Listen to thisAustralia de-institutionalised earlier and more extensively than other developed countries. Residential care, the previous first-choice option when out-of-home care (OOHC) was needed, even for infants and small children, rapidly became the option of last resort. By the mid-1980’s, more than 15 years after de-institutionalisation took hold, over 40% of children in OOHC were still in residential care – 20 years later (2005), that percentage had dropped to under 5% (trend data from Ainsworth & Bath, 2023).
We all know the reasons for this. There were multiple reports of abuse, neglect and peer bullying in the older, large institutions; there were emerging theories highlighting the importance of close attachments and the dangers of ‘maternal deprivation’; there was a powerful policy emphasis on ‘normalisation’ of living arrangements; and there were also cost pressures and economic incentives to prioritise foster care arrangements where paid staffing was not required.
The shape of residential care also changed. The larger congregate care institutions gradually disappeared to be replaced by smaller group homes, in campus-style arrangements or ‘scattered’ (as they used to be described) throughout the community. Often these were operated by a married couple, but within 20 years most of these group homes were staffed by youth workers on rotating shifts.
There was a discernible shift over time in the numbers of children in each group home. In the 70’s and 80’s it was common for there to be 10 or more, but this number has decreased over time. Six was common in the 1990’s while 4 is currently the norm. For decades now, there have been largely informal arrangements funding ‘one to one’ residential care for particularly challenging young people, and recently government funding bodies have been formally funding very small units for two or three residents.
Despite the reduction in size of group homes and the increasing staff-child ratios, reports from multiple states attest to the fact that these small units are plagued with behavioural issues, assaults on staff, peer bullying, and frequent runaways. Recent reports also suggest that the young people in care often feel unsafe. Small units, being more ‘normalised’ and less complex, should be easier to staff and should have fewer behavioural challenges, but clearly this has not been the case. This partly because the dwindling number of residential beds available are increasingly reserved for the most troubled young people many of whom have long histories of behavioural issues and placement breakdowns (Ainsworth & Bath, 2023).
Despite the ongoing challenges with small residential units, there continues to be a strong policy and practice emphasis across the country on reducing the numbers of children coming into care in the first place and more particularly on continuing to reduce residential care provision. Moreover, where residential care is used, it is always seen as a short-term rather than a long-term option. These policy emphases are apparent in administrative policies and directives, in academic papers and presentations, and in funding and grant provisions to NGO’s which continue to provide most out of home care.
James Whittaker and his colleagues (2023) who have investigated the use of out of home care internationally, place Australia at the leading edge of a small number of countries that have de-institutionalised most radically (p. 430). These countries have shifted most children who need out of home care to non-institutional, home-based care options. This policy emphasis is a laudable one where home-based options are available and can meet the needs of the young people in question.
But there’s a major problem.
Despite the strong policy directives, the percentage of children in residential care across Australia has steadily risen since the early 2000’s – albeit from a very low base of under 5% of the total in care. In the decade from 2010 to 2020, number of children in out of home care rose by 27.8% but the number in residential care rose by 64.5% (data in this paper have been extracted from the ‘Child Protection Australia’ series of annual reports published by the Australian Institute of Health and Welfare).
What’s more remarkable is the fact that in the last two years for which we have data (2020-2022) the overall number of children in out of home care has actually plateaued and started to dip for the first time in three decades. Residential care, on the other hand, continues its resurgence, increasing by 25.6% in the same period. From a low of under 5% of the total number in care in the early 2000’s, the percentage of young people in residential care is now approaching 9%.
In our largest state NSW, the overall numbers in care have declined by 5.8%, but residential care provision has risen by a remarkable 40.9% in the same two-year period.
Developments in NSW highlight a growing dilemma. As the funding for residential care has dwindled, more and more children are being placed into temporary, largely unregulated settings such motels and caravan parks. They are mostly looked after (‘surveilled’ is perhaps a better descriptor) by unregistered carers employed by a growing number of commercial ‘pop-up’ outfits that have seized the opportunity to make a quick buck.
The children are placed into these temporary arrangements because there are no home-based or suitable residential options available. They are provided shelter rather than being cared-for and largely left to their own devices without appropriate programming or case planning. Many are also cut-off from regular education. A recent report from the NSW Children’s Advocate (ACYP, 2024) has highlighted the plight of these children who exist in a limbo-like netherworld, sometimes for months, even years, while they await a more permanent and regulated care option.
As of 30 June 2023, it was reported that there were 500 children in such temporary arrangements in NSW – shockingly, this represents over 70% of the total number reported to be in residential care, but it is uncertain whether the official statistics even pick up all the children who are in such arrangements.
What does all this tell us? One thing is becoming clear – you cannot change the realities on the ground, the numbers of young people with significant care needs, simply by manipulating the care options that are provided. By drastically cutting the number of regulated care options that are funded, the NSW Department of Communities and Justice (along with authorities in other states) has created an unregulated, out of control policy disaster that is seriously compromising the safety and wellbeing of hundreds of already vulnerable young people.
The reality is that most of the young people in question cannot be placed into home-based care. Suitable home-based options are very scarce and difficult to sustain, and most cannot meet the care and safety needs of these young people, many of whom have long histories of failed foster care placements. Moreover, efforts to prevent placements in the first place or to divert young people to less-intensive options, are unlikely to succeed with the majority of the young people in question given their complex needs.
It is becoming apparent that there is a ‘floor-effect’ when it comes to effective de-institutionalisation, beyond which the system itself becomes responsible for causing the very harms that have been ascribed to residential care. This is particularly the case in Australia which de-institutionalised extensively over 4 decades. Insisting that fewer and fewer young people should be placed into residential care inevitably leads to further neglect, a reality we are seeing play out across the country.
Residential care has many challenges and difficulties, but the only realistic option is to ensure that it is better resourced and supported and enabled to offer services of the highest quality. We need more rather than fewer residential options; services that address specific target groups; services that offer medium to long-term care options for those that need it; specialist treatment options; better training pathways for workers; and better integration with less intensive forms of care, including ‘step-down’ home-based options.
References
ACYP (2024). Moving Cage to Cage: Final report of the Special Inquiry into Children and Young People in Alternative Care Arrangements. Sydney, NSW: NSW Advocate for Children and Youth People.
Ainsworth, F. & Bath, H. (2023). Therapeutic Residential Care in Australia: A new dawn or more of the same? in J.K. Whittaker, L. Holmes, J. del Valle & S. James (Eds.), Revitalizing Residential Care for Children and Youth. Oxford, UK: Oxford University Press (pp. 391-404).
Whittaker, J.K., Holmes, L., del Valle, J.F. & James, S. (2023). Future prospects and challenges for residential care for children and youth, in J.K. Whittaker, L. Holmes, J. del Valle & S. James (Eds.), Revitalizing Residential Care for Children and Youth. Oxford, UK: Oxford University Press (pp. 429-442).
