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Building home on a fault line: aging out of child welfare with a serious mental health diagnosis
- Authors:
- KLODNICK Vanessa V., SAMUELS Gina M.
- Journal article citation:
- Child and Family Social Work, 25(3), 2020, pp.704-713.
- Publisher:
- Wiley
Youth aging out of foster care are at high risk for homelessness. This research explains how and why homelessness occurs among youth with serious mental health struggles after aging out of residential and transitional living programmes. Using a longitudinal constructivist grounded theory design, we analyse 20 in‐depth interviews exploring youth's transition experiences and perceptions of transition success within 4 months of emancipation and at 6 and 12 months postemancipation. Monthly 15‐min check‐ins prevented attrition. A three‐phase transition process was observed driven by participant desires and actions to cultivate psychological home through establishing physical home alone away from social networks. Pre‐emancipation, the promise of home was privacy and opportunity for self‐redefinition. Shortly after emancipation, home became a physical and social space to be, a valuable resource to share and a demonstration of personal transition success. However, later in the year postemancipation, maintaining physical home proves nearly impossible given the risk context. Findings speak to how and why youth aging out appear overly self‐reliant upon emancipation. Cultivating a psychological sense of home has practice implications for child welfare providers who aim to prepare youth to live independently postemancipation. (Edited publisher abstract)
Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies
- Authors:
- SEKER Suheyla, et al
- Journal article citation:
- European Child and Adolescent Psychiatry, early cite June 2021,
- Publisher:
- Springer Nature
While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3–17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6–66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33–2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks. (Edited publisher abstract)
Improving mental health support for our children and young people: Expert Working Group final report
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 69
- Place of publication:
- London
The final report of an Expert Working Group which was set up to improve how the emotional wellbeing and mental health needs of children and young people in care are met. This includes children in kinship are, those adopted from care, those under a Special Guardianship Order and care leavers. The project was commissioned by the Department of Health and Department for Education, and the Expert Working Group supported by the Social Care Institute for Excellence. The Group drew on evidence from a review of the literature, a call for evidence of good practice, consultation with children and young people with lived experience of the care system and professionals from across health, education and social care. The report outlines recommendations from children and young people consulted for the project, sets out 11 key findings to act as drivers for change in meeting the mental health needs of looked after children; and presents seven quality statements developed by the project. The report also includes a model developed by the Group which champions the mental health needs of the young person and places the child or young person at the centre. The recommendations and quality statements cover the areas of commissioning and accountability, leadership, workforce, voice, care pathways and assessment. They include the use of a needs-based model which places the child at the centre of decision-making and, where appropriate, allows them to exercise child as to what support they need. (Edited publisher abstract)
Rejected referrals: looked after children and care leavers' access to child and adolescent mental health services
- Author:
- KIRKMAN Maddy
- Publisher:
- Barnardo's Scotland
- Publication year:
- 2019
- Pagination:
- 28
- Place of publication:
- Edinburgh
This report explores looked after children and care leavers’ access to Child and Adolescent Mental Health Services (CAMHS). It discusses four barriers of accessing services: a lack of stability in children’s lives; lack of engagement; symptoms not severe enough and lack of clarity around referral criteria; and an assumption that a service already being provided by another organisation. The report found that children with care experience and care leavers are disproportionately affected by rejected referrals to CAMHS services. It also found that many care experienced children and young people do not receive the services they need. This can be due to the types of therapy available not being suitable for their needs of the care experienced population who are more likely to be struggling with mental health problems as a result of trauma and aspects of policy and practice within CAMHS services that create additional barriers for care experienced children and care leavers. The report makes recommendations for policy and practice looks at the roles agencies, practitioners and policy makers can play in implementing positive change. (Edited publisher abstract)
Health, health behaviours health promoting services for care leavers: perspectives of young people and LAC nurses
- Authors:
- MORGAN-TRIMMER Sarah, SPOONER Suzanne, AUDREY Suzanne
- Publisher:
- Cardiff University. School of Social Sciences
- Publication year:
- 2015
- Pagination:
- 5
- Place of publication:
- Cardiff
Looked after children and adults with a prior history of being looked after tend to have poorer health and social outcomes, even when compared to populations with similar socioeconomic backgrounds. To investigate how looked after children view their own health, interviews were carried out with 16 young care leavers in south Wales. Focus group were also carried out with 14 looked after children’s (LAC) nurses. Young people identified emotional well-being as a primary health concern, with most interviewees having experience of mental health problems, stress and social isolation. A healthy diet, weight were all seen to contribute to good health and excessive alcohol consumption recognised as having detrimental effect. LAC nurses found that their work priorities were usually emotional and social care issues. The also felt that the area of emotional and mental health was one which could be improved and that those working directly with looked after children, such as carers, teachers, social workers would benefit from training and support from mental health professions. Barriers to services identified by LAC nurses included residential instability, long waiting lists, difficulties in transitioning to adult mental health services and the reluctance of some young people to engage in services. (Edited publisher abstract)
