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Children Who Died in State Care [and 5,000 Children in State Care]

I Could Have been Tracey Fay

Irish Times, 20 March 2010 by Carl O'Brien Chief Reporter


Horror story: 'I feel like a victim, but I'm also a survivor. It hurts,' says Louise Rafter, above.

Horror story: "I feel like a victim but I'm also a survivor. It hurts." says Louise Rafter above
Photograph: Aidan Crawley

After Louise Rafter was abused in a foster home at the age of nine, her life became a blur of care placements, drug-taking, self-harm and ‘going crazy’. Now 21, she considers herself lucky to have survived Ireland’s under-resourced care system

LOUISE RAFTER’S PHONE beeped with a text message. “Turn on the news,” her friend said. The main item on the six o’clock news that day a few weeks ago was the story of Tracey Fay, an 18-year-old who had died in 2002 while in the care of health authorities. It mentioned an independent report that was highly critical of health authorities for their “chaotic” provision of care. It listed the many “missed opportunities” where the State should have intervened earlier. A Government minister said there had been big improvements in care; her story was the exception, rather than the rule.

Rafter stopped. Her heart was pounding madly. She turned off the TV.

“I was sick to my stomach,” she says. “I thought, ‘that’s what I went through’. That girl was abused as a child, just like me. And didn’t get the support when she needed it. The news mentioned more than 20 others who have died in care. All I could think was, ‘I could have been one of those statistics’.”

For Rafter, who was placed in the care of the State before her first birthday, the care system has been a chaotic and profoundly damaging experience.

Despite being placed in the system for her own safety, she ended up being abused while in care. As a teenager, life became a blur of different care placements, with innumerable social workers, sketchy care plans and little or no stability. As her behaviour began to grow out of control, she was put in an adult psychiatric hospital at the age of 16. She had tried to take her own life a few hours before.

In the end, as she sees it, she fell through the cracks of a system which damaged her more than any other form of abuse could.

Today, at the age of 21, she sees herself as a survivor and as a spokeswoman for children who feel failed by the care system.

“I’m one of the lucky ones. That’s the way I feel. There are a lot of children in care who have ended up abused or on drugs or homeless because of the failure of the care system,” says Rafter, who is now the mother of a one-year-old boy.

“The HSE is supposed to be there to protect children from abuse, neglect, abandonment, whatever. But I never felt they were on my side. They take children away from parents – and then put them in a system where they can be even more vulnerable. As far as I can see, that’s all covered up. Someone has to shout ‘stop’.”

* * * * * * *

At any time, there are around 5,000 children in State care. The vast majority – upwards of 90 per cent – are placed in foster care. For many, their experiences are positive. These families often provide a loving, stable environment for children. But this isn’t always the case.

Health authorities are investigating seven local health areas over complaints of abuse of children in foster care, some of which were sexual in nature. In addition, large numbers of children in care are living with unapproved carers who have not been vetted by the HSE.

Social workers say there are too few of them to provide a proper, basic service that can meet the needs of vulnerable children. This would mean every child having access to a social worker, having a care plan, and knowing their rights.

Norah Gibbons, director of advocacy at Barnardos, says it is crucial that every child has a social worker available to them.

“It is really important that a child has someone to talk to, and that any complaint they make is followed up immediately,” she says.

The HSE says it is planning to introduce a pre-inspection system for foster parents following a national audit of all fostering services which it completed in the past six months. As of now, it maintains, every family in which a child is being placed is vetted by the Garda and by the HSE.

* * * * * * *

The night is seared into her memory. Rafter was lying in bed in a stripped-down room in Ballydowd, a high-support unit for troubled young people. She was wild-eyed and tearing out clumps of her hair.

Looking back, she sees she was trying to come to terms with unresolved issues relating to her abuse in care as a nine-year-old.

“I was filled with anxiety about the abuse and didn’t know who I could turn to. I felt just alone. No one seemed to be there to help me. I needed support and a therapeutic environment, but no one seemed to listen to me,” she says.

“I was told this place, Ballydowd, was what I needed. I would have freedom and all the support I would need. But the first thing I saw was the metal gate on the way in, around 10 feet tall, and then all the locked doors.

She didn’t always feel so alone. Looking back, the foster parents were kind and loving. She had happy memories, such as winning a dancing competition on holidays with the father as a child. She got on very well – and still does – with her foster mother. But the abuse incident overshadows everything.

Secretly, an older boy in care was sexually assaulting her. In addition, she was being forced by him to abuse a younger boy in his presence. She was told to keep it a secret, which she did, though it gnawed and gnawed away at her.

That was until social workers approached her out of the blue three years later. The older boy – who was in a different care placement – had admitted the abuse. It was decided that she would be moved to another foster family.

“I was told it was just for a week, but it wasn’t,” she says. “I wanted to go back to my foster family. What was the problem? That [older] boy wasn’t in the family. I couldn’t understand it. They were the only family I knew.”

She was 13 years old. The new foster placement was very different. She recalls the other foster kids drinking and taking drugs. The parents didn’t seem to have much control. She even remembers being given a bottle of cider by one of the parents at a party in the house.

“The mother would roar at me. Another time, she ripped up my social worker’s contact details. I didn’t know where to go. I was moved out of there eventually. A social worker told me she could not believe that a foster parent could have so much anger towards a child.”

