Children deprived of their liberty: An analysis of the first two months of applications to the national deprivation of liberty court

What are the needs and characteristics of children subject to deprivation of applications?

• Children subject to DoL applications are highly vulnerable. They typically have multiple and complex needs. 
• The most commonly identified risk factors were behaviours that were considered a risk to others (e.g. physical or verbal aggression; recorded in 69.2% of all cases), concerns about mental health or emotional difficulties (59.1%), placement breakdown (55.3%), self-harm or suicidal ideation (52.4%) and absconding behaviours (46.6%).
• Most of the children had experienced significant adversities and trauma throughout their childhoods, including abuse and neglect, rejection and bereavement.
• Children were well known to services. Only 10 out of 208 children had recently come to the attention of the local authority and almost all (96.6%) were in care at the time of the DoL application. Just under half (44.7%) had come into care within the last 2 years, with almost a fifth of children (19.2%) coming into care in the 6 months prior to the DoL application being made.
• Children had experienced significant instability in the months and years prior to the application. Several children had experienced periods in and out of care, and over half (55.3%) had experienced multiple changes in their placements.
• 19 children had experienced the breakdown of adoption (10) or special guardianship (9) arrangements, due to the carers being unable to manage the child’s behaviour.
• Most children (70.7%) were aged between 14 and 16 years old at the time of the application but there was nevertheless a significant number of children who were aged 12 and under (7.2%).
• Information about children’s ethnicity was not consistently recorded but initial analysis suggests an overrepresentation of children from Mixed, Black and White Other ethnic backgrounds among children subject to DoL applications.

What was the main reason for the DoL application?

• In most cases the DoL application was made due to concerns about the child’s behaviours, and the severe and immediate risk of harm faced by the child or others as a result of this. 
• We identified seven primary reasons that a DoL application might be made, reflecting the main concern in each case. The most common reason was ‘risk to others’ (24.0% of all cases), related to concerns about the risk posed to others from the child’s behaviour, examples of which included violence towards others, and/or causing damage to property either in the placement or the community, including setting fire to things.
• The second most common primary reason for a DoL application, in just over a fifth (22.1%) of cases, was to manage a child’s needs or behaviours that were the result of a severe learning disability, a physical disability and/or autism. 
• Other primary reasons included self-harm (16.8% of cases), mental health (12.5%) – identified as a primary reason where there was evidence of a diagnosis of mental health disorder, and/or treatment from specialist mental health services in the past or currently – sexual exploitation (10.6%) and criminal exploitation (8.7%). 
• In a small number of cases (5.3%) the reasons given for the DoL did not fit the situations described above. This included cases where the main concern was the use of drugs (including class A drugs) and alcohol by the child, or cases where the main concern was the child going missing for periods of time. 
• Although we were able to identify a primary reason for the application – the central concern that led to the DoL application being made – in almost all cases (95.2%), there was more than one risk factor present and most (65.7%) had four or more. The children had multiple and overlapping needs. 
• There were notable gender differences in the reason for the DoL application, with girls much more likely to be subject to applications due to self-harm, mental health, and sexual exploitation, while boys were more likely to be subject to applications due to concerns about the risks they posed to others and criminal exploitation. This may reflect gendered differences in the understanding of children’s behaviours – with girls’ challenging behaviours more likely to be seen as relating to internalising difficulties and boys’ with externalising or ‘aggressive’ behaviours – and assumptions about extrafamilial risks faced by girls and boys.

Are there distinct cohorts of children with different needs, who may require different types of care?

We identified three broadly distinct groups of children – for whom the DoL application was being sought for different reasons – which may help guide future service development. In all three groups, there was a high level of need and severe risk of harm that was considered difficult to manage without restrictions on the child’s liberty.

