I needed help.

“Being in care and the reasons that led me there are still impacting all aspects of my life. That impact doesn’t go away.”

Armitage carries a shame that doesn’t belong to her. It hits home hard. How this is a child who was failed countless times by professionals trusted with her care.

In Scotland we know all too well about the horrendous life chances of children who are removed from their families.

The vast majority of the 15,000 children in care have experienced neglect or abuse. Yet all too often these children – the most vulnerable – don’t get the help they need until their circumstances become desperate. What’s worse is that after going into care the system can perpetrate yet more lasting harm.

Scotland’s Independent Care Review, published last week, is calling for an end to systemic failures that lead to young people like Armitage being caused more damage by the very system designed to protect them.

Hailed as transformational, the root-and-branch review heard from over 5,500 people. The commitment of the review to speak from lived experience is clear – more than half had experience of the care system, across foster care, adoption, kinship care, residential and secure, or being looked after under supervision at home.

Armitage said: “It’s good to see a call to end the criminalisation of young people in care. And calls for adult support for as long as it’s needed. We shouldn’t have to leave care and be forced off a cliff edge into adult life.

“But it opens by saying the review doesn’t want to point blame. If it’s to be transformative, surely failures need to be acknowledged? People are making big mistakes. We need accountability as well as statements of principles.”

Thousands, like Armitage, who poured their hearts and souls into the review have pinned their hopes on it to deliver a blueprint, a clear way forward.

For children and young people already in care the review is urgent – a matter of life and death.

Every day, people with care experience die prematurely. The First Minister told us that when she announced the review. She said that they are 20 times more likely than the rest of the population to die before they are 25. Tragically, we actually don’t know how many, because figures for recorded deaths have huge gaps in data.

Chair Fiona Duncan, who has personal experience of care, travelled across Scotland to hear testimonies from children, young people and families. Her decision not to openly share details of her own experience demonstrates compassion in the review’s approach. It has given others the confidence to get involved in the review.

“It was important for children and young people to know that they didn’t need to broadcast their experiences, that they could feel safe while their voices were heard,” says Duncan.

“The report is what children, young people and adults said, not what policy makers want to hear. It doesn’t make recommendations – the changes set out are not optional.”

The report is a tough read. We hear that children in secure care are being restrained when they are distressed; brothers and sisters separated for long periods with no say in future contact, children not getting mental health help until they are in acute crisis and even then waiting too long for support, adults abandoned once they outgrow child services.

In the lead-up to the recommendations this week Scotland’s review has drawn attention from countries around the world. Campaigners in England have asked for a similar major review of care.

To take forward 80 actions the review has formed an implementation group.

Urgent calls for an end to 16 and 17-year-olds being sent to prison or detention put renewed pressure on the Scottish Government to introduce a policy making sure enough secure care and alternative provision is available and to end the “monetisation” of care – Scotland must not profit from vulnerable children.

Complex procurement arrangements mean that the number of teenagers from England in Scotland’s five secure units has doubled in a year. The impact of this is brought into sharp focus when we remember 16-year-old William Lyndsay who took his own life in Polmont YOI. He should never have been there.

Other major changes demanded are for kinship carers to be given the same financial support as foster carers; a national register of foster carers to be created; parenting education for all in advance of parenthood; no age limit for supporting adults who are care experienced; and legal protection for sibling relationships for those in care.

The review also calls for specialist therapeutic settings for girls who have been sexually abused and exploited. Sexual abuse survivors like Armitage have backed this.

The clear takeaway conclusion threaded through with “unrelenting focus” is that the care “system” in Scotland is preventing children from forming positive, lasting relationships with adults that they so desperately need.

It states: “Scotland must understand the pervasive and persistent harm of a lack of loving relationships.”

“Cold” and “unfeeling” agencies are no substitute for the love of parents or family. But the review found standards of care are undermined persistently as a result of risk-averse policies that can prevent children forming stable relationships with professionals.

Duncan stressed that for young people in care having one adult they can trust matters. She added that distressing experiences and lack of lasting relationships to fall back on often had a lifelong effect.

