Off to a flying start

Family Start case manager Tania Beekmans is there for K and little Zayna. Picture / Paul Estcourt

When a Family Start worker first set foot in an Auckland home last winter, five preschoolers were huddled together for warmth in the middle of the living room. As she comforted Mum, who was crying in the kitchen, the visitor could see Dad pacing around the lounge.

"He was mentally unstable and unsettled," says Kato Prescott, who now runs Family Start in Auckland for the Otahuhu-based Anglican Trust for Women and Children.

"He was suicidal. His debt was $5000. He just couldn't 'go to work because he had to pay off all those debts' - he was in that frame of mind."

He had been on a benefit for five years. For much of that time, he had worked part-time without telling Work and Income NZ (Winz). Now Winz had caught up with him.

To pay Winz, he had stopped paying off the car, and when they caught up with him he stopped paying the rent. He was so stressed that when he went to see Winz or Inland Revenue, he would fly into a temper. The bureaucrats refused to deal with him.

The house was "a dump - it should have been up for demolition", Prescott says. There was no heating, and no food in the cupboards.

A Plunket nurse who visited newborn baby number five referred the family to Family Start as soon as the service was extended to Auckland City midway through last year. The baby became the service's first Auckland client.

Fifteen months later, Dad has a job and has paid half his debt. The oldest child is going to school - "always clean, always with a packed lunch". Dad can now deal with Winz calmly.

"His communication skills with other agencies have improved 150 per cent," Prescott says. "He is not feeling so hopeless. He can see the end of the tunnel."

Most importantly, that baby and its four siblings now feel loved and secure, rather than afraid. The generation-to-generation cycle of abuse and neglect into which they were born may finally be broken.

Right now, New Zealand needs something to break. Riki Mafi, the 17-year-old bystander killed with a metal baseball bat in a fight in Otara last weekend, was the seventh in three months to die from violence in South Auckland.

A few days earlier, Liam Ashley, also 17, was killed in a security van on the way to the Mt Eden remand prison. Then Mairina Dunn, 17 too, was beaten to death in Whangarei.

Our homicide rate in a 1993 comparison was a moderate 15 in each one million people, statistically in about the middle of developed countries. England and Japan both have 6 but Australia has 19 and the United States 99.

Maori are being killed at a far higher rate, however. Health Ministry figures show that 47.5 Maori in every one million died from assault each year in 2002 and 2003, compared with 23.7 for each one million Pacific Islanders and just 2.8 for Pakeha.

About half of all homicides are attributed to family violence.

Professor David Fergusson, who has led a 29-year study of children born in Christchurch in mid-1977, says the evidence is clear: family violence and homicide are not isolated and a violent family almost always has a host of other problems.

"The real problem with the family is not the violence, it is the fact that it is malfunctioning in many ways," he says.

Principal Youth Court Judge Andrew Becroft has said that he can pick future offenders at the age of 3. He says that if we do nothing youthful misbehaviour hardens into adult criminality.

In 2001 the Corrections Department calculated that it would cost $20,000 to intervene with a 25-year-old aggressive criminal, with a 20 per cent chance of success.

To intervene with a 5-year-old would cost just $5000, with a success rate of 70 per cent.

Family Start aims to intervene even earlier - when the baby is still in the mother's womb or within six months - or at most two years - after birth.

It was inspired by a Hawaiian programme, Healthy Start, which screens all mothers giving birth to identify at-risk families. Those families are then offered intensive help from a family support worker.

In 1995, Fergusson used the results of his long-term study to push for a New Zealand version - initially for 50 families in Christchurch - which he called Early Start.

Plunket nurses identified at-risk families, who then had a trial month with an Early Start worker and a full needs assessment before deciding whether to enrol.

Ten years later, Early Start is funded to work with 220 Christchurch families. Family support workers visit at least once a week at first, reducing this to once a month as families get their problems under control.

They make sure children get their vaccinations, go to the doctor when necessary, sleep safely and live in homes with minimal hazards.

"Our parents have never experienced responsible parenting themselves, so it's very hard for them to visualise what that might be like," says general manager Hildegard Grant.

"Also, you have to teach the mums to eat a better diet. What we are finding is that many of our mums are unable to cook.

"It's hard for me to understand, but they can't cook. So part of the input we do is to teach them how to shop and how to cook cheap nutritious meals."

Early Start workers help parents to draw up goals. In one case, where Dad was on heroin and Mum was on methadone, the goals included "a warm and comfortable home environment", learning about being a good parent, complying with the methadone treatment and getting access to Mum's older children who were in care with Child Youth and Family Services (CYFS).

Support workers then draw up their own "family support plan" and ask the parents to sign it.

For the couple on heroin and methadone, this included better housing, consistent baby-care routines, home safety measures, and getting Mum contraceptive advice and treatment for her depression.

In the first six months, that family installed smoke detectors, made sure their baby didn't sleep face down, went to a doctor about Mum's depression, practised regular contraception and were given budgeting advice.

An evaluation last year found that Early Start families were more likely than other comparable families to go to the doctor when needed and enrol their children with dentists and preschools. And they were much less likely to have assaulted their children - the rate was 4 per cent, against 12 per cent for comparable families.

