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Homicides, Inquiries and Forensic Social Work: past experiences
At the March 2009 meeting of the Social Work History Network (SWHN) hosted by the Social Care
Workforce Research Unit, King’s College London, Professor Colin Pritchard, research professor in
psychiatric social work at Bournemouth University, presented his research on the sadly continuing
relevant subject of Child Abuse Related Deaths. He has completed a study covering the major
developed countries from 1974 – 2006, with a focus on England and Wales (partially published in
Pritchard and Sharples, 2008).
Colin emphasised that, contrary to the current reports in the tabloid press and adverse comments by
some government ministers, an analysis of data collected over three decades showed that child
protection outcomes had improved overall both in England and Wales and internationally. The
concept of ‘baby battering’ had been coined in the USA in the 1960s. A decade later, the death of
Maria Colwell in southern England had shaken the nation. This tragedy was followed by others and
led to a series of government initiatives to enhance inter-agency working. In the main, recent
policies such as Working Together (DCFS, 2006) and Every Child Matters (DCFS, 2006) were working
well and front line social workers, educationalists, health staff and police, rather than being
condemned, generally deserved to be praised for their endeavours.
The nature of child homicides is by definition complex. Evidence suggests that, as is the case with
child neglect and abuse, its incidence is closely associated with poverty. Yet Government ministers
have consistently failed to reflect this link. Colin expressed the view that the often related topic of
sexual abuse had previously been eclipsed by Freudian interpretations of children’s developmental
behaviour and had only been acknowledged as a serious matter relatively recently. He suggested
that over the years the conceptual and systemic connections between child protection and mental
disorder had been ‘lost’ in spite of a number of studies that have implicated parental mental illness
as a key causative factor in child homicides. He cited the case of Victoria Climbie as one recent
example and said that the transcripts of the Aunt’s evidence strongly suggested to him that the
child’s Aunt was mentally ill. However, the press simplistically portrayed this tragedy as a child care
case. There was a pressing need to recapture the mental health and child protection interface.
Colin explained that the reported incidence of undetermined child deaths has always been relatively
high in England and Wales, in comparison to elsewhere. However, this may be due to coroners in
this country being more cautious than their counterparts abroad and may also reflect differences in
data collection. He suggested that undetermined deaths were amongst the most difficult cases for
social workers and others caught between policing and supervision on the one hand, and support
and counselling roles on the other. It would be simply terrible to wrongly accuse a bereaved parent
or parents of causing a child’s death.
Funding for resources and services has increasingly been an issue. However, Colin said he had been
advised to play down the positive evidence of child protection outcomes. He quoted a former
Director of Social Services: ‘Colin, this is good news, but don’t shout too loudly. If the elected
members think we are doing well, they’ll cut the budget’.
Support systems
In the general discussion the importance of expert supervision, as voiced in former SWHN seminars,
was upheld as an important component of the child protection armoury. Robust supervision should
require that practitioners are observant when they visit their clients and report and record any
concerns and discuss these with their supervisors. The case of Baby P had highlighted the
importance of reviewing local authority thresholds for legal intervention, in particular cases of
neglect which have the potential to end in tragedy for the whole family. The question was asked, in
practitioners’ endeavours to keep families together ‘had we lost sight of the ‘rescue’ approach’ ? The
issues of attachment theories and feelings of parental rejection on the part of children separated
from their families were raised. On a positive note, Colin stated that there was new evidence that
looked after children, when compared with children excluded from school, fared better in terms of
crime and suicide rates, although they came from more difficult family backgrounds (Pritchard and
Williams, 2009). However, it was acknowledged that an expansion in and development of high
quality care services would be needed if local authorities were to ‘rescue’ more children from
adverse home circumstances, who currently fall just below present day thresholds.
Whilst the recent merger between child protection and education was generally considered to have
some positive aspects, there were also worries that funding might be directed to education because
it ‘had more votes’, at the expense of children’s services. It would take time for the two services and
regulatory processes to bed down. However, there was general concern about educationalists
heading up child protection, although inter-professional learning between the two professional
groups was viewed as potentially positive. In respect of the educational achievement of children in
need and ways out of poverty, Colin asked if we had lost the ‘class culture’ link highlighted in the
Plowden Report (1967) which had demonstrated the tremendous educational disadvantages of
‘working class’ children in comparison with their ‘middle class’ counterparts.
