Susan was a 14 year old whom I hadn’t met when I did a house visit at her father's request. Her complaint was acute abdominal pain and on examination and in discussion it became clear the cause was most likely to be severe constipation probably directly related to poor diet.
What was most striking during this house visit, however, was the dysfunction of normal routines in the household. The house was chaotic and Susan clearly had little support. It is very easy in a very busy GP practice to deal with the surface issue only, particularly when the patient is quite reticent. But it was clear that advice on a high fibre diet was unlikely to impact on this young person's life.
With a pilot GIRFEC structure I was able to communicate with Susan’s school and other health colleagues and subsequently a range of other services became involved, all with Susan and her father's permissions of course. Nothing in the scenario gave any suggestion of any child protection concerns, this was all about wellbeing.
It transpired that Susan was in fact missing a lot of school but not enough to trigger formal action. And she wasn’t achieving her academic potential.
Susan was an unsupported young carer for her diabetic father and often missed school because of his poor diabetic control and hypoglycaemic episodes. None of this was known to any professional before I visited the house.
Without the GIRFEC structure I would have had no way to gather together these pieces of a hidden picture. No one professional could do that, each of us held one small piece of the jigsaw of Susan’s life and she and her father had no idea help was available.
The school-based Named Person worked with a Lead Professional from Family Support services. With effective cross-disciplinary communication about Susan, her life was radically altered over time.
It took time and a range of interventions to make a difference for Susan and her father but both benefited enormously and Susan gained qualifications at credit level allowing her to access further education in her chosen course.
The final part of this case study has lessons for the future. I had reason to hear how Susan was faring a year after entering further education. She had dropped out of college and the college professional herself said that she was sure with improved GIRFEC communication beyond the end of school education, support for young people like Susan would make a significant difference.
I optimistically look forward to our goal of delivering ever more robust GIRFEC services in Scotland, helping all our young people to make the transistion into adult life.