The expected and the unexpected in recovery and development after abuse and neglect: The role of early foster carer commitment on young children's symptoms of attachment disorders and mental health problems over time

Neurodevelopmental problems in adulthood following severe early deprivation: A qualitative analysis of clinical needs and service user experiences

“…Nevertheless, studies in childhood have highlighted a range of service needs of adoptees following adoption, including support for early emerging internalising/externalising problems, bolstering of relationship quality/attachment bond formation with the adoptive family, help strengthening educational attainment, recognition of later emerging struggles with identity formation, and for international adoptees, addressing concerns around discrimination/stigma (Hartinger-Saunders and Trouteaud, 2015;Ryan and Nalavany, 2003;Zosky et al, 2005). The evidence base is broadly consistent in finding that there is usually an initial period of catch-up, provided that adequate care is put in place (e.g., Turner at al., 2022) and also that after this period, there remain elevated levels of difficulties for a significant minority of adoptees and that these problems can persist into adulthood (e.g., Sonuga-Barke et al, 2017). Experiential focused studies have shown that barriers to receiving appropriate support in childhood and adolescence include a deficit of specialised care provision, a lack of a 'joined-up approach' in service provision, an absence of awareness of what support is available, instability in the caregiving environment, variability in the extent to which caregivers are able to advocate on behalf of the young person, and disengagement from the young person themselves (Luke et al, 2014;Zosky et al, 2005).…”

Editorial: Early intervention and prevention of severe mental illness: A child and adolescent psychiatry perspective

“…This may partly be due to the differences in diagnostic categorization and therapeutic models of service provision amongst child and adult services. For example, child services are less diagnostically driven, making the identification of specific at-risk groups (i.e., ADHD, at-risk of psychosis, mood disorders, and personality disorders) challenging ( 3 ). Lack of data about the transition between child and adult services limits knowledge about discontinuities in service provision for children, adolescents and young adults with most complex needs.…”

“…2. Improve functional outcomes: Our research has shown that key early signs of severe psychiatric illness are functional impairment and rate of change in functioning ( 3 ). A common argument against early intervention in psychiatry is that, unlike cancer, psychiatric illness can be difficult to distinguish from less-than-optimal normal functioning.…”

“…Yet only a small minority of young people with the poorest functioning and most complex psychiatric presentations are in contact with mental health services by age eighteen ( 2 ). Barriers to service delivery include missed diagnosis and poor early identification leading to widening social, health and occupational disadvantage ( 3 ).…”

“…Both have the same rate of change in functioning. We have shown that investigating severe functional impairment or rapidly deteriorating functioning can be an important way of identifying severe mental illness at an early stage ( 3 ).…”