Life can be tough. Particularly for kids in the care system.
The very fact of being in care means life has already been very tough!
Aside of meeting children’s physical needs for a place to live, there are the huge needs that spring from family separation and a poor start in life. So…
How do we promote good mental health for Looked After kids?…
In their recent report: What Works in Preventing and Treating Poor Mental Health in Looked After Children? the NSPCC took a long hard look at the evidence. This included:
– The existing situation: Looking at what “ordinary care” is available, how we conceive of children’s well-being and what the key issues are in the care system that effect it.
– Tools for assessment – of mental health and well-being. Which ones are being used and what is the evidence for their efficacy in practice?
– Interventions – a literature search and review of database and web evidence of interventions that have been evaluated.
One thing is for sure – those looking after these children have a huge job on their hands.
Already damaged by difficult and abusive experiences, these children are also coming to terms with losing their “real” family. So foster families and residential care staff have this double challenge to overcome.
In a nutshell, this is a problem of mental health and well-being – how to mitigate the effects of the past and promote children’s chances of recovery…
– Many aspects of children’s well-being are amenable to change – high quality caregivers alongside targeted intervention can effect change. “…the happiness and well-being of children in different foster homes and residential units varies greatly with the way staff or foster carers look after them.” (p.110)
– Early interventions are more likely to promote good mental health – where children need to be removed from their families to prevent ongoing maltreatment, this should be done as early as possible.
– Developing relationships is crucial for children to make progress – “Given that looked after children and young people can be sceptical about mental health services, it is important to ensure positive engagement and good working relationships in any direct work that is done with them.” (p.113)
– Carer training is a promising method for influencing children’s outcomes – good training interacts with carers’ skills to impact children. More UK-based research is needed into training programme effectiveness, as is more good quality support for carers’ implementation of learning in practice.
– Continuity (in terms of permanence, stability and consistency) can influence success – consistency and commitment from carers influences placement stability and interventions’ effectiveness. Consistency, predictability and reliability are key features of successful placements.
– Efforts to improve mental health should be systematic and sustained – “There is a need not only for services to work together to support the mental health needs of looked after children, but for assessments and interventions to take account of the whole picture to include not just the individual child but also their relationships and environment.” (p.116)
– Children and young people should be treated as individuals – “The need for integrated interventions targeting the systems surrounding the child does not negate the need to take account of the individual, albeit within context…it is important to think about and formulate the whole range of a young person’s strengths and difficulties.” (p.117)
– Professionals need to listen to children and young people – “…many young people feel that choice and control are lacking in their experiences within the care system, affecting their willingness to engage with mental health services, so there is a pressing need to explore how they can be given more of it.” (p.118)
– Caregivers’ attitudes can influence the take-up of mental health services – “…children who struggle with behavioural or emotional well-being need a supporting adult who can advocate for them in accessing mental health assessments and interventions…Caregivers also need to ‘buy in’ to the techniques used in indirect interventions.” (p.118)
– Interventions need a clear theoretical base but should be open to more than one interpretation of children’s behaviour – “…children in care do best with ‘authoritative parenting’, where carers are clear and agreed about what they expect, encouraging, and firm, but also warm, committed to their foster children and sensitive to their needs.
This is a very cursory look at an excellent report. I would encourage you to give it a thorough read through – you can get it here.
What became clear to me in considering these issues is the simple fact that, as a society, we do not appreciate the difference we can make to the lives of our most needy children
Where there is good planning, good people and good funding, we really can help kids to turn their very poor start in life into a success story!
– What do you think needs to change for us to better serve the mental health needs of LAC children?
Please add your views in the comments section below, or by clicking here.
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© Jonny Matthew 2015
With thanks to the NSPCC for their excellent report: What Works in Preventing and Treating Poor Mental Health in Looked After Children?