Forensic mental health
James Lloyd Williams, member of BASW’s forensic special interest group (SIG) then spoke about the
history and role of forensic social work. James commented that people placed in forensic units were
often the grown up children of families where abuses and often homicides had occurred. Forensic
mental health provision is currently expanding. The care of forensic patients is located in a wide
range of inpatient and community settings. High, medium and low secure provision is provided in
NHS, private and independent hospitals. However, forensic patients are also placed in residential
units, supported accommodation and social housing. By way of general background, in England and
Wales the origins of facilities for people with mental illness who have offended were laid in
legislation dating from 1573 when powers to detain a ‘mad man’ who posed a serious danger to the
public were introduced. The 1744 Vagrancy Act made provision for the detention of mad and
dangerous people prison. A Lunacy Act of 1860 allowed for the transfer of the insane from prison to
hospital. In 1863 Broadmoor hospital was established followed by Rampton in 1912. The insanity
defence rules, often referred to as the McNaughten Rules, were introduced in the mid nineteenth
century to exclude sane people from pleading insanity. A new legal criterion of diminished
responsibility was introduced under the Infanticide and Homicides Act 1909. Following the review of
mental health and mental deficiency legislation from 1954 – 1957 (Percy Report, 1958) (Rapaport
and Manthorpe, 2009) the Mental Health Acts of 1959, 1983, and 2007 have governed the detention
and treatment of mentally disordered offenders.
In the light of a number of psychiatric homicides and the Reed Report (1992) there was an expansion
in the number of medium secure units and beds. Special Hospitals such as Broadmoor and Rampton
were brought under NHS control. Facilities in these hospitals and also designated prisons have also
been developed for people deemed to have Dangerous Severe Personality Disorder (DSPD). DSPD is
a relatively recent medically determined category which broadly encompasses people considered to
be extremely dangerous who might formerly have been detained under the now abolished legal
classification of psychopathy, on grounds of abnormally aggressive or irresponsible conduct.
Social work role
It was not until 1969 that a social worker was appointed to work in Broadmoor. The Butler Report
(1975) promoted the development of forensic social work in hospitals and the community. Forensic
social workers became an established part of forensic mental health teams. Taking the best practice
from probation and social work they learn by experience and to this day, there is no special
qualification for the job. However, the BASW forensic social work SIG, inaugurated in 1984,
developed a forensic social work competency framework which was later adopted by CCETSW. Since
then the SIG has contributed to the Reed Report, legislative reform and a range of public protection
policy consultations. Forensic social work has continued to grow in tandem with the expansion of
forensic services from the 1990s. However, it remains a fairly rare specialism.
The forensic social worker provides a detailed social history of the patient’s childhood and family
circumstances, addressing attachment and systemic issues. He or she also provides a contextual
assessment of risk, ever mindful that the main client is the general public. However, the importance
of identifying the balancing factors of client strengths is also recognised. Liaison with outside
agencies to inform care, treatment, monitoring and aftercare is also a key part of the forensic social
worker’s role. Home visits, family therapy or psycho-education, victim work and assessing safe
contact with children are other elements of the task. Some patients are never discharged because of
the seriousness of their index offence. For those who are discharged, generally under a ‘conditional
discharge’ requiring them to adhere to certain conditions such as residence and treatment plans, the
forensic social worker provides post discharge support to the patient, victim and family. Community
social workers and in some cases probation officers are appointed as ‘social supervisors’ to supervise
the patient and to provide regular reports to the Ministry of Justice on progress. A significant part of
the role comprises report writing for appeals, care planning meetings and occasionally the courts.