The review heard from increasing numbers of social workers who had been “pulled up” on fitness of practice grounds after responding to young people in a state of crisis outside working hours of 9 to 5 when the young person had nobody else to turn to.

It heard from children and young people so starved of interactions while in secure care that they sought physical restraint because it was their only experience of human touch.

Despite services being under enormous pressure, often stretched to beyond capacity, the review heard from workers trying to do their best for young people who felt they were being “thwarted” by harmful policies as part of a risk-averse system that only kicked in once families and children were already in crisis.

The review is unequivocal on this – such rules need to be scrapped.

In the past 12 months the Scottish Social Services Council has had 62 fitness-to- practise referrals relating to professional boundaries, resulting in sanctions in four cases, three had warnings with consent and one was a warning and condition with consent.

For most people bonds with family can be relied on when facing challenges, so it can be hard to grasp the importance for children in care of having trusted adult relationships outside of their family home.

A strong body of evidence from the New Economics Foundation and others backs the need for “one trusted relationship” when young people are likely to have already been repeatedly let down by adults close to them.

For this shift to come about the review is demanding the “cessation” of crisis services and a change of culture that makes earlier intervention and prevention the standard.

If we can help families when problems arise, before a child needs to be ripped away from home, this would save so many problems further down the line.

For the first time the review has put a price on the annual cost of looking after children in care, at £932m. It also laid bare the cost of getting it wrong – a staggering £875m a year is spent picking up the pieces of earlier failures in the system, across mental health, homelessness and addiction services.

Now we know the stark price – human and economic – surely it’s time to move beyond rehashing long-understood principles of early intervention?

We shouldn’t need vulnerable families, children and young people to make this plea through the care review – yet again. We need to see real investment in family services.

The value of safeguarding children earlier is already a key part of legislation in the Children and Young People Scotland Act (2014) and is embedded in the national Get it Right for Every Child policy framework.

Last year the Scottish Government commissioned another, separate review into the practices across 32 local authorities in supporting families where children are “at risk” of needing to be looked after.

Carried out by CELCIS, the Centre for Excellence for Looked After Children in Scotland, it found that neglect was repeatedly highlighted as a “huge issue” where children were at risk of becoming looked after.

It spelled out clearly the challenges to supporting families early – large caseloads and lack of funding for early-intervention services.

For the families on “the edge” of care, suffering the impacts of poverty, mental health issues, drug and alcohol misuse, domestic abuse and parental learning disabilities, the review report out last week repeats calls for extensive “wraparound” family support to reduce the numbers of children going into care. Let’s be clear – because we have heard this before doesn’t detract from how important it is. But does the review go far enough in setting out how this will be delivered? How do frontline services make a sea change in an era of austerity, while children and family departments grapple with budget cuts – only some children and family budgets are ring-fenced? It’s cheaper to send a young person to Polmont young offenders’ institution than it is to give them a place in secure accommodation. And how can a workforce make time to give children and young people the care they deserve when they are operating beyond capacity with unsafe caseloads?

Last year Unison raised fears that social workers reported they were at breaking point. Nine in ten said they were thinking of quitting.

In 2006 charities in the care sector put together a manifesto called “There’s no time to lose” charities made same plea for early family support and supports for children and young people in care with broadly the same proposals as set out in the review.

Yet here we are circling back around the same principles. It sits uneasily. How many times does Scotland need to hear this before we see significant change on the ground?

In spite of Scotland’s commitment to the UN Convention on the Rights of the Child and a plethora of Scottish legislation and initiatives, there’s still a gap between policies and what children experience.

Laura Beveridge, Chair of the Stop Go work group, says there is a postcode lottery of support. She firmly believes that the review’s implementation group can create a cohesive, national plan.

Sixteen years after Beveridge left care, she’s painfully aware of how young people like Armitage are still paying the price for the failures of the system.

“Things don’t seem to have moved on at all in that time. Support for young people is so patchy. I know a family who needed help but they were not seen as ‘in crisis’ enough. The teenager got a befriender through a charity over summer then was dropped back into the family. They were still experiencing the same problems. The bottom line is it shouldn’t have to all fall to charities, we need to give families what they need.”

