Cynulliad Cenedlaethol Cymru

Y Pwyllgor Plant, Pobl Ifanc ac Addysg

Gwaith dilynol ar yr adroddiad Cadernid Meddwl

MOM: 24

Ymateb gan: Cymorth I Ferched Cymru

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National Assembly for Wales
Children, Young People and Education Committee

Follow-up on the Mind over Matter report

MOM 24

Response from: Welsh Women’s Aid

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About Welsh Women’s Aid

Welsh Women’s Aid has been the umbrella organisation in Wales for over forty years that supports and provides national representation for independent third sector violence against women, domestic abuse and sexual violence (VAWDASV) specialist services in Wales (comprising our membership of specialist services and members of the regional VAWDASV Specialist Services Providers Forums).^{^[i]} These services deliver life-saving and life-changing support and preventative work in response to violence against women, including domestic abuse and sexual violence, as part of a network of UK provision. We also work for and with those with lived experience of these forms of abuse, considering the effects of multiple and intersecting disadvantage through a human rights-based approach.

As an umbrella organisation, our primary purpose is to prevent domestic abuse, sexual violence and all forms of violence against women and ensure high quality services for survivors that are needs-led, gender responsive and holistic. We collaborate nationally to integrate and improve community responses and practice in Wales; we provide advice, consultancy, support and training to deliver policy and service improvements across government, public, private and third sector services and in communities, for the benefit of survivors.

We also deliver direct services including, for example, the Welsh Government funded Live Fear Free Helpline and a National Training Service partnership. We are piloting the Survivors Empowering and Educating Services (SEEdS) project, which is empowering survivors of violence and abuse to collectively influence and inform improvements in public services and commissioning frameworks, and help change attitudes.

We deliver the Wales National Quality Service Standards, a national accreditation framework for domestic abuse specialist services in Wales (supported by the Welsh Government) as part of a UK suite of integrated accreditation systems and frameworks. (More information on the NQSS can be found here: http://www.welshwomensaid.org.uk/what-we-do/our-members/standards/)

Welsh Women’s Aid welcomes the opportunity to respond to the assessment of the extent of the implementation progress made on the recommendations from the Mind over Matter report, two years since publication.

Welsh Women’s Aid has engaged with our membership of specialist services in order to inform this response, which is centred on how the report recommendations need to be underpinned by violence against women, domestic abuse and sexual violence (VAWDASV) in order to address the emotional and mental health of children and young people. As stipulated in the committee response, where necessary implementation feedback will be graded Red, Amber or Green.

Our annual membership data shows that 268 children and young people were living in emergency refuges each quarter of last year. 3,193 children and young people were supported by specialist domestic abuse community-based services.[1] Research by Public Health Wales has demonstrated how Adverse Childhood Experiences (ACEs) [2] can negatively impact children and young people’s mental health, well-being, academic attainment and their relationships lasting well into adulthood. It is vital that schools and educational institutions provide an effective preventative and early intervention approach to supporting all children and young people affected by VAWDASV.

As an organisation we have worked in consultation on the new curriculum development around violence against women, domestic abuse and sexual violence (VAWDASV) and healthy relationships. An understanding and awareness of children’s experiences of all forms of VAWDASV is integral in order to ensure the objectives and ambitions set out in ‘A curriculum for Wales – a curriculum for life’ are met. Welsh Women’s Aid has also worked with Welsh Government to draft their ‘Good Practice Guide: A whole education approach to ending violence against women, domestic abuse and sexual violence in Wales.’[3]

In December 2017 Welsh Government published The Future of the Sex and Relationships Education Curriculum in Wales: Recommendations of the Sex and Relationships Education Expert Panel.^{^[4]} As a member of this panel Welsh Women’s Aid would call for the implementation of the recommendations set out in the report.

Summary of recommendations

Welsh Women’s Aids’ key recommendations to improve mental health services for children and young people would be as follows;

The Mind over Matter report and recommendations need to be VAWDASV informed due to prevalence and the direct impact of experiencing abuse on children’s lives.
Funding for a diverse range of therapies in specialist services needs to be made available.