The role is both challenging and demanding because in forensic work, practitioners are ‘constantly
processing other people’s trauma’. Some patients, because of their insecure childhoods, are expert
at dividing team members. Forensic practitioners also have to cope with the outcomes of inquiries
and high profile media attention which are generally of a derogatory nature. However, James said
that in his experience, the social work supervision provided in high and medium secure settings was
generally of a high standard.
The families of the patients, in the vast majority of cases, have been known to social services
because of abuse, neglect and not infrequently, homicides. The patients have very often
experienced serious childhood traumas such as emotional, physical and sexual abuse and many have
been in local authority care, where in some cases they have been abused again by staff or others in
authority. The whole range of mental disorders is present in the patient group, in particular
personality disorders, post traumatic stress disorder (PTSD) and addiction disorders.
Managing trauma and risk
In response to questions, James acknowledged that determining the best interests of the child in
respect of child visits and rehabilitation where violence had occurred, was complex. It was generally
a case of accepting a lower base line of ‘no harm’. If a mother had harmed a child or other children
in the family, she might have recovered to some extent and contact might therefore be appropriate.
The most poignant situations occurred where the mother had been severely psychotic at the time of
killing a child and had been unaware of what she had done at the time. The bereavement process
was fraught with danger and could end in the mother committing suicide.
In attempting to rehabilitate a patient who had often been in hospital for many years, changes in the
patient’s social circumstances were inevitable. Marriages had usually broken down, families and
communities had memories of the index offence. Not surprisingly, it was often very difficult to place
people who had offended against or killed their own or others’ children. In some cases it was
necessary to find placements in areas distanced from their former homes or offending locations.
Where rehabilitation to the home area is possible, care still needs to be taken as often the families
of patients also have their problems. Patients who had been asylum seekers posed particular
difficulties in respect of care, treatment and aftercare planning, as there were often huge difficulties
researching backgrounds and culture because of political turmoil in the countries of origin.
Observations were made that the forensic social work role was a last remnant of the former
psychiatric social worker (PSW). James considered that forensic social work was closer to child
protection work than to that of adult mental health given its legalistic and high risk nature. Forensic
social workers and child protection practitioners shared the same client group and level of public
protection concerns. Colin stressed the importance of research and practice approaches that helped
social workers to recognise their successes as well as their failures. He was most concerned about
the media vitriol and its adverse effects on the ethos and morale of frontline workers. Whilst
practitioners should feel encouraged by the child protection statistics, in the case of Baby P, and any
child, one death was always one too many. In addition, the account of forensic social work
demonstrated that the consequences of child homicides, neglect and abuse were long lasting and far
reaching.
Acknowledgements also to: Richard Dale Emberton, forensic social work SIG and Professor Jill
Manthorpe, SCWRU, KCL.
References
Butler Report (1975) Report of the Committee on Mentally Abnormal Offenders. London, HMSO.
DCFS (2006) Every Child Matters: The Children’s Workforce Strategy – the Government’s Response
to the Consultation, London, DCFS.
DCFS (2006) Working Together to Safeguard Children: A guide to inter-agency working to safeguard
and promote the welfare of children, London, DCFS.
Plowden Report (1967) Children and Their Primary Schools. London, Advisory Council on Education.
Percy Report (1958) Royal Commission on the Law relating to Mental Illness and Mental Deficiency.
London, HMSO.
Pritchard, C. and Sharples, A. (2008) Violent deaths of children in England and Wales compared to
the Major Developed Countries 1974-2002: Possible evidence for improving child protection? Child
Abuse Review. 17: 297-312.
Pritchard, C. and Williams, R. (2009) Does Social Work Make a Difference? A comparison of former
LAC v Excluded from School adolescents as Young Men: crime, suicide and homicide. Journal of
Social Work, in press.
Rapaport, J. and Manthorpe J. (2009) Fifty years on: the legacy of the Percy Report.
Social Work, in press.
Journal of
Reed Report (1992) Review of the mental health and social services for mentally disordered
offenders and others requiring similar services, Vol 1. London, HMSO.
If you wish to receive information about SWHN events, please email Joan Rapaport at
[email protected]
With grateful thanks to Richard Dale Emberton for his contributions to James’ presentation.