We've got to be bolder when it comes to children's mental health

Posted by Kate Maher / Thursday 15 September 2016 / Care leavers Children in care Mental health
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Yesterday, the Government responded to the Education Committee’s* inquiry into the mental health and wellbeing of children in care.

(see our response here)

Usually, the Government responds to inquiries like this within two months. For this report, they took almost double that amount of time.

The situation is urgent. As you will have read in our previous blog posts, children in care are almost five times more likely to struggle with mental health problems than children in the general population. Poor mental health puts them at further risk of instability and uncertainty, after everything they’ve already been through. 

Despite this, children in care can find it difficult to access the mental health care they need, especially if they are in an unstable placement and without a permanent address.

That’s why the Alliance for Children in Care and Care Leavers, which Action for Children co-chairs, is calling for the Children and Social Work Bill, currently passing through Parliament, to compel local authorities and the NHS to promote the mental and physical health and emotional wellbeing of children in care. We also want to introduce mental health assessments for children when they first enter care, and then as they prepare to leave it. 

In May, the Committee made a number of recommendations to improve children’s mental health and wellbeing. These included:

  • All children in care should have a full mental health assessment by a qualified mental health professional
  • Statutory guidance should make it clear that a Strengths and Difficulties Questionnaire (a tool used by local authorities to assess emotional wellbeing and pick up any mental health needs) must be completed for every child entering care
  • Child and Adolescent Mental Health Services should be made available for all care leavers up to the age of 25, to avoid the transition to adult mental health services where that would be unhelpful
  • There should be investment in outcomes monitoring to better understand the challenges that young people face whilst in and when leaving the care system. Specifically, there is an urgent need for comprehensive and up-to-date data on children’s mental health and wellbeing. 
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The Government did acknowledge many of the Committee’s points and have started promising work in this area (the Expert Working Group for Looked-after Children, referenced throughout the report, is a good example of this). But, overall, their response was disappointing.

Emotional wellbeing for children in care is not being prioritised. The Government’s response on the scarcity of up-to-date data on children’s mental health and wellbeing did not mention wellbeing once.

It is not a requirement to measure emotional wellbeing at the moment, at a local or national level. As we have explored in previous blogs, wellbeing measures would make it possible to identify when care is doing a really good job, and when it needs to improve. No such measures feed into any of our national datasets – which are used to shape policies with the aim of protecting and nurturing children. This means that children’s own voiced experiences of being in care and how they’re feeling are not being captured. 

Further, the Government did not see the need for specialist mental health assessments. We know, as the Government itself points out, that mental health and emotional wellbeing should be covered as part of a young person’s initial health assessment when they first come into care – yet we also know that this is often neglected in reality. 

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Although the Government asserted that the guidance for local authorities is already clear on the need for a Strengths and Difficulties Questionnaire (SDQ) to be completed for each child, it is obvious that this isn’t happening on the ground. In England, more than 1 in 4 children do not have this questionnaire filled out. Plus, the SDQ actually misses some factors crucial to the way a looked after child builds up emotional wellbeing. 

We are urging the Government to look again at how to improve the system. The Children and Social Work Bill is a timely opportunity to do this. The Bill could further help children in care by making the proposed mental health assessments a requirement, and by placing a duty on local authorities and the NHS to promote the physical and mental health and wellbeing of children in care. The designated professional for looked after children could take this forward in each local area – a role which, at present, is not being fulfilled as it should be. 

We have to be bolder when it comes to the mental health and wellbeing of children in care. 

(Check out our July blog on the Children and Social Work Bill and what the Alliance for Children in Care and Care Leavers is calling for here.) 

*There are Select Committees in both the House of Commons and the House of Lords. They are comprised of parliamentarians and they conduct inquiries and produce reports on various policy areas. They are a key way of holding Government to account for their decisions and policies: Government Ministers cannot be chosen for these Committees, and neither can members of the Shadow Cabinet.

There is a Commons Select Committee for each Government department. The Education Select Committee looks at the work of the Department for Education, with an emphasis on spending, policies and administration. Members (generally 11 MPs or more) decide upon useful subjects for inquiry and then gather oral and written evidence from stakeholders. Findings are reported and published, and the Government must then produce a response in answer to the Committee’s recommendations. 

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