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Children of Prisoners, Interventions & Mitigations to Strengthen Mental Health

Final Report Summary - COPING (Children of Prisoners, Interventions & Mitigations to Strengthen Mental Health)

Executive summary:

Worldwide, unprecedented numbers of people are being imprisoned and in many countries incarceration is on the increase (Walmsley, 2009); indeed 'more parents than ever are behind bars' (Murray et al., 2012) and each year, an estimated 800,000 children within the newly-expanded European Union are separated from an incarcerated parent. Despite this, the psychosocial impact on children is little known and rarely considered in sentencing even though the evidence to date suggests that children whose parents are imprisoned are exposed to triple jeopardy through break-up of the family, financial hardship, and extremes of stigma and secrecy, leading to adverse social and educational repercussions. Until the COPING study, very little was known about these children and despite a spate of recent publications on the subject, the translation of empirical data into practice and policy remains underdeveloped. Funded by the European Union (Seventh Framework Programme, Health Theme), the COPING Project, launched in 2010, aimed to address this deficiency in knowledge by investigating the mental health needs and resilience of children of prisoners and the most promising policy and intervention responses in four countries: the UK (England and Wales), Germany, Romania and Sweden. Led by Professor Adele Jones (University of Huddersfield, UK), the project was implemented by a consortium comprising six non-governmental organisations and four research institutions from the partner countries.

Using a mixed-methods multi-sequential research design, COPING (see online) gathered evidence from over 1,500 children and adults from four European countries representing different social and cultural traditions, different incarceration levels and penal policies and different levels of support services. COPING used a child-centred, positive psychology approach to explore the characteristics of children with imprisoned parents, their resilience, and their vulnerability to mental health problems. One of the strengths of the project was its ability to generate insights into the impact of parental imprisonment on children from a number of angles. A clear picture of the effects of parental imprisonment on children's resilience and upon families was produced using an integrated strategy which included different research methods. The project began with a literature review of other studies that had been carried out in relevant areas. This was followed by a survey of children and parents using standardised instruments to measure strengths, difficulties, self-esteem, wellbeing and quality of life. A series of face-to-face interviews was then undertaken with children of prisoners, their carers and the imprisoned parent in each of the four countries. In parallel to this, a detailed mapping exercise was undertaken of the services and interventions for children of prisoners that were currently up and running and these were assessed in relation to their fit with the evidence we had garnered on children's needs. Alongside these activities, stakeholder consultations sessions were carried out, not only in the four partner countries, but more extensively across Europe (with NGOs in Belgium, Croatia, Czech Republic, France, Netherlands, and Norway) – this was in order to broaden the collection of evidence about the needs of children, the extent to which the findings were more generally applicable and to ascertain views on whether existing interventions, support and criminal justice processes are aligned with children's needs. These different strands of evidence were carefully scrutinised to identify emerging themes and sub-themes and from these, policy and practice implications were distilled.

Children with a parent/carer in prison were found to be at significantly greater risk of mental health problems than their peers in the general population. Children seemed at particular risk of internalising difficulties (emotional problems), rather than externalising problems (hyperactivity and conduct problems). Key factors relating to children's resilience included: children's innate qualities; the importance of family stability and, sustaining relationships with the imprisoned parent. The data confirmed that children's resilience is closely linked to open communications systems and that children need opportunities to discuss their experiences. Despite overall deficiencies in services, which must be a major concern given the mental issues raised, the study found a wide range of good practice examples by NGOs supporting children of prisoners and their families across the four countries. The findings have been converted into a set of actionable recommendations at country and Pan-European levels.

Project Context and Objectives:

In Europe we have about 800,000 children with an imprisoned parent (more children are separated from a parent because of imprisonment than for any other reason) (Eurochips 2007). This group is affected by multiple difficulties resulting from the parental imprisonment through break-up of the family, financial hardship, and stigma and secrecy, leading to adverse social and educational repercussions with higher risk for mental health problems, antisocial behaviour, drug use and poor educational performance (Kjellstrand and Eddy 2011, Murray and Farrington 2008, Murray et al. 2012). There seems no public recognition for the extreme disadvantage experienced by these young people. Support available, for example, in accessing prisons and participating in prison visits is extremely variable and mainly provided through non-governmental organisations. Less is known about the support from the prisons for the children and their families. The relatively few high quality studies on the topic highlight several issues to be considered both at the governmental and the European level; these can be summarised as those pertaining to children's rights and wellbeing, services for vulnerable children and, the dissonance between policy on criminal justice and that concerned with the welfare of children.

Firstly, because of the low profile attached to this work, governments and policy makers have neglected to fully consider the effects of parental imprisonment on children. This is an oversight which runs the risk of punishing innocent victims, and hence children of prisoners have been referred to as the 'forgotten victims' of crime, or the 'hidden victims of imprisonment.' The combination of official disregard and public indifference can be situated within the current moral and political dimensions of punishment, which tend to provoke deeply conflicting interests. As Garland notes, the institutional framework of modern penology has tended to obscure the broader social ramifications of the imprisonment of much larger numbers of offenders. Secondly, there remains no mainstream provision available to this client group, with children of prisoners often finding that they fall between a number of different government departments, such as health, the criminal justice system and child welfare services. Not only does this leave no obvious source of funding or governmental remit, but some authors have argued that the very different organisational cultures and philosophies, and the different institutional priorities of these diverse arms of government have acted to inhibit collaborative working arrangements. As the recent Social Care Institute for Excellence (UK) guide acknowledges, it is left to the voluntary sector to drive the agenda for children of prisoners, and this would similarly appear to be the case in other countries. Because of short term, insecure funding, voluntary sector organisations have struggled to fill the gaps in provision, resulting in patchy provision which falls short of national coverage. Thirdly, there are no accurate figures indicating how many children in Europe are impacted by parental imprisonment since this information is rarely collected and even in Sweden where this information is collected, it is difficult to access and hence we can only estimate the size of the potential problem. This is because registering prisoners' children is not part of the prison reception procedure in many countries, and there appears to be no organisation or statutory body at the respective national levels that routinely monitors the parental status of prisoners. Furthermore, prisoners can be reluctant to voluntarily disclose information which they fear may result in their children being permanently taken away from them. The result is that governments do not know the numbers of children of imprisoned parents, either at any one point in time or, the numbers of children negatively affected by the imprisonment of their parent over any given period of time. This paucity of research attention and a general lack of public interest in the plight of children of prisoners occur at a time when there are unprecedented numbers of people being sent to prison throughout Western nations. It is therefore likely that the numbers of children experiencing enforced separation from a parent because of imprisonment is also at unprecedented high levels. Where the research is more plentiful is in the area of specific effects of imprisonment on families and children. However, much of this research has focused on child circumstances related to parental offending and few studies have investigated actual children's experiences, emotional or psychological. Furthermore, much of the information was gained from parents rather than from the children themselves.