Beveridge, 35, was forced out of residential home at 16. She wanted to stay but was told at a children’s hearing that it was time for her “get on with it” and stand on her own two feet.

“My mental health was bad at the time, I didn’t feel ready to do it.”

Shortly afterwards Beveridge was discharged from young people’s unit. “They told me it was just trauma. I will never forget that. I felt like I was screaming at a brick wall.”

The residential home she was living in couldn’t cope with her self-harming. She recalls sitting in Waverley Station with her stuff in plastic bags wondering where she would sleep that night.

Her gran found her supported lodgings. “It was completely by chance,” says Beveridge. “There was no plan to help me. If ever I needed support, I have always had to fight for it.

“The problem with the current system is it’s more of a containment industry. Often children and young people are seen as a problem. That hasn’t changed much over the years.

“It has taken me over 20 years to be able to come to terms with my experiences but I had to seek out my own therapy later in life. Help should have been offered years before and not just for me. If someone had helped my mum rather than ridiculed her, what a difference it could have made.

“The way that services kick in is all about waiting until crisis, it’s so sad. I went through the system for years. I couldn’t go home because my mum and gran were both struggling and I thought nobody else wanted me.”

Beveridge says that the review is uncompromising on fundamental rights, such as sibling contact.

“It goes against the status quo on many assumptions that are status quo, like separating brothers and sisters. At the launch of the review last week I sat beside my brother, and I kept thinking how different things could have been for us.”

The review says seclusion of children should be stopped and urges Scotland to “move towards” cessation of the controversial practice of physical restraint. However, it stops short of requesting an immediate ban.

The UN has urged an end to the use of institutional care for young children, stating it has such harmful affects it amounts to “a form of violence against children”.

Beveridge says: “We don’t believe that residential care should be scrapped right now. But I think if we get early intervention right, the need for residential care homes will shrink.”

That makes sense. But how is it going to be delivered when local authorities are already not meeting their duties to support youngsters who are eligible to apply for additional support up to the age of 26?

To stop people falling through the cracks local authorities and all with parenting responsibility are asked to set out how they plan to deliver “integrated services” for care leavers into adulthood. The review says those with statutory responsibility “don’t fully understand the extent of their obligations”. Meanwhile, thousands of young people continue to be shoved into empty beds in dingy B&B accommodation across Scotland.

Since April 2015, young people have been eligible or potentially eligible for aftercare including accommodation. Yet at least 21 per cent become homeless within five years of leaving care, according to the latest statistics from the Scottish Government. That figure could be as high as half.

In a recent report, Heriot Watt University found too many young people are still living in B&B and hostel accommodation while homeless, which can be “intimidating and harmful”.

Someone from the review who asked not to be named said more accountability was needed. “We heard from professionals that poor practice is tolerated. That’s not included in the report. But people need to hold their hands up. After all this time we know what needs to change but to get there we need real leadership and that can only come with accountability.”

Robert Foster, Cabinet member for North Ayrshire Council health and social care partnership, says he was disappointed by a lack of “actionable specifics” in the review.

North Ayrshire was the first council in Scotland to introduce council tax exemption for care experienced young people in 2018. It was then rolled out nationally.

Foster says: “There is little here I could hold in my hand, day-to-day. Nothing I could walk into the office with tomorrow and say let’s do this. It’s good to see how much we spend on a system that is failing our young people. But it needs to go much further and ask for more investment.”

What’s clear from the impetus the review has given to the plight of care-experienced children and young people, and the responses, is an agreement on the need for the platform it has provided. With the First Minister’s very personal vow to see it actioned, along with cross-party support, let’s hope those with the power to make real changes keep their promises this time around.

Chair Fiona Duncan says now Scotland has a choice to invest in the right services. “There are no excuses now. Previously, we’ve heard that there isn’t money. Inadequate funding can no longer be a reason. The money is there, it’s just being directed into the wrong places. We have a moral obligation to make these changes happen urgently. We can’t afford not to.”