· Schools and specialist services are sufficiently resourced to develop designated referral pathways for children and young people to access to specialist support. Particularly ensuring mental health support in schools is engaged with local specialist VAWDASV services to facilitate the referral process.

· Welsh Government carries out monitoring of the full implementation of the Whole Education Approach, this should be included in an inspection framework as part of aligning new inspection arrangements to the new curriculum.

· Welsh Government should implement in full the recommendations of the SRE Expert Panel report including Welsh Government establishing an SRE professional development pathway, differentiated for stage of education, to be incorporated into ITE and professional learning courses.

Key recommendation: That the Welsh Government make the emotional and mental well-being and resilience of our children and young people a stated national priority. This status should bring with it a commitment to:

· Provide adequate and ring-fenced recourse for our schools to become community hubs of cross-sector and cross-professional support for emotional resilience and mental well-being;

· Ensure that emotional and mental health is fully embedded in the new curriculum

· Ensure that everyone who cares, volunteers or works with children and young people is trained in emotional and mental health;

· Publish every two years an independent review of progress in this area

Amber

Welsh Women’s Aid member services have an awareness of Mind over Matter and have witnessed the HUB placed, “in many schools where children can go to talk if they need to,” which is contributing to a, “positive movement” towards increased mental health support for children and young people in schools. There remains inconsistency in local authorities, with some members stating they, “have not heard specifically about Mind over Matter in our area.”

Any experience of abuse has a significant impact on a child or young person’s mental health. A recent study has shown that children who have experienced abuse or neglect are four times more likely to develop serious mental illness such as psychoses, schizophrenia and bipolar disorder[5]. Childhood sexual abuse has been found to be associated with depression, anxiety, post-traumatic stress disorder, sleep disorders and suicide attempts[6]. When this risk is aligned with the above statistics, the severity of the potential lifelong impact is significant and sobering. In short, despite the progress made to date on the over-arching recommendation much more needs to be done to ensure blanket support for those children and young people who need it most.

The above evidence shows that an acknowledgement, awareness and understanding of children’s experiences of all forms of abuse is vital in order to protect well-being and mental health. Children and young people need to learn about age-appropriate relationships and sexuality education and have access to high-quality learning and support about equality, safety, sexual consent and healthy relationships. This education must be delivered by trained and skilled teachers, in partnership with domestic abuse and sexual violence specialist services. Furthermore, engagement and access to local specialist services is extremely important in order to identify pathways to appropriate support for any child or young person who presents with mental health issues as a potential sign or symptom of abuse.

Members have reported an awareness of schools and doctors receiving training on Adverse Childhood Experiences[7], which has improved the referral process to specialist services, however this training, support and awareness is patchy and therefore not meeting the significant need of children and young people in Wales. Teacher training needs to be delivered by external experts to increase awareness, specifically around mental health as these are the signs and symptoms that may present more within the school environment, which means staff must be educated and empowered to identify risk and understand how to access the support pathways in place. There is no public data or information on the monitoring of teachers and other school staff having adequate training on VAWDASV.

According to the Estyn report on Healthy Relationships^{^[8]} it was recommended schools “implement Welsh Government guidance to provide a whole-school approach to preventing violence against women, domestic abuse and sexual violence” (R1) and “ensure that all staff who work in schools complete the training set out in the National Training Framework” (R2).

We are significantly concerned that the Welsh Government Online safety action plan for children and young people in Wales 2019^{^[9]} stated that “in light of the need to reduce bureaucratic burdens, and the review of the curriculum, the Welsh Government does not intend, at this stage, to introduce the duty for local authorities to report on educational provision in respect of the (VAWDASV) Act” under action 15.

The Welsh Government committed to review and monitor the impact of the Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 and local authorities’ duties in relation to education provision. Our engagement with survivors, specialist services, education professionals and regional advisers suggests that the implementation of the Whole Education Approach, where it is happening, is predominately focused on one off RSE lessons and is not embedding a response to survivors of VAWDASV (both children and adults) throughout the school system. This engagement has suggested that key areas of the Whole Education Approach are not being delivered on. This has left some survivors feeling that their children have been further victimised by a school system that could not support their needs.