On the other hand, there was no apparent difference between Early Start and comparable families when it came to smoking, depression, addiction and debt.

In 1998, the National Government picked up the Christchurch model, renamed it Family Start and made one major change - the new scheme uses a "strength-based" philosophy which encourages parents to draw up their own plans, without imposing support workers' ideas.

Almost 90 per cent of the families start the programme on benefits; 59 per cent are Maori, and 12 per cent Pacific Islanders. Most have domestic violence problems, just over half are sole parents and half are smokers.

But the criteria are wide enough to cover many needy situations. A Pakistani mother who came here with her husband and baby son four years ago was referred to the Anglican Trust's Family Start service last year when a Plunket nurse noticed that she had a rare bone disease which meant she could not lift her baby daughter, Zayna, or hold her in her arms.

On top of that, her son, Shurahbeel, was diagnosed as mildly autistic, and Zayna was born with both kidneys on one side.

Family Start worker Mia Gallichen, and then Tania Beekmans, have helped to get the mother and children to doctors and hospitals because the mother's bone condition prevents her from driving.

They organised home help through the health system twice a week to do tougher tasks the mother couldn't manage.

The mother, who wishes to be known as K, set goals for fitting in with New Zealand society.

She is passionate about cooking, so Gallichen and Beekmans gathered their friends and relations to attend Pakistani cooking classes in K's kitchen as a trial run for classes she would like to offer soon through evening classes at a school.

They linked her with Autism NZ and with mothers in the area who have autistic children.

"That gave me such a good feeling that I was not alone," K says.

"They are also there, they are also working hard. I want to keep in touch with them now."

Even though K has a university degree and had already brought up her son for three years, she still heeded tips from Family Start's Born to Learn parenting education. "I knew so many things but I was not implementing them the right way," she says.

"I came to know that I should be consistent. If I am doing a routine I should be doing it regularly.

"They are the small tips that make a difference that I didn't know."

Family Start's coverage is patchy. For example, Rotorua's Tipu Ora Trust, one of the first three 1998 trial sites, has 240 families enrolled out of 9200 families in the district with dependent children (2.6 per cent).

However, in Auckland City, where there are 43,000 families with dependent children, the Anglican Trust has enrolled only 200 families and is funded to serve 375 (0.9 per cent) by Christmas.

Many other areas, such as Kaipara, Rodney, North Shore, Franklin and Tauranga, do not yet have the service.

A pilot project which pays as much as $6.19 an hour for a child to attend an early childhood centre, is available in only 12 of the 31 Family Start districts. Tipu Ora services manager Raewyn Bourne says 90 of her 240 families are using the subsidy.

"We do have a very lovely story with this Early Learning pilot because the child was able to go to the early childhood centre and the mum was able to get a part-time job," she says.

An evaluation of Family Start last year found mixed results.

Parents rated the programme highly for giving them more skills to meet their children's needs.

But in hard statistics, rates of breastfeeding and immunisation fell well below the national average.

A midwife told the researchers that the scheme taught parents life skills such as eating properly, buying proper food, washing the baby's clothes properly, getting a car seat organised and, in one case, getting out of bed and getting moving.

But a family violence agency commented: "They work from a strength-based approach and do not look at the problems.

"But how does that make women and children safer?

"It may take away worries, but how does that challenge men's attitudes and stop the behaviour?" the agency said.

Willem Adema, from the Paris-based OECD, writing in the Ministry of Social Development's Social Policy Journal, says New Zealand's early childhood policy is "incoherent".

She points to a more integrated policy in Britain, where Family Start-type services are combined with childcare in "children's centres".

Anglican Trust chief executive Wilson Irons would like to see the same kind of "one-stop shops" here.

The trust already provides an integrated service in Otahuhu and aims to do the same at branches that opened in Avondale last month and that will open in Panmure at the end of this month.

He says it is far too soon to evaluate the real benefits of supporting at-risk families, which can't be properly judged until 20 years have passed.

"This is a long-term programme, a long-term investment in families and children," Irons says.

"The outcome, when the investment will mature, is when these children have children.

"One of the things this programme struggles with is that within society today everybody wants short-term outcomes.

"A lot of government agencies are ambulances at the bottom of the cliff.

"We have to be a signpost at the top that says: Don't walk this way."

Irons is frustrated that the government funds programmes such as Family Start, which identify problems, but often does not fund specialist services such as drug and relationship counselling.

"You can get a disability allowance through Winz, but that doesn't cover the cost of a counsellor," he says.

"I've just had an email from Preventing Violence in the Home saying their child crisis team could only cater for 86 families last year.

"There is a whole thing going on in Auckland about investing in Auckland, making sure the infrastructure is right.

"My challenge is that we need to invest in the children of Auckland.

"What has happened with the youth gang stuff and other things is that the investment hasn't been made.

"It is long-term investment in children and families that is going to make Auckland the city it wants to be, not investment in infrastructure stuff - and I never mentioned the Rugby World Cup."

Preventing Violence in the Home is collecting items today, 8am to 1pm, for its giant fundraising garage sale, Get Organised Auckland. Ph (09) 270 2545.