LAST RESORTS

In many western jurisdictions OOHC, and within that residential care in particular, is seen as a last resort rather than a positive choice. This notion is often reflected in legislation, theories of change, service designs, policies, priorities and investment decisions; it is sometimes also seen in negative attitudes towards those who work in OOHC and even the children and young people who they care for.

An English-language idiom in use since the 1600s, last resort is a solution or recourse for when all other avenues to resolve a problem fail. A last resort is an answer or solution that one turns to reluctantly. With legal origins, the expression comes from the French, en dernier ressort, which originally referred to a court from which there could be no appeal–the decision was final.

The Oxford English dictionary defines last resort as “a final course of action, used only when all else has failed” and the Collins dictionary as “you can find no other way of getting out of a difficult situation or of solving a problem”. While last resort can be framed positively, e.g. an insurer of last resort who will provide cover in the event that other insurers cannot or will not, in our everyday language, that is generally not the case.

I passionately believe that we need to get much better at supporting children and families in their communities and avoiding unnecessary use of OOHC; OOHC is never a step to be taken lightly and outside of Scandinavia, it’s use is likely to involve compulsory measures. OOHC is an expensive and scarce resource and its use does need to be carefully rationed. Our history and contemporary experience powerfully tells us, that OOHC also comes with risks to children (and politicians), and in some jurisdictions and organisations there are significant problems with the quality of the provision.

However, to take a health analogy, if you or I were diagnosed as needing heart by-pass surgery, in most western countries we would expect to receive (hopefully timely) surgery in a major hospital with the necessary specialist staff. We would not expect to be told to just change our diet but to come back if we had a heart attack and they would reconsider us for surgery.

It's not that I don’t believe that the notion of last resort has any place in OOHC. For example I would probably view the use of all secure care and physically restraining children as last resorts. However, beyond our legislative frameworks, the notion of last resort can also take us down a very simplistic, narrow, ideologically and often budget-driven position, on the best interests of the child. Indeed, having to repeated fail first is intrinsic to the very notion of last resort. High quality and timely OOHC can be a positive choice.