Psychological therapies

Recommendation 20: That the Welsh Government, in light of the current variation in provision and the crucial role therapeutic interventions have to play, set out a national action plan for the delivery of psychological therapies for children and young people. As a minimum this should include:

· An outline of how primary, secondary and specialist services will work together to ensure a range of therapeutic services across the spectrum of need are delivered effectively;

· Specific plans for developing and maintaining a stream of sufficiently trained (and regulated/registered) therapeutic practitioners;

· Details of the proposed review of prescribing trends for children and young people with emotional, behavioural and mental health problems, building on previous work undertaken by Professor Ann John and including assessment of whether other interventions have impacted on these trends, to begin in the next 12-18 months; and

· An assessment of the plan’s financial implications and affordability, and how its outcome will be measured.

Red

While schools are providing generic mental health responses or safeguarding responses to children and young people affected by VAWDASV, these do not provide them with the specialist support they need. School counsellors are not necessarily VAWDASV-trained / experts and cannot provide the specialist support needed by the child or young person. Schools need to be sufficiently aware of the referral pathways and processes to local services to ensure access to help is achieved when a child or young person needs it most. This will be especially important when the new Relationship and Sexuality Curriculum comes in due to the potential trigger points for students.

In many areas funding to engage local specialist support services to engage with education institutions does not exist and referral pathways are minimal. Training is vital to ensure teachers and other staff are aware of referral pathways to specialist support services for children, parents and staff affected by VAWDASV. It’s imperative that primary, secondary and specialist services work together to ensure a range of therapeutic services are delivered effectively to children and young people.

Analysis we have conducted with specialist services highlights there is a significant lack of provision for children and young people within specialist services in Wales. Our analysis of evidence suggests that at least 69% of children in Wales who experienced violence and abuse did not receive specialist support last year^{^[10]}. The current picture of specialist service provision is varied across Wales. Within our membership of specialist services:

• 33% of specialist services have just one dedicated children and young people’s member of staff providing full (19%) or part time (14%) support.

• In one organisation this part time provision equates to 5 hours a week to provide support to all the children and young people using their service.

• One service has no specialist children and young people staff in place at all.

• 24% of specialist services have between 1 and 2 members of staff providing full (10%) or part time (14%) support.

• 33% of specialist services have between 2 and 3 members of staff providing full (19%) or part time (14%) support.

Access to specialist services and, specifically, group work, had a positive effect on the majority of the children who took part in the research, making them feel “happier”, “safer” and “a bit more confident with things”, however due to a deficit in funding, specialist services are struggling to deliver a range of therapeutic services effectively, ensuring that all children feel supported and safe. Therefore, in order to be effective funding for specialist services must be secured and sustainable.

Conclusion

All children and young people have a right to a full range of support services that are tailored to their needs. For these services to be effective, collaboration, training and awareness are key. Educational settings are an important site where attitudes that condone violence against women, domestic abuse and sexual violence, endorsed by stereotypical gender norms or gendered spaces, can be challenged. A Whole Education approach is intrinsic to this and can and will contribute to a cultural shift that’ll tackle the impact of all forms of abuse.

Welsh Women’s Aid will continue to work to improve the safety of children who have experienced domestic abuse by working with survivors and their children to get their voices heard. If you have any comments or questions about this briefing, please don’t hesitate to get in touch with:

[2] Adverse Childhood Experiences (ACEs), Public Health Wales, http://www.wales.nhs.uk/sitesplus/888/page/88524

[4] https://gov.wales/sites/default/files/publications/2018-03/the-future-of-the-sex-and-relationships-education-curriculum-in-wales.pdf

[5] Chandan et al, (2019). The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. The Lancet Psychiatry, vol 6, issue 11, p926-234: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30369-4/fulltext

[6] Chandan et al, (2019). The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. The Lancet Psychiatry, vol 6, issue 11, p926-234: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30369-4/fulltext

[9]https://gov.wales/sites/default/files/publications/2019-10/online-safety-action-plan-for-children-and-young-people.pdf