David Lane - Editor Facts and Fads In May 2003, a group of eminent childcare professionals got together in Sweden and agreed the Stockholm Declaration*, whose essential message is that residential care should be avoided for children and young people, virtually at all costs. It is a message which has been around for several decades in Great Britain, and it is one which divides those who see the benefits and value of residential care from those who see it as inherently pernicious. Sometimes the divide has been seen as a battle between residential childcare workers and field social workers; sometimes it has taken the form of a comparison of foster and residential care, as if they were rivals. It seems to rumble on without going away or ever being resolved. Clearly, the Stockholm Declaration has a campaigning tone, stoked up by feelings as well as rational argument. The defenders of residential care also feel strongly about the matter. In this issue, for example, Keith White* reacts passionately to the Stockholm Declaration. Can we throw any light on the issue? Why the feelings, and what are the facts? First, there have clearly been a large number of examples of bad residential care in recent years, and it is a good thing that people have been motivated by strong feelings to do something about the situation. These have included the large orphanages in eastern Europe where unwanted children were minded with minimal care in awful conditions, but there have also been the homes and schools in richer western European and North American countries where children were sexually and physically abused. None of this bad practice should be excused and it has to be stopped. But the bad practice in these schools, homes and orphanages does not offer a rational argument for jettisoning residential care as a whole. More children are abused in their own families than anywhere else, but it is unlikely that the Stockholm pundits would use this fact as an argument for abandoning families, or only allowing children to remain at home as a last resort. The critics of residential care seem to think that there is something inherently bad in it. The Stockholm Declaration, for example, argues that residential care should only be used as a last resort and for brief periods. It does not include any positive reasons for using residential placements at all, though it acknowledges that some will exist. However, if one analyses the nature of residential childcare and other places where children may be brought up, each has different qualities, strengths and weaknesses, but there is nothing inherent in any setting which makes one form of care necessarily bad or other types of placement good. The quality of a setting depends to a large extent on the people involved. Bad foster carers can be as pernicious as bad residential workers, and good residential workers can help children and young people as much as good fostercarers. A key point made by Keith White is that the wishes and needs of children and young people have to be taken into account. To take wishes first, children and young people sometimes positively request placements in residential care. Are these wishes to be ignored or over-ruled by adults who think that they know about a child’s needs better than the child? It may be that at times, a child’s stated wishes need to be over-ruled, but there is a real risk that those who argue that residential care is inherently bad steer children to non-residential placements as a matter of their professional judgement, regardless of the child’s wishes. It is a complex matter to assess what a child or young person needs, but among the factors are security, being valued as an individual, a sense of belonging, opportunities for social contact, social controls, the chance to address personal problems, access to education or work, scope for leisure activities, the chance to plan ahead and a whole range more besides. The options open for a child or young person who can no longer live at home, such as adoption, fostercare, children’s homes and residential schools all have varying constellations of these qualities, and matching the placement to the child is a difficult task. Some agencies and some national guidance suggests that in such circumstances adoption is best for children, fostercare is next best and residential placements of any sort come last, to be used only if neither of the others is available. Such crude prioritisation risks ignoring both the wishes of the children and the complexities of needs assessment and matching. It makes life simpler for those involved in care planning, but it may well not be right for the children and young people. As Professor James Anglin’s book Pain, Normality and the Struggle for Congruence* shows, good residential care can be a powerful force to help young people. As Victims of Benevolence* shows, residential care can be equally powerful in damaging children and young people. Because residential settings can control the whole of children’s life space, they can be highly influential for good or bad. This does not mean that residential care is in itself bad. It means that it has to be used carefully, sensitively and professionally in the interests of the resident children and young people. If used in this way, it can be as effective as any other form of care or education. If we are to understand the Stockholm Declaration, we need to consider what triggers such feelings. Movements sweep across the world of social care without proper evidence, despite the Declaration’s claim to an evidential basis. The antipathy for residential child care has been strong among field social workers for thirty years in the United Kingdom, and it could be argued that it is this very antagonism which has resulted in the system’s failings. In 1998 in a UNICEF report, Gunnar Dybwad, a leading activist in Europe and the United States, concluded, "four decades of work to improve the living conditions of children with disabilities has taught us one major lesson: there is no such thing as a good institution." Now, the Stockholm Declaration confirms that the view of residential care as inherently damaging is acknowledged worldwide. In our view, this is a dangerous myth. It may be that we need such movements to motivate us to take action about bad practice, to raise funds, to encourage support and to create commitment in the workforce, but we should not pretend that they are necessarily rational or based in fact. The danger with myths are that they can create damage before they are exploded, and the people who lose out are usually those whom we are trying to help. * Starred references relate to articles or reviews in this issue. If you are concerned about the way things are going and wish to help to shape future thinking, why not join CfC? Then you can have your say. Click here for an application form.