• Children with learning and physical disabilities needing support/supervision: In these cases, the DoL was sought primarily due to a need to monitor and supervise the child to manage their care needs and/or to place restrictions on their liberty to manage challenging behaviours that were linked to the disability.
• Children who had multiple, complex needs, which were often recognised to be a response to complex and ongoing trauma. These were cases where children were considered to be very vulnerable as a result of a range of overlapping risk factors and needs, primarily related to mental health concerns, self-harming behaviours and risk to others.
• Children experiencing or at risk of external or extrafamilial risk factors such as sexual or criminal exploitation. In these cases, the primary concern was to manage the immediate risk of exploitation – although the children in this group also had multiple, complex needs, often as a response to complex and ongoing trauma.
  

What was being applied for, and by whom?

• In our sample, the majority (97.5%) of DoL applications were made by local authorities. Five applications (2.4%) were from hospital trusts.
• The restrictions on children’s liberty that were requested in the applications were multiple and involved severe constraints on the child, including, in almost all cases, constant daytime supervision (ranging from 1:1 to 4:1 adult to child supervision), as well as the locking of doors and windows to prevent the child leaving the placement, restrictions on their use of the internet, social media and mobile phone, and access to belongings, including money, and the use of physical restraint.
• Too few placements were available that could meet the complex needs of children. In just under half of applications, children were going to be placed in unregistered settings (45.6%) – this included the use of semi-independent (unregulated) placements, hospitals, residential homes that were Care Quality Commission (CQC) but not Ofsted-registered, and rented flats or holiday lets staffed with agency workers.
• We found that children with learning and physical disabilities were less likely to be placed in an unregistered setting. In contrast, where the DoL application was primarily related to concerns around self-harm, risk to others and/or criminal exploitation, children were more likely to be placed in an unregistered setting. This may indicate a particular lack of sufficient and suitable placements for children with these needs.

• Our analysis confirms the complexity and severity of risk faced by children subject to DoL applications and highlights an urgent need for increased resource, creativity and collaboration across all systems responsible for the care of these children if we, as a society, are going to better meet their needs. 
• Children who are subject to DoL applications are extremely vulnerable. They typically have multiple and complex needs that are evident in behaviours that can make them a risk to themselves or others. Some have severe physical or learning disabilities, some have been subject to criminal or sexual exploitation. Most have experienced significant adversities such as rejection, bereavement, abuse and neglect during their childhoods.
• Although their needs may have recently escalated, the vast majority of children who are subject to DoL applications are well known to statutory services. For many children, their emotional and behavioural difficulties are evident from late childhood. It is clear that they need far better support at an earlier stage.
• By the time they are subject to a DoL application, the risks children face are immediate and severe. It is obvious that they are in need of intensive care: as a minimum, they are likely to require care that is stable, with consistent professional support from carers who are able to build trusting relationships over time, along with access to specialist therapeutic support and education. Yet we know that in many cases this is not available. Applications are too often made to place children in unregistered provision as a stopgap in the hope that more suitable provision will become available. But a dire national shortage of suitable homes means that in many cases, children will remain in temporary or crisis placements for much longer.

Priorities for further research

• What are children’s experiences of being deprived of their liberty, and what opportunities do they have to participate and have their voice heard in proceedings?
• What are the short and longer-term outcomes for children subject to DoL orders?
• What is the ethnicity of children subject to DoL applications and is there any variation in their needs, the reason(s) for the application, and the arrangements made for their care by ethnicity? Information about children’s ethnicity was often not included in application forms. 
• What access do children have to education when subject to DoL orders?
• Are staff who are caring for children subject to DoL orders sufficiently trained to provide the level of care required, including with regard to the use of restraint? 
• How are orders made under the inherent jurisdiction being reviewed and monitored, and how does this compare to the requirements for monitoring and review under the statutory schemes? 
• How many parents are legally represented in DoL cases and what are the barriers to accessing representation? Given that, in our study, the majority of applications for a DoL were made outside of care proceedings, it appears that most parents would not automatically be entitled to legal aid for legal representation. 
• What is the impact of parental consent on whether DoL orders are made or not?

This report underlines the urgent need to develop new provision, at a local level, with joint input from children’s social care, mental health services and schools. It is not something that can be left to chance. It will require a nationwide strategy, with significant commitment at local and national level, including national government.