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In care experiences

Many children in care experience poor emotional wellbeing and some experience diagnosable mental health problems. These can be caused by pre-care experiences or by the impact of being in care. Without appropriate and timely support and treatment, poor mental wellbeing can have a significant impact on future life experiences. Many children will have experienced trauma before they come into care. This may be caused by the effects of abuse and neglect or other pre-care experiences, perhaps as an unaccompanied asylum seeking child, as a result of a disability or the death of a care-giver.

Children’s experiences of entering care may also have an impact on their emotional wellbeing. Coming into care means separation from parents, and often siblings and possibly a new school. Unfamiliar adults will enter a child’s life, and the child will live in a new house with new rules. Children may present with needs relating to their emotional wellbeing and mental health at any time.

Children in care should have their mental wellbeing assessed each year, using the Strengths and Difficulties Questionnaire, which is a tool that can help to identify child emotional and behavioural problems.

Not all children are ready to receive help when they first enter care, or indeed when they first identify with a problem. When they do present with a problem, it can take a long time for them to be seen by appropriate health professionals. Waiting times for Child and Adolescent Mental Health Services (CAMHS) are usually very long and when children do get support the types of treatment is often limited to short-term talking therapies. These do not suit all young people and may not provide enough space and time for them to come to terms with traumatic experiences. Young people often do not get any choice over what support they receive, which can make it difficult for them to engage with the service.. Some young people might prefer one to one sessions, while others may prefer group sessions, or art or play therapy.

Young people aged between 16 and 18 face additional problems. CAMHS provision varies across Clinical Commissioning Groups (CCGs). Some CAMHS services are only available to 16 year olds, some have an upper age limit of 18, while others offer support care leavers until they are 25.

 

After care experiences

Leaving care can present young people with new challenges to their emotional wellbeing. Many struggle with the loneliness of living alone. The stresses of running a household, reconnecting with family members or coming to terms with pre-care experiences can all take their toll.

Young people from care are also less likely to have the sort of support networks that mean that they do not end up reaching crisis point. While children who have grown up out of the care system are able to call their parents or close family to share emotional burdens or problems, care leavers are less likely to have someone they can call at any time of day. They may not recognise the signs of mental or emotional distress, or know about coping techniques for staying well.  Care leavers are at greater risk of living in poor accommodation and not being in education, employment or training – all things that can have an impact on a young person’s emotional and mental health.

Once a young person leaves care, they are entitled to less support from social services. Care leavers have to navigate the health system with little guidance, or even alone.

Young people who are already receiving treatment for their mental health needs will have to transfer from children’s to adult services. Catering to a much wider population, adult services often do not meet the needs of care-experienced young adults, either by not having specialist knowledge of care or providing services that are generally not young people friendly. Long waiting times coupled with services which provide only a limited number of sessions can mean that young people are put off from accessing or continuing with support.