The primary focus for COPING was to investigate the mental health needs of this large and vulnerable group of children. What is distinctive about COPING is that it adopted an explicitly child-centred approach from the outset and has examined some of the more subtle dimensions of parental imprisonment, including the meanings that children attribute to the event, the experience of stigma and social isolation that may follow parental imprisonment as well as the family dynamics before, during and after parental imprisonment and any impacts these factors may have upon the child's psychological health and wellbeing.

2.1 Country Context
The COPING study was carried out in four different countries with differing criminal justice systems, socio-economic conditions, cultural norms and welfare services:

1. Sweden is the smallest of the four countries (by population). Fewer people are imprisoned than in the other COPING countries. Sentences are shorter and more use is made of alternatives to custody. Sweden is a wealthy country, with a well-developed welfare system. Children of prisoners in Sweden are well served by Bryggan, an NGO with an explicit children's perspective. Prison authorities focus on ensuring a good quality of visits for children. Home leaves are built in to prison sentences for suitable prisoners and prisoners are allowed to have their children with them in their early years; each prison also has an ombudsperson for children
2. Germany is a populous and wealthy country. Imprisonment rates are lower than in England and Romania, although it has the second highest average imprisonment length. The guiding principle of penal policy is rehabilitation. Prison policy also prioritises maintaining contact with family members. Home leave and conjugal visits can be included in sentence plans. Female prisons allow children to live with their mothers until they are aged 3 years (up to 6 years in open prisons), and its prison system has been described as "child centred"
3. Romania is by far the least economically developed of the four countries included in the study. It has the second highest imprisonment rate, and the longest sentences of the four countries. Its prison population, however, has fallen steeply in recent years. Prisons have been neglected; they are mainly old and in disrepair. There are few statutory or NGO services for children of prisoners and their families in Romania. Regular visits, including conjugal visits, are permitted, but there are restrictions in place for higher security prisons. Infants and children are able to stay with their mothers in prison until the age of 1 year
4. The UK (England and Wales) has the second highest number of children deemed at risk of poverty or social exclusion in the four countries. The prison population has nearly doubled since 1993, and more people are imprisoned than in any other COPING country, with a consequent significant increase in the number of children experiencing parental imprisonment. NGOs provide information and advice for prisoners' families and run visitors' centres. Eligibility to receive visits is linked to incentives and earned privileges. Female prisoners may be permitted to keep an infant with them for the first 18 months

2.2 Theoretical Framework
In instigating this major pan-European research agenda for what is a chronically under researched 'at risk' group, the theoretical concepts which underpinned the COPING methodology were:

a) Use of an explicitly child-centred methodology to investigate the mental health needs of children of imprisoned parents based on the view that engagement with the perspectives of children as active research participants (and not just subjects of study) can enhance the claims of empirical research in studies about children (Fraser et al 2004).
b) Adoption of a 'positive psychology' approach. Moving away from the predominant focus of previous studies that have been primarily concerned with documenting adverse mental health outcomes in favour of also understanding how children can cope with and survive this experience by investigating resilience at the individual and relational level – this approach is considered to have a vital bearing on designing successful interventions.

The COPING project was innovative in that it departed from mainstay approaches of much previous research, so rather than just focusing upon the psychological and emotional difficulties children may face when a parent is imprisoned, the study explored how some children employ coping strategies and exercise resilience for successfully managing this experience. To date, there is very little research on resiliency processes among children of prisoners, but knowing how some children negotiate and survive through such experiences relatively unscathed, and flourish later, broadens the scope of current research on children of prisoners. It has also provided a theoretical framework to assess the value of these concepts for planning methods and techniques for successful interventions in order to ameliorate any adverse mental health impacts a child may suffer.

Resiliency "combines the interaction of two conditions: risk factors – stressful life events or adverse environmental conditions that increase the vulnerability of individuals – and the presence of personal, familial and community protective factors that buffer, moderate and protect against vulnerabilities. Individuals differ in their exposure to adversity (vulnerability) and the degree of protection afforded by their own capacities and by their environment (protective factors)" (Norman (2000: 3). A key aspect of the COPING study therefore, was an examination of the interaction between children's experiences of parental incarceration and the impact on their lives of separation (risk factors) and the presence of personal, familial and community features/dynamics (protective factors), to determine the extent and contribution of protective factors in enhancing resilience during times of trauma and anxiety.

2.3 Project Objectives

The objectives of COPING were to:

1. Enhance our understanding of the mental health needs of children of prisoners
2. Explore childhood resilience and coping strategies and assess the value of these concepts for planning interventions
3. Bring together European and international perspectives to investigate the nature and extent of mental health problems affecting children in this group
4. Identify relevant and effective policy interventions to ameliorate the mental health implications for affected children
5. Raise the awareness of policy makers to the needs of this under-researched group.