Models of care and care pathways to support mental health and wellbeing of looked after children: Findings of call for evidence
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 63
- Place of publication:
- London
This document presents the findings of a call for evidence to identify examples of effective practice in relation to mental health and wellbeing support for looked after children (including unaccompanied asylum seeking children), care leavers, those under a Special Guardianship Order and adopted children. It was conducted as part of a Department of Health and Department for Education-funded project to develop models of care and care pathways to support the mental health and wellbeing of looked after children. Contributions were invited from the following four areas: care pathways, models of care, prevention and early help, and assessment. A total of 68 practice examples were received and a further 14 submissions which took the form of a proposal or policy response to the group. The examples are presented under the follow clusters: Multi-disciplinary looked after children’s emotional and mental health support services; screening and identification; training and support for foster carers; foster care placement types; approaches and models in residential care; residential placements for children and young people with complex needs; training and support for adoptive parents; independent/third sector specialist therapeutic teams; care leavers; attachment assessment framework; reunification practice framework; CAMHS based in education; forensic CAMHS services; boarding school places; building self-esteem; raising awareness; and policy submissions from national bodies. (Edited publisher abstract)
MCR pathways lockdown survey: how to build back better: listening to the voices of our young people
- Author:
- MCR PATHWAYS
- Publisher:
- MCR Pathways
- Publication year:
- 2020
- Pagination:
- 35
- Place of publication:
- Glasgow
Findings of a survey of 1,347 care-experienced and disadvantaged young people (aged 13 -18) from across Scotland, gaining insight into their experience of the COVID-19 lockdown, specifically in relation to mental wellbeing, home learning, and impact on career plans and future expectations. Key findings on the impacts of the lockdown include: impact on mental wellbeing – two thirds (66.8%) of young people are feeling low, more anxious and stressed since lockdown and 88.8% said their sleeping patterns have changed and over a quarter (26.5%) said they were experiencing significantly disrupted sleep; impact on education and return to school – since lockdown, 68.2% did not use any learning materials provided by the school while, significantly, over a quarter had caring duties that impacted on their capacity for home learning; impact on the future – 64.8% of young people say that COVID-19 has not changed their future plans for what they want to do when they leave school and 38.5% of leavers are feeling confident about their next steps. The report makes a number of recommendations, including ensuring education is provided on a full-time basis, schools offer a recovery curriculum, and disadvantaged young people are systematically and comprehensively consulted as a matter of course throughout the formation of all recovery and rebuild plans. (Edited publisher abstract)
Exposing challenges in transitioning post residential mental health treatment: the case of the “Poster child”
- Authors:
- PREYDE Michele, et al
- Journal article citation:
- Residential Treatment for Children and Youth, 35(4), 2018, pp.336-349.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
A case report is employed that illustrates the need for residential mental health treatment (RT) and the need for continuation of support post RT. Children and youth with moderate-to-severe mental health needs that require intensive treatment in a safe setting for a duration of several months might access RT. RT is sometimes the treatment of choice, and, in fact, is the best treatment option for some youth regardless of whether the youth is in the care of the family or child welfare authorities. However, mental health needs do not stop after discharge from RT. A continuation of supports and continuation of contact with a mental health professional may provide stability that can foster the youths’ progress in education and interpersonal relationships that are significantly affected by the mental health disorders but are simultaneously essential for transitioning to adulthood. (Publisher abstract)
Caring for better health: an investigation into the health needs of care leavers
- Authors:
- BRADEN Jakeb, GODDARD Jim, GRAHAM David
- Publisher:
- Care Leavers' Association
- Publication year:
- 2018
- Pagination:
- 54
- Place of publication:
- Manchester
This report summarises the findings of research into the views of care leavers and health professionals on how health services can be improved to better meet the needs of care leavers of all ages, including adult care leavers over the age of 25 years. The project received funding from the Department of Health, and was carried out during 2014-2017. It involved surveys and forums with both health professionals and care leavers to gather their views The Care Leavers Association also worked with Clinical Commissioning Groups (CCGs) to set up working groups to explore care leaver health needs in different local areas. A total of 418 care leavers also completed a survey on health needs. The initial findings of the survey found that a high number of carer leavers experienced low self-esteem, anxiety, depression and isolation. In some cases these experiences continued over several decades, highlighting the importance of address the causal factors as early as possible. The report makes recommendations designed to improve the commissioning process and improve health outcomes for care leavers. (Edited publisher abstract)
Children and young people's views on being in care: a literature review
- Authors:
- HADLEY CENTRE FOR ADOPTION AND FOSTER CARE STUDIES, CORAM VOICE
- Publishers:
- University of Bristol, Coram Voice
- Publication year:
- 2015
- Pagination:
- 50
- Place of publication:
- Bristol
Drawing on existing research, this report highlights the voices of looked after children on their experiences through the care system. Chapter 1 provides a summary of the key issues that emerged from a review of the literature on young people’s views of their care experiences, highlighting four primary themes: relationships, respect, rights and responsibility. Chapter 2 explores the literature on the views of looked after children who may have specific issues associated with their particular experiences, for example, being an asylum seeker, having a disability, or being a care leaver, being a parent, living in residential care or in secure settings or experiencing mental health difficulties. (Edited publisher abstract)