Instead of foster care, social services decided a residential unit in Sandymount in Dublin would be best for her.

“I was told it would be good for me, that there would be no male staff or male residents. It would be therapeutic. I said okay,” says Rafter. “But it was full of male residents and male staff. I felt let down again. I couldn’t trust anyone.”

She desperately wanted to return to her original foster family, but she was told it wasn’t going to happen. The social workers didn’t explain, she says.

She still remembers a care worker telling her, “no one wants to have a troubled 13-year-old”.

“I reacted badly. I went a bit crazy. I wanted to go back to my original foster family, so I did everything to get thrown out of the residential unit. I was drinking, taking drugs. I got involved with older men. I started self-harming. It was a terrible time.”

* * * * * * *

The HSE says at least 23 children have died in care over the past decade. About half died of medical or natural causes. The other deaths have never been satisfactorily explained. Social workers familiar with some of the cases say they all point to the same kind of gross systems failure that was evident in the Tracey Fay case.

If there are investigations into these deaths, they say, findings are likely to point to the same kinds of failures: chaotic communication; bad planning; lack of follow-through; overburdening of staff; and inadequate qualifications.

“It will say all of those kinds of things and it will be no surprise to anybody who is involved in the system, but if everyone of them keeps the fire lit, then we will begin to get action,” says Fergus Finlay, chief executive of Barnardos.

“Virtually every social worker I know in child protection is hugely overburdened, hugely overstretched. Huge case loads that they can’t get near. That is why there are thousands of children who are known to be at risk who haven’t been assessed.”

In addition, latest figures show that about one-third of children who are in care have no continuing care plan. This, say social workers, is deeply unsatisfactory. It means that risks facing young people go unaddressed and their problems escalate while they are in the care of the State.

* * * * * * *

The more Rafter realised there was no way out of where she was, the worse her behaviour and drug-taking became. Today, some of the memories she has of this time are just fragments, bits of half-remembered incidents.

She remembers being picked up by gardaí in her pyjamas after running away from the residential unit. And then there was the time she was found lying on the Stillorgan dual carriageway after overdosing on drugs. She was in hospital a few times as well, sometimes after taking overdoses, other times just as a place of sanctuary.

There were numerous other care placements. Some social workers were very good, she recalls, and a family therapist in particular seemed to understand her situation. He recommended a gradual return to her foster family. When that promise also fell through, it marked a turning point.

She abandoned hope. She took a number of serious overdoses, one which brought her perilously close to losing her life.

“I just felt like there was no one there to help me. Instead of helping me to get to my original foster home, the home I had known since [I was] a baby, people were doing everything in their power to do the opposite.”

By the age of 16, she was committed to the adult unit of John of God’s psychiatric hospital.

“It was a low point. For a young person going into a place like that, it’s very tough. You see people banging their heads, talking to themselves. Weird things. One person could be laughing one minute and going loopy the next.

“I was suffering from post-traumatic stress from the abuse, and all the chaos. I was depressed. I was told later I had a ‘borderline personality disorder’, which Im told is mainly linked to young people who have been traumatised, neglected or abandoned.”

* * * * * * *

There are thousands of young people – children and adolescents – waiting for basic mental health assessments. Latest figures show that around 2,600 are on a waiting list; more than a quarter are waiting more than a year to be assessed.

The danger, say health professionals, is that problems that could be addressed through simple therapy can grow to the point where acute in-patient treatment is needed.

The lack of in-patient beds for young people is another problem. A total of 155 adolescents were placed in adult psychiatric units last year. It’s a practice that the Inspector of Mental Health Services, Dr Patrick Devitt, has described as “inexcusable, counter-therapeutic and almost purely custodial in that clinical supervision is provided by teams unqualified in child and adolescent psychiatry”.

The HSE says the development of child and adolescent services are a priority, and that it is continuing to invest in new services despite pressures on the public finances. The number of in-patient beds for this group has increased from 12 in 2008 to 30 last year, for example. It is set to grow further this year.

LOUISE IS 21. She accepts that she made bad decisions and wasn’t an easy child to handle. But she feels haunted and damaged by the chaos of her earlier years. With the stories of girls such as Tracey Fay, she now wants to highlight what she says is happening to other vulnerable children.

“I still have flashbacks and nightmares about what I was put through, all the homes I was in, what the social workers did . . . the way they dealt with the situation traumatised me more than the actual abuse.

“There are lots of vulnerable children in similar situations right now. Tracey Fay is just one person. I’m not so much shocked about the numbers who have died or who are still at risk – but I’m shocked at how the authorities seem to cover up their failures.

More energy needs to be focused on supporting families and parents in difficult situations to raise their children, she says. And if a child does need to be admitted into care, authorities must do everything possible to ensure it is a stable, loving placement that meets their needs.

“The last thing a vulnerable child needs is to feel abandoned and unwanted. Life is tough enough. I feel like a victim, but I’m also a survivor. It hurts. I’d rather have every bone in my body broken than feel this emotional pain. But we can’t allow the current system to continue the way it is.”

“Social workers say there are too few of them to provide a proper service that can meet the needs of vulnerable children. This would mean every child having a social worker and a care plan, and knowing their rights