2.4 Methods

Utilizing a mixed-methods multi-sequential design, the study gathered evidence from over 1500 children, care-givers, imprisoned parents and stakeholders across the four EC countries being studied.

Mixed methods research can be defined as an approach or methodology:
- which address research problems by searching for understandings of real-life contexts, diverse perspectives, and socio-cultural influences
- employs rigorous quantitative methods to investigate scale and frequency of factors alongside credible qualitative methods to exploring the meanings attributed to those factors
- uses multiple methods
- integrates or combines these methods to draw on the strengths of each in interpreting results
- frames the study within a clearly articulated philosophical and theoretical position

COPING involved two quantitative methods: survey (Work Package 1) and mapping of interventions (Work Package 4) and two qualitative methods: in-depth interviews (Work Package 2) and stakeholder consultations (Work Package 3). A parallel mixed analytic technique (Teddlie and Tashakkori, 2009) was used to facilitate independent analyses (individual methods) and also, to facilitate interaction between data sets based on the primary purposes of our multi-sequenced design: triangulation; complementarity; initiation; development (Greene et al. 1989).

A self-reporting survey (WP1) was designed which utilized four scientifically validated instruments against which country norms had been established: the Goodman (1997) Strengths and Difficulties Questionnaire (SDQ), the Rosenberg (1965) Self Esteem Scale, the KIDSCREEN-27 Questionnaire (The KIDSCREEN Group Europe, 2006) and the WHO Quality of Life-BREF instrument (WHO, 2004). This was administered to 730 children, aged 7-17 and parent/carers across the four countries in order to ascertain coping strategies and mental health problems for the children surveyed. The results of the questionnaires were compared with normative population samples and purposive sampling carried out to identify a representative cohort of children and parents for in-depth interviews (WP2). A total of 349 in-depth interviews with children and families (161 children, 123 non-imprisoned parent/carers and 65 imprisoned parent/carers) were conducted across the four countries. In addition, simultaneously a multi-method stakeholder consultation strategy was carried out with 122 professionals/groups (WP3) (including face-to-face interviews, focus groups, telephone interviews and a COPING on-line questionnaire). Questionnaires were standardised and to further ensure consistency, operational guides were developed for each consultation group. Ten groups of stakeholders participated in this aspect of the study: caregivers; staff within children's homes; social workers; prison staff; NGO staff; children of prisoners; imprisoned parents; government staff involved in policy relating to children/families of prisoners; NGO staff involved in policy formulation and, school-related stakeholders. These data analysed locally based on a centralised analytic framework.

2.5 Analysis
Quantitative data were analysed using SPSS version 18 with subsequent analysis carried out using the R, Splus and Mplus statistical packages and qualitative data were analysed using the NVivo software package. The data on needs were subjected to factor analysis in order to extract need dimensions and these were then compared with a theoretical framework derived from the literature on needs.

The needs analysis involved several methods:
a) need hierarchies were ranked for children and parents,
b) SDQ and Rosenberg self-esteem variables were correlated with parent-assessed dichotomous needs variables by country,
c) parent/carer well-being was assessed in relation to national norms, and compared between countries,
d) variables were entered into logistic regression models to explore possible predictors of need and
e) service levels in the different countries were juxtaposed against the top three parent-assessed needs identified.

This concluded the data gathering and analysis phase of the study.

Project Results:
Overview reports are available on each of the methods used in the study and these provide a detailed description and discussion of both quantitative results (illustrated by graphs and tables) and qualitative findings (illustrated by themes and quotations). For the purposes of brevity, only a summary of the results is presented here.

3.1 Study Limitations
Given the difficulties in identifying a representative sample of participants, one of the limitations of the research is that sampling bias was inevitable. The impact of this is threefold: firstly, children from minority groups or who experience other forms of marginalisation or social exclusion (e.g. children in care, disabled children, refugee children, children from minority ethnic groups) were largely absent from the COPING study; secondly, as recruitment in all countries (except Romania) was facilitated through NGOs working with prisoner's families, most children were accessing some form of support services and this may mean that these children are more resilient and have fewer needs than children who do not access services and thirdly, the selection of prisons was determined by external factors which meant that imprisoned parents in the study were not representative of the general prison population. In Romania, for example, the prisoners who participated were from high security prisons and had committed serious crimes for which they were serving long sentences and this may have led to false negatives in the overall sample. These limitations aside, the methods were subject to robust quality assurance procedures and results (where appropriate) were validated through comparison with normative data for each country and thus the findings are reliable in terms of the relationship between children and families who participated in the study and those in the wider population.

3.2 Survey Results
The content and structure of the child and parent/carer questionnaires are shown in Table 1 Content and structure of child and non-imprisoned parent/carer questionnaires, with individual topics listed in the order in which they appeared in the questionnaires.

3.3 Survey Sample
Our aim was to select a purposive sample of children stratified according to age and gender, and the gender and ethnicity of the imprisoned parent/carers. It was relatively straightforward to recruit roughly equal proportions of boys and girls but proved more difficult to strike a balance in terms of the gender and ethnicity of parents/carers who were in prison. This is due to the fact that the large majority of prisoners in the four countries are male and White (in terms of their ethnicity). We did attempt to boost the numbers of female and Black and Ethnic Minority prisoners who featured in the survey but with limited success. We were able to record the ethnicity of participants in Romania and the UK, but it was not possible, for legal and/or ethical reasons to ask this question of respondents in Germany or Sweden. We encountered considerable practical difficulties in identifying children of prisoners and in the end relied heavily upon convenience sampling to recruit children and their parents/carers into the survey. The initial aim was to recruit 250 children aged 7-17 years in each country however in only two countries - Romania and the UK – did we reach these targets (251 and 291 respectively). In Germany 145 children (and parents) participated and in Sweden (where the prison population is small) 50 children and their parents took part in the study.

