Supporting adolescents on the edge of care - using short stays in residential units to prevent longer term care

There has been renewed and increased focus on preventative strategies for adolescents on the edge of care in the UK. This has been driven, in part, by the rising number of young people in care (currently at its highest in... [ view full abstract ]

There has been renewed and increased focus on preventative strategies for adolescents on the edge of care in the UK. This has been driven, in part, by the rising number of young people in care (currently at its highest in almost 20 years) and in particular, the increase in those aged 10 years and above entering care. The resulting pressures on services and resources together with research and practice evidence that highlight the risk of poor outcomes for care-experienced young adults, have reinvigorated the search for effective strategies to support families and prevent entry to care for adolescents. Alongside this, is the observation that many adolescents enter care for very short periods of time before returning home to families, raising the question - was entry to care the right option, the best option or the only option at a time of family crisis? The paper considers the growth of preventative strategies for adolescents on the edge of care, focusing particularly on the use of short stays in residential units as a means of preventing longer term care. It will explore the characteristics and needs of families and adolescents using the services; the approaches used to support young people, and outline learning points for further development.
Methods and results
The paper draws upon three recent studies carried out by the authors and colleagues:
• A completed mixed-methods study that focused on a model of short stay residential care within a wraparound family support service. This study reported on the characteristics of adolescents and families using the service and on experiences and early outcomes.
• A recently completed national evidences scope that explored the needs of adolescents on the edge of care and the use of short stays in residential units to prevent longer term care.
• An ongoing mixed-methods study exploring a range of preventative options for young people at risk of care or homelessness. Preliminary data suggests useful learning from the developmental and operational stages of setting up a short stays service.
Conclusions
The paper shows that locating the ‘edge of care’ is both complex and changeable, as is defining the characteristics of the edge of care group and the type of support they need. That said, the studies found that families and adolescents accessing ‘edge of care’ support such as short stays, were often vulnerable with longstanding and high thresholds of need. Those using short stays in residential units reported positive experiences and outcomes (at least in the short term), particularly when this was accompanied by a programme of adolescent and family support. There was also some indication from practice, that where entry to longer term care proved to be the best option for the adolescent, the prior use of a short stay service could ease the transition into longer term care and provide time for more detailed assessments of need. Findings highlight a need for further policy and research attention to the challenges facing edge of care services in targeting support at the right families at the right time and also on understanding the longer-term outcomes for families and adolescents using short stays options.