A Mental-Health Service for Young People in the Care of the Local Authority

Abstract

Children in care constitute a deprived and needy group of young people, who are at high risk of developing mental-health problems and disorders. This article describes the development of a direct access child and adolescent mental-health service for children living in residential units or with foster families, with data on the pattern and characteristics of referrals, and discussion on the arising difficulties. The main aims of this service are, to be responsive and flexible, to provide mentalhealth assessment and treatment, and to work with residential care staff, foster parents and field social workers. Young people referred to the mental-health service had high rates of abuse, history of offending behaviour, poor school attendance and frequent previous contacts with child mental-health services. There were also high rates of child mental-health disorders, particularly mixed conduct and depressive disorders, and history of self-harm. Anticipated benefits include a coordinated and cost-effective assessment, improved mental-health outcome, contribution to the care plan and prevention of further difficulties. Joint commissioning between health and local authorities should prioritize children in care. Different models of mental-health provision may be appropriate and require evaluation. K E Y W O R D S care, children, mental health, young people Children in care A B O U T 5 1 , 2 0 0 C H I L D R E N are looked after by social services departments in England and Wales at any time (Department of Health, 1997). This is a substantial young population (5.5 per 1000 of the population under 18 years), despite its steady decrease of 35% during the last decade. There is a trend of increasing placements with foster families rather than in children's homes, although the rates vary across the country. Accommodation of children has increased in recent years, in contrast with emergency orders made in the UK. This population is heterogeneous, and entry into accommodation may occur

Screening for psychopathology in child welfare: the Strengths and Difficulties Questionnaire (SDQ) compared with the Achenbach System of Empirically Based Assessment (ASEBA)

“…Children in foster care show an increased prevalence of psychopathology that range from 15 to 57% [6,14,24,30,32,38]. The prevalence rates for children living in residential care are even higher, ranging from 34 to 86% [5,23,27].…”

The effectiveness of interventions aimed at improving access to health and mental health services for looked-after children and young people: a systematic review

“…Other professionals that could act on their behalf such as GPs or teachers may be absent at times of placement breakdown and transition (Arcelus, Bellerby & Vostanis 1999). Thus the proportion of LACYP accessing services they need, both specialist and universal, is likely to be lower than among the general population of children and young people.…”

Gender Differences in the Relationship Between Self-Esteem and Aggression in Young People Leaving Care

“…In a report describing a mental health service for young people in care Arcelus, Bellerby and Vostanis (1999) found that aggressive behavior was one of the main reasons for referral to the service, and Stanley, Riordan and Alaszewski (2005) found that anger and aggression were frequently identified mental health problems. There is evidence that aggression (feelings of anger or antipathy resulting in hostile or violent behavior) and conduct disorders (mental disorders diagnosed due to a repetitive and persistent pattern of antisocial behaviors) in childhood are predictive of aggression in adulthood (Copeland, Miller-Johnson, Keeler, Angold, & Costello, 2007;Loeber & Hay, 1997).…”