3.4 Demographic and other Variables
Demographic variables compared across the four countries, shows summary statistics for the main demographic and background variables in the study, together with summaries of the key predictor variables. Of the 737 children in the study, 54% were boys, with some non-significant variations across the four countries, with Sweden having the smallest proportion of boys (44%). Just over half the children (56%) were 11 years old or older.

- indicates significance at the p less than 0.05 level
a This refers only to inmates who have been sentenced i.e. not those who are on remand (awaiting trial) or those who have been tried and convicted but are awaiting sentencing.

3.5 Findings from In-depth Interviews and Stakeholder Consultations
A purposive sample of participants was selected for in-depth interviews. The target in each country was to obtain an equal proportion of children falling within the normal and the borderline-abnormal ranges of the Strengths and Difficulties Questionnaire, thus representing children with a range of difficulties.

3.6 Implications of SDQ results
For children aged 11 years and above, both the self report and parent/carer rating provide a reliable indication of their level of difficulties. In all four countries, the mean rating provided by parent/carers fell around the cut-off point for normal-borderline, thus indicating that on average there was a low-moderate likelihood that these children would experience mental health difficulties. Comparable reports by children presented a more positive picture; mean scores fell well within the normal range, suggesting that on average there was low likelihood that these children would experience mental health problems. Further exploration of the parent/carer ratings revealed that in the UK, Germany and Romania a similar proportion of children fell in the normal and borderline-abnormal ranges. In Sweden more children fell within the normal than the borderline-abnormal range (66.7% compared to 33.3%). This indicates that the target position was achieved in all countries except Sweden. Again scores produced by children present a slightly more positive picture; around two thirds to three quarters of children fell within the normal range. According to child-ratings the desired position was not achieved in any of the four countries. For children aged below 11 years, only the parent/carer rating provides a reliable measure. There was greater variation in the mean scores for children aged less than11 years.

3.7 Family Relationships
Across the four countries a key finding was the relationship between the caregiver and the child. Sweden found that poorer outcomes were associated with less stable families. Also, in all four countries, children's resilience was enhanced by close and supportive relationships with grandparents and siblings. Children with secure attachment to the imprisoned parent can experience severe disruption when the trusted parent is incarcerated (Christmann, Turliuc, and Mairean, 2012). Insecure attachments (ambivalent, avoidant or disorganized) can lead to deficiencies in social functioning in adulthood. Ambiguous loss can contribute to disruption of other secure attachment patterns. When a loved person is physically absent but psychologically present, as in situations of parental incarceration, divorce or immigration, it can be very confusing over a long time whether the imprisoned parent is in or out of the family. According to Boss (2007), ambiguous loss is the most stressful kind of loss: should a parent die, rituals of funeral and mourning allow normal grief and lead to acceptance and closure. With ambiguous loss, it is not possible to grieve over the absent parent, and with uncertainty and stigma, children of prisoners can turn to internalizing behaviour leading to depression, or externalizing, antisocial behaviour (Bocknek et al., 2009).

3.8 Children's Resilience and Coping Strategies
The concept of resilience can help to understand how children of prisoners deal with stigma, attachment issues and ambiguous loss. A basic definition of resilience is positive adaptation to life after being exposed to adverse events. Researchers often see resilience as a process that is affected by personality factors, biological factors, environmental systematic factors or an interaction between all three. Particularly important are environmental aspects termed protective and vulnerability factors (Herrman, Stewart, Diaz-Grandos, Berger, and Jackson, 2011). Boss (2007) has suggested that resiliency in the face of ambiguous loss involves finding meaning, reconstructing identity, normalizing ambivalence, revising attachment and discovering hope.

3.9 Honesty, Communication and Sharing Information
Children of prisoners are sometimes told nothing or false stories about what happened to the imprisoned parent. Non-disclosure may come from a desire to protect the child; parents may lie pre-trial, assuming they'll be found not guilty and return. However, imprisoned parents may be motivated to protect themselves rather than do what is best for the child or the family. Some prisoners (wrongly) thought that by keeping the imprisonment secret, they could return to the family and things would be the same as before the sentence. Sometimes one parent wants to tell the truth and the other doesn't, which adds difficulty. Children find it much harder to deal with the parent's absence if the truth is concealed: it can increase insecurity and erode trust between parents and children. Children may find out the truth from other sources. Disclosure of the imprisonment (in an age-appropriate way) was felt by many stakeholders to help the children adjust to the situation and reduce feelings of anxiety and guilt.

3.10 Schools
Schools in Germany, Sweden and the UK were mainly supportive when informed about parental imprisonment. Evidence from Romania was more mixed. In Germany, families participating decided not to inform schools in about half the cases. Although a low threshold school social work service is located in many German schools, evidence from the study was that children and carers mainly communicated their concerns with classroom teachers (not school social workers or counsellors), and that teachers have shown understanding and offered emotional, practical and counselling support. While most children interviewed in Germany kept up their school attendance, in the UK school attendance was adversely affected for a number of children, mainly boys; and there were reports in Sweden of older children frequently missing school, particularly at times close to the arrest of their parent, or when the parent was on home leave.

