Addressing the mental health needs of looked after children in foster care: the experiences of foster carers

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link: Accessible SummaryWhat is known on the subject?  In the UK and internationally the number of looked after children is increasing year on year. Mental health problems amongst looked after children are significantly higher than in the general population and the uptake of mental health services for these children is low. There is a poor prognosis for children with untreated mental health problems; this is further compounded if the child is within the care system. What does this paper add to existing knowledge? This study adds to our understanding of foster carers' experiences of the mental health needs of looked after children and demonstrates some of the challenges associated with accessing appropriate and timely mental health services. New knowledge derived from this research is that the barriers to accessing Child and Adolescent Mental Health Services (CAMHS) are not at the time of initial referral as previously reported , but later, once within the mental health system with long waiting times experienced particularly for specialist services. To our knowledge this study provides new insights into the experience of being a foster carer and the levels of support and resources needed that directly relate to the viability of the placement. The majority of the foster carers interviewed were from a Black and Minority Ethnic (BME) background, previously under-represented in this research area.What are the implications for practice? A number of areas in current CAMHS provision need addressing with a focus on accessibility, consultation, and support for foster carers. Waiting times need to be addressed and improved communication with other agencies is also highlighted. 3 CAMHS nurses are well placed to develop and deliver a comprehensive care package to foster carers, offering more tailored support to them whilst enabling the children and young people in their care to access and engage more effectively with mental health services.

Supporting foster and kinship carers to promote the mental health of children

“…The results of this study suggest that both foster and kinship carers promote good mental health, consistent with the relevant literature (Fergeus et al, 2017;York & Jones, 2017). Carers describe the experi- Given their role as primary caregivers, foster and kinship carers play a critical day-to-day role in assisting children to feel as normal as possible (McClung, 2007;Single, 2005), in contrast with the sense of otherness many of the carers in this study recognised in the children in their care.…”

Inter‐professional practice in the prevention and management of child and adolescent self‐harm: foster carers’ and residential carers’ negotiation of expertise and professional identity

“…The present study has explored the complex experiences of foster carers and residential carers working at the inter‐professional interface with clinicians. Self‐harm management and prevention served as an interesting site for empirical consideration, primarily due to current policy frameworks and guidance indicating that existing structures are not working effectively (House of Commons Education Committee , York and Jones ). While there is a wealth of extant research explaining inter‐professional tensions, these have predominantly privileged healthcare and affiliated professionals’ interactions (O'Carroll et al .…”

“…NICE guidance has recognised the integral role of effective multi‐agency team collaboration in promoting the mental health and wellbeing of care‐experienced children and adolescents (National Institute for Health and Care Excellence ). Efforts to standardise and improve such an approach have become imperative where structures to support inter‐professional working are not considered to be working effectively (House of Commons Education Committee , York and Jones ). Accounts of such failings in this area have historically centred on the lack of time or inadequacy of access across agencies (Stanley ).…”

Survival, Signaling, and Security: Foster Carers’ and Residential Carers’ Accounts of Self-Harming Practices Among Children and Young People in Care

“…Existing NICE ( National Institute for Health and Care Excellence, 2010 ) guidance on the promotion of mental health for those residing in care recommends the provision of a dedicated and sensitive multiagency support that is inclusive of mental health professionals. To date, such structures are not considered to working effectively ( House of Commons Education Committee, 2016 ; York & Jones, 2017 ). Explanations of these challenges have often been attributed to inadequate time and access ( Stanley, 2007 ), but discrepancies and debates around expertise need to be attended to.…”