Aims and Objectives:
The relationship between health and social inequalities is well documented (Marmot, 2010), in that inequalities in social conditions are associated with poor health for particular vulnerable social groups. Both nationally and internationally, children and young people in care are considered one such group (Mather, 2010). They are largely drawn from families who experience considerable social disadvantage and deprivation (McSherry et al., 2010). Most of those who enter the care system have experienced abuse or neglect (DoH, 2009), which may have adverse consequences for their cognitive development, educational attainment, self-efficacy, attachment relationships, and social competencies (Tanner & Turney, 2003). In relation to their mental health, large-scale surveys conducted in England, Scotland, and Wales indicate that, across Great Britain, around 40% of children and young people in care have some form of clinically significant mental disorder; 39% have conduct disorder, 13% have an emotional disorder, and 10% have a hyperkinetic disorder, although these percentages varied across three countries (Meltzer et al., 2003; 2004a; 2004b). No such survey was conducted in Northern Ireland at that time. The current study was designed to address this deficit.
Methods:
The study used a mixed-methods approach, which included: a review of policy and practice documents; five focus group interviews with senior social work managers in each of the local government authorities across Northern Ireland; 233 telephone interviews with carers (foster, kinship, and residential); 25 semi-structured interviews with young people; and multi-disciplinary focus group interviews across the HSC Trusts.
Key findings:
- 40% had been diagnosed with Behavioural problems; 35% with emotional problems and 21% with depression or anxiety;
- One third were suffering from a long-standing illness or disability;
- Young people living in residential care had a much more negative health profile than those living in foster or kinship care;
- Some had difficulties in accessing the services they needed, due to a range of issues;
- Some positive factors were identified as currently helping to meet the children's health needs including: priority status for children and young people in their referral to particular services; professional co-operation; placement stability and well supported foster placements; and support services from statutory and voluntary organisations.
The study makes 10 recommendations to improve the health of children and young people in care, including the need for a greater focus on prevention and early intervention, and moving towards a more proactive approach, as opposed to one that is reactive and crisis-led.
References
DoH (2009). Statutory guidance on promoting the health and wellbeing of Looked After Children. London: Department of Health.
Marmot, M. (2010). Fair society, healthy lives. London: Department of Health.
Mather, M. (2010). 30 years of childcare practice and research: An overview. Adoption & Fostering, 34, 2010.
Meltzer, H., Corbin, T., Gatward, R., Goodman, R. & Ford, T. (2003). The mental health of young people looked after by local authorities in England. London: Office of National Statistics.
Meltzer, H., Lader, D., Corbin, T., Goodman, R. & Ford, T. (2004a). The mental health of young people looked after by local authorities in Scotland. Edinburgh: The Stationery Office.
Meltzer, H., Lader, D., Corbin, T., Goodman, R. & Ford, T. (2004b). The mental health of young people looked after by local authorities in Wales. London: The Stationery Office.
McSherry, D., Weatherall, K., Larkin, E., Fargas Malet, M., & Kelly, G. (2010). Who goes where? Young children’s pathways through care in Northern Ireland. Adoption & Fostering, 34(2), 23-37.
Tanner, K. & Turney, K. (2003). What do we know about child neglect? A critical review of the literature and its application to social work practice. Child & Family Social Work, 8(1), 25-34.