3.11 Stigma and Bullying
Stigma is, indeed, a phenomenon from which the children of prisoners in COPING suffered (Robertson et al., 2012; Steinhoff and Berman, 2012). Parental imprisonment can lead to children being labelled as different, as having an undesirable characteristic and being in a category of 'them' as opposed to 'us'. The stigma of having a parent in prison can cause children of prisoners to be labelled and rejected by peers, while children may feel they are different from others and withdraw from social contacts. They do not attract sympathy from others and can be stigmatised by prison staff, school staff and parents of their friends. Fear of stigma can stop children telling others about the situation, which can means their problems are often hidden. Children want to be integrated and not stigmatised or ostracised: if families move to a new area, the parents may want a 'fresh start' and not to tell anyone about the imprisonment.

3.12 Experiences of Criminal Justice System
More evidence was obtained about experience of the criminal justice system in the UK than in the other countries. Much of the evidence in the UK related to experience of police arrest, with examples of heavy-handed police practice and (rather fewer) instances of higher levels of sensitivity for children's welfare. There were some isolated instances in Germany and Romania of distress caused to participants at the point of arrest. Other concerns related to stress caused by extended periods of bail for children and families in the UK; children having no opportunity to say 'goodbye' to parents when they were remanded into custody (UK); and serious concerns about restrictions on contact with families for remand prisoners in Sweden. The study has stressed the importance of prompt contact between children and their parent immediately after imprisonment.

3.13 Contact with the Imprisoned Parent
For most of the children involved, regular contact with their imprisoned parent was crucial for their well-being and resilience. A small number of children had either no or infrequent or haphazard contact with their imprisoned parent, and the prior relationships between these children and their parent had often been fraught. Most children (percentages were higher in the UK and Romania) visited their imprisoned parent, although visits were much less frequent in Romania. Long journeys were involved, particularly in Sweden and Romania. Visits could be costly, and often unaffordable in Romania. Most children adapted successfully to the experience of visiting prison, although for a much smaller number this proved upsetting. Saying 'goodbye' was difficult for many and the aftermath of visits painful for some. Children in the UK and Sweden mainly got used to the prison environment, particularly in less secure establishments.

3.14 Needs
Within the survey (WP2), 737 children 7 to 17 years old were asked if they wanted help with life areas specified in 9 variables. The 9 variables loaded on three components following oblique rotation: physical/survival needs, family and school needs, as well as health/social service needs, explaining 54.7% of the variance.

3.15 Services and Interventions
Only a minority of prisons provided specific interventions for children of prisoners and their families. Each prison should offer at least one intervention focused on the needs of children of prisoners, and particularly addressing the contact between the imprisoned parent and child. These measures should also be applied to promote and increase the number and quality of community-based services, as well as the information about available support. We found a lack of specialised services in the community in all four countries (which means in the familiar living environment of the children). Affected families only have access to specialised services in a selected few regions. Available services and interventions are normally unknown to parents and children. It has also to be considered, that the usage of non-specialised services as an important option given the low possibility of children being able to access specialised support.

3.16 Summary of Main Conclusions
Children of prisoners have additional needs compared to children without imprisoned parents. Ambiguous loss, disrupted attachment and stigmatization contribute to a shaken sense of ontological security, all of which together can partly explain the increased risk for intergenerational crime identified in prior research. Strengthening children's resilience in order to improve coping capacity is a key path to empowering these children and their families, and improving the chances of a healthy, productive adult life. Interventions and services, both prison- and community-based, exist in all four countries studied, to varying degrees. However, children of prisoners' needs are to a large extent still unmet, and numerous avenues to improving their situation are available. Stigma remains a barrier to accessing interventions and services and to functioning optimally in the school environment. Stakeholders suggest that negative attitudes about the needs of children of prisoners may have influenced the failure at the policy level, to identify these children as a vulnerable group, and the allocation of resources for their support (Robertson et al., 2012).

The main findings of COPING can be summarised as follows:

1. Children with imprisoned parents as a group are at a significantly greater risk of suffering mental health difficulties than children who do not have parents in prison.

2. COPING has identified key factors relating to children's resilience, including: children's innate qualities; the importance of stability provided by caregiving parents; and the importance of sustaining and maintaining relationships with the imprisoned parent. The importance of the quality of the parents' relationship with the child prior to imprisonment has also been underlined. Support from other extended family members can also be significant.

3. Evidence has shown that children missed their fathers in prison as much as their mothers (perhaps in different ways), particularly in the UK.

4. The data has confirmed that children's resilience is closely linked to open communication systems, and that children need opportunities to discuss their experiences throughout the period of imprisonment.

5. COPING has reinforced the potential for schools to contribute to the emotional well-being of children of prisoners.

6. Levels of stigma varied between the four countries, and seemed more ingrained and marked in Romania.

7. Maintaining contact with the imprisoned parent is in most instances beneficial to children's mental health and wellbeing. Positive environments are needed for children's visits to prisons, and the importance of telephone contact has been underlined.

8. While a range of services and interventions exist, these are not often targeted towards the needs of children of prisoners; services are patchy, uncoordinated and accessible by only a relatively small number of children. Nevertheless COPING found examples of good practice supporting children of prisoners and their families developed by NGOs across the four countries.

3.17 Translating Results into Policy and Practice Recommendations
A systematic approach was developed to produce recommendations. This involved a three stage process that comprised: a) a Research Findings Workshops by each partner at different points in time during the final year of the project; b) the convening of Recommendation Workshops at COPING Consortium meetings and less formally, within each partner country, to distil potential recommendations from the research findings; and c) the completion of a common template, the 'Development of Recommendations Form' designed to inject consistency in the way in which recommendations were drafted, presented, discussed and categorised. Together, these activities provided a structured way in which learning from the COPING project could be articulated and thereafter, translated into a clearly stated agenda for policy development and reform.

Eight broad themes were identified from the study:
- Family Relationships
- Resilience
- Stigma and Bullying
- Honesty and Communication
- Schools
- Experience of the Criminal Justice System
- Contact with imprisoned parent
- Services and Interventions

For each theme, the research teams were asked to consider the following questions:

1. Is there any action that needs to be taken arising from this theme'
2. What needs to happen'
3. When, where and under what circumstances does this need to happen'
4. What is the evidence from COPING that leads to this conclusion'
5. Who can make this happen'
6. How can they make this happen'
7. Is this action dependent on other factors (e.g. training, raising awareness, obtaining sufficient funds)'
8. What are the risks that it will not happen'
9. How can these be minimised and overcome'
10. Are there any other questions concerning this'

Potential Impact:

This section of the report highlights the potential impact of the COPING findings, raises some policy and practice considerations and presents recommendations for action. An awareness of the need to develop recommendations was embedded in COPING from the outset and emphasis was placed on identifying the 'action implications' stemming from the research findings. This required a careful judgment about how far the research had highlighted an unmet need, a practice that needs to change, a perception that needs to be addressed or anything else that needs to be remedied. These 'areas for improvement in policy and practice' emerged by comparing findings from different Work Packages paying particular attention to where needs, challenges and opportunities identified in one Work Package were corroborated and reinforced by the results from other Work Packages.

4.1 Child-friendly Criminal Justice Systems
Evidence from the study suggests that the welfare of the child is not given sufficient priority by the police and criminal justice agencies. For example, prior to a parent going to prison, the attitude, behaviour and language used by the police in searching a home and making an arrest, can have a profound impact on the psychological and physical well-being of a dependent child witnessing such events. Examples of practices that are distressing to a child include police wielding guns, doors being broken down in during forced entries, drawers being spilled, teddy bears being cut open to look for drugs. In all four COPING partner countries parental arrest was the start of a period of emotional upheaval for the families affected. This process can significantly disrupt a child's life affecting who cares for the child and where it lives.

4.2 Representing the Child's Interests in Judicial Decisions
Considering the child's best interests before sentencing involves asking questions such as: is the parent about to be sentenced the only carer that the child has, what will happen after imprisonment, who is going to care for the child, where is the child going to be living, which prisons are at a reasonable distance from the child's home. Other considerations include exploring if there is an alternative to custody for the parent. The consideration of these and other issues amount to a 'Child Impact Assessment' of the consequences of judicial decisions.

Recommendation 2 - A Child Friendly Criminal Justice Systems
1. All EU Member States should legislate to ensure that courts take the child's best interest into account at the time of sentencing and in decisions on imprisonment. When it falls to the courts to decide the location of imprisonment, this decision should take into account the proximity of the child's place of residence to the prison.
2. Consideration should be given to the adoption of Child Impact Assessments prior to sentence. The assessment should consider the status of the offender in relation to the child i.e. sole or joint carer, the current location of the child and the likely residency arrangements for the child following a custodial sentence.

4.3 Maintaining Contact with the Parent in Prison
COPING's research suggests that for most children, regular contact with the imprisoned parent and maintaining the child-parent relationship was crucial for their emotional well-being and capacity for resilience. The right of a child to stay in contact with both parents is clearly stated in the CRC. There are two forms of contact, direct and indirect. Direct contact is where the child visits the prison in person and has face to face contact with their imprisoned parent. Indirect contact involves keeping in touch by various means including telephone calls, email and by post. Both forms of contact are valued, but the research undertaken by COPING highlights the importance of visits in providing face-to-face contact and direct interaction with the imprisoned parent.

COPING's research suggests that the first visit to prison is of crucial importance to children and families, particularly in terms of providing reassurance that the imprisoned parent is safe and well. Children can be very concerned about their parent in the immediate aftermath of imprisonment and often lack the information they need about what prison is like and how their parent is managing. This was evidenced in the relief expressed by several families following their first visit. Delays in arranging first visits because of prison bureaucracy can cause undue distress and anxiety to children and families. Introducing first-time families to different aspects of prison life, through a prison tour, is an excellent approach. It can dispel myths that children have about prisons countering images conjured up in children's minds through fiction and the media of mediaeval dungeons and places of great danger.

Recommendation 3 - Maintaining Contact with the Parent in Prison:
1. Visits should be seen as the right of the child rather than as a privilege for good behaviour on the part of the offender.
2. Children should have the same right to maintain contact with an imprisoned parent who is on remand as to a parent serving a prison sentence following conviction.
3. Visitors should be informed about the purpose of searches.
4. Search procedures for visitors to a prison should be carried out in a manner which causes minimum distress to children and families.
5. Governments should ensure that children can visit an imprisoned parent within the first week following incarceration. This applies to both imprisonment on remand and following sentencing.
6. All prison security and administrative measures should be made compatible with the child's well-being and the child's right to maintain contact with an imprisoned parent. Whilst recognising the need for heightened security in many cases, these measures must be reconciled with a child's right to maintain contact, when this is in their best interest.
7. Where feasible, children should be given the opportunity, on their first visit, to tour the prison, be provided with information about prison procedures and have the chance to ask questions.

4.4 Promoting continuous quality contact with imprisoned parent
Once established, it is particularly important that quality contact is maintained between the imprisoned parent and the child both directly (face to face) and indirectly by different methods of communication. Direct contact should be of sufficient quality for the child to interact and engage with the imprisoned parent. This means having visiting facilities that are welcoming and comfortable rather than cold, noisy and crowded and ensuring that security restrictions on visits, including but not limited to those on physical interaction, are kept to a bare minimum. It also means organising age-appropriate activities for children, on the one hand to promote engagement and support attachment and on the other, to prevent them from becoming increasingly bored or agitated throughout the duration of visits.

Recommendation 4 - Maintaining Contact with the Parent in Prison:
1. In order to promote quality interaction between children and their imprisoned parent, prisons should provide, at least to minimum standards, welcoming and comfortable visiting environments, and ensure that security restrictions on visits, including but not limited to those on physical interaction, are kept to a bare minimum.
2. All prisons in all EU Member States should provide age-appropriate activities that both occupy children during visits and foster interaction between children and their imprisoned parent. Child-friendly prison-based schemes should be offered to every child visiting an imprisoned parent.
3. The prison and probation services should ensure that they (or an NGO) provide visits groups or visitor centres at or near the prison. This should involve easy booking procedures, information to families prior to the visit (to ensure it is best for the child) and support to child and parent/caregiver prior to and after the visit.
4. Prison authorities in all EU Member States should ensure that all prison staff behave in a respectful, child-friendly manner when dealing with families. Education and training modules for prison staff should introduce the child's perspective and provide guidance on how best to welcome and accompany children and families.
5. Consideration of the journey time for families should be taken into account by prison authorities in housing prisoners, and financial aid provided for travelling offered where necessary (as in UK).
6. Prisoners should be able to both make affordable outgoing calls, and receive incoming calls from their family in their own language.
7. Modern forms of technology that permit two-way communication between prisoners and their families and facilitate quick response times should be piloted in prisons and adopted where possible.
8. Where it is in the child's best interests home leave should be considered and offered to prisoners

4.5 Advice and Support to Parents, Care Givers and Children
Away from the prison, how do children, carers and other family members get through it all' What advice and support do they need and what is available to them' COPING has found that children's resilience is closely related to sharing information with them openly and honestly about what has happened and the reasons for their parent's imprisonment, consistent with their age and maturity. On the whole, honesty is good for children and helps promote their positive mental health. Inevitably the information would leak out eventually whether or not children are informed. Findings have highlighted the need to talk to children throughout their experience of parental imprisonment, starting as early in the process as possible.

Recommendation 5 - Advice and Support to Parents, Care Givers and Children
1. Parents and caregivers should be offered guidance from mental health and social welfare professionals, on what and how to tell the children in extreme cases, taking account of the child's age, individual personality and developmental stage.
2. The care-giving parent and the imprisoned parent should share responsibility for providing information from the start of the process to its eventual conclusion; decisions about how much children should be told should be reached in the best interests of the children (not those of parents).
3. Parents/caregivers and imprisoned parents should carefully consider sharing information about parental imprisonment with their children's school and wherever possible communicate this information so that schools can provide children with the support they need.

4.6 Promote NGOs' role in supporting for children and families of prisoners
There was evidence that some families of prisoners were unaware of organisations specifically designed to support them. These families reported that they would have welcomed the opportunity to receive support, particularly regarding what to expect when visiting prison. Much more can be done by the police and the prisons to tell families where to find support but the NGOs need to ensure that criminal justice agencies are fully aware of their services so that they can refer families to them.

Recommendation 6 - Advice and Support to Parents, Care Givers and Children
1. The valued role of NGOs in providing services to children and families impacted by imprisonment should be recognised by national governments.
2. NGOs should ensure that their support services are effectively advertised to potential service users and other relevant personnel involved in the entire criminal justice system process- from arrest to resettlement- to increase awareness of and accessibility to these services.
3. Criminal justice agencies should be aware of the particular needs of children with imprisoned parents and commit to publicising information for them at all stages of the criminal justice process.
4. Protocols with the police service should be developed so that when a parent is arrested, the police inform the family (carer and child) about where to find support.
5. Prisons should ensure that standardised letters advertising the services provided for children and families of prisoners by NGOs are to families of prisoners.
6. NGOs and support agencies not currently working in this area should be encouraged to expand their role to include support for families of prisoners and run activities specifically for children of prisoners.

4.7 Recognise and Support Care Givers in Building Children's Resilience
The contribution of care giving parents is crucial for children's resilience. But grandparents also play a role, sometimes taking over children's full time care, sometimes sharing household duties, helping financially, counselling and offering support with prison visiting. Grandparents were well placed to nurture the child's relationship with the imprisoned parent. The supportive role played by siblings was also strongly evidenced across all four countries.

Recommendation 7 - Advice and Support to Parents, Care Givers and Children
1. The crucial value of support provided by care-giving parents, grandparents and siblings to children of prisoners in underpinning the children's mental health and promoting and protecting their well-being should be formally recognised by all EU Member States.
2. Caregivers should be provided with the support they need to fulfill this role by statutory agencies throughout Europe

4.8 Promote the Parenting Role of the Imprisoned Parent
COPING recognises the potential role of the imprisoned parent as active agents in promoting children's welfare. Encouraging imprisoned parents to contribute to their children's daily lives can be problematic because they might not appreciate how hard it is for their children to deal with their imprisonment; they might not realise just how important they are in promoting their child's welfare and they may fail to see how they can possibly carry out their role as a parent from prison. Imprisoned parents need to have their awareness raised about the importance of their role, the difficulties their children may face and the various positive coping strategies that the family can develop. Just as carers need support on the outside, the imprisoned parent should be offered advice and support on parenting from within the prison through the provision of and participation in parenting groups and classes. But it is not just a case of changing perceptions.

Recommendation 8 - Advice and Support to Parents, Care Givers and Children
1. Imprisoned parents should be offered opportunities to contribute to their children's daily lives, including being involved in their children's schooling, when feasible.
2. Parenting groups, workshops and other forums for sharing experience and receiving support as a parent should be widely available in prison to help them carry out their parenting role.

4.9 The Role of the School
Children of imprisoned parents are at a significantly greater risk of suffering mental health difficulties and may face particular issues as a result of their parents' imprisonment. Those working with children need to be aware that children of prisoners have both generic and individual support needs. For example, many children of prisoners take on additional responsibilities including acting as young carers while their parent is in prison. Where the fact of parental imprisonment becomes public knowledge, children can also be bullied and stigmatised. Schools are the one institution that almost all children regularly attend and are a significant influence on their socialisation. Where teachers or other trusted school staff (such as assistants or school nurses) do know about the situation, they can provide emotional and practical support to children of prisoners. Parental arrest and imprisonment can potentially make the transition from junior to secondary school more challenging and have an adverse effect on children's performance at school, at least in the short term. Teachers can help affected children academically, through homework clubs or extra tutoring. This can reduce significantly the burden on the non-imprisoned parent or carer especially when they were stressed, overworked and having to devote an increasing proportion of their time on running the household and managing family budgets. Schools can also encourage parents to be open with their children about parental imprisonment and they can reassure and encourage them to be honest about the impact of parental imprisonment on their child's school attendance (e.g. absences due to prison visits). They can also protect children from bullying and stigmatisation.

Recommendation 9 - The Role of the School

1. Across the EU, local, regional and national education authorities should include the children of prisoners as a vulnerable group in their strategic planning.
2. Training materials for teachers, school counsellors and others should be produced and used to raise their awareness of the emotional and educational support needs of children of prisoners (among other vulnerable groups) so that they are better able to identify and respond to them. This training could be done in partnership with individuals or NGOs.
3. Stigma surrounding parental imprisonment should be tackled by raising awareness of this issue in schools and promoting a positive, non-discriminatory school environment.
4. Schools should refer children of prisoners experiencing severe anxiety or trauma resulting from parental imprisonment to trained counselors.
5. Schools should make clear their open, non-judgmental approach towards children of prisoners and so encourage children and their caregivers to share information about a parents' imprisonment

4.10 Public Awareness and Policy Recognition
Working to safeguard the well-being of children is a common value throughout Europe, a value enshrined in the CRC and the Europe 2020 Strategy, which urges the promotion of policies that prioritise early childhood interventions in areas such as health and education. However, COPING has recognised from the start that children of prisoners have received less than adequate recognition for their needs from Government in the four partner countries — Germany, Romania, Sweden and the UK.

This is attributable to several factors, the most significant of which are:
- A lack of awareness by both the public and policy makers that children of prisoners are a vulnerable and marginalised group in need of support;
- The fact that children of prisoners are a difficult-to-reach group, which compounds the problem and prevents these "invisible" children from accessing the support they may require;
- A negative portrayal by the media of offenders, and potentially their families, which can be harmful and stigmatising to the child;
- The absence, across the EU, of consistent information about the number and needs of children of prisoners the capture of which, either through a national monitoring body or through the prison service, is necessary in all EU Member States.

Recommendation 10 - Public Awareness and Policy Recognition
1. An EU Framework be established for national support initiatives for children of prisoners. This Framework should define common objectives, including improving the information base about the numbers and needs of children of prisoners and the development of cross-agency support initiatives to meet these needs, to be translated into national policies according to the principle of subsidiary.
2. The Framework should establish common indicators against which to measure progress; require periodic monitoring; promote cooperation between relevant agencies and foster the exchange of good practice and ideas on a national level and among EU Member States

4.11 General Public Awareness-Raising and Media Coverage
In all countries, COPING identified a need to raise the awareness of and 'sensitise' media personnel to the often challenging circumstances that children of prisoners face and the impact that stereotypical or other portrayals can have on their well-being, with a view to preventing stigmatisation. Campaigners and researchers also need to be aware of possible negative repercussions of their efforts to raise the public profile of children of prisoners and a careful balance is needed between highlighting their needs and preventing further stigmatisation.

Recommendation 11 - Public Awareness and Policy Recognition
1. General public awareness-raising should be an on-going process across the European Union, primarily through articles in magazines for different groups of professionals and other media channels and through educational materials and sessions in schools. Content should focus on raising awareness of the existence of children of prisoners alongside other issues which create vulnerability, marginalisation or stigmatisation for children, the potential impact of parental incarceration and the need to develop effective support schemes.
2. Media should be sensitised as to how their reporting impacts upon children, to how stigmatisation can arise as a result of media reports about parental incarceration, and to the need to protect the dignity and anonymity of these vulnerable children.

4.12 Consideration of Children's Perspectives
Within EU states, where national governments are implementing EU law, children are legally protected by Article 24 of the Charter of Fundamental Rights. This states that:

- Children shall have the right to such protection and care as is necessary for their well-being. They may express their views freely. Such views shall be taken into consideration on matters which concern them in accordance with their age and maturity;
- In all actions relating to children, whether taken by public authorities or private institutions, the child's best interests must be a primary consideration;
- Every child shall have the right to maintain, on a regular basis, a personal relationship and direct contact with his or her parents, unless that is contrary to his or her interests.

Recommendation 12 - Public Awareness and Policy Recognition
1. Decision-makers should ensure that anyone whose work impacts (directly or indirectly) on children of prisoners considers their best interests, needs, rights and perspectives, allowing for the development of support initiatives in schools, statutory agencies, the criminal justice process, and other relevant areas.
2. In the longer term, all member states party should seek to ensure that national law, especially in criminal matters, is more closely aligned to the Convention on the Rights of the Child.
3. EU legislation should be passed to ensure that Article 24 is enforceable across EU Member States in relation to the needs and rights of children of prisoners.

4.13 Dissemination and Awareness-Raising
A comprehensive and wide reaching dissemination and awareness strategy was developed at the beginning of the project (at both Pan-European and country levels) with multi-level events organized throughout in order to raise awareness of the needs of children of prisoners and to disseminate and discuss emerging findings. These events are detailed in the overview report for Work Package 7. The events include: conferences, seminars, workshops, public engagement events, media releases, videos, art exhibitions, project websites, published articles and media interviews. These activities will continue into the foreseeable future in order to maximize the impact of the project.

List of Websites: