Foster care and mental health

Blog post by Martin Barrow for the Centre for Mental Health.

In the conversation about the mental health of children and young people, one significant group of people is generally excluded. As foster carers, we share our lives with some of the most vulnerable youngsters, helping them come to terms with trauma or to manage mental health conditions that have proved difficult for their own families. Yet our voices are rarely heard, and our work is largely unrecognised. Nor is there concern for the impact it has on our own lives.

There are some 55,000 foster families in the UK, caring for almost 80,000 children and young people who are unable to live with their birth families, for a multiplicity of reasons. Many of these boys and girls suffered neglect or abuse for some years before the authorities intervened, and have lived at the fringes of the care system. Many will remain in care until adulthood, and will likely spend time with two, three or even four families along the way.

Not every child in care will suffer from mental health issues. But many will, and the mere act of being forced apart from mum and dad to live with strangers, even if it is only for a matter of weeks, raises profound questions. Many children blame themselves for what has happened, and struggle to live with the burden.

Read the full blog post here

Substance use, subjective well-being and interpersonal relationships among young people in foster care and private households

Long S.J. et al. (2017) BMJ Open. 7:e014198

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Objective: To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11–16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships.

Conclusions: Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions and interventions to reduce substance use and improve well-being in FC should include a focus on supporting healthy social relationships.

Read the full article here

Children’s mental health pilot aims to bridge care ‘disconnect’

Gamme, J. HSJ | Published online: 5 September 2016

  • Pilot project for CAMHS aims to bridge disconnect between community and inpatient care
  • West London project one of two granted devolved commissioning powers to create new care models in the sector
  • Project leaders hope to integrate tier three and four CAMHS services to reduce number of admissions and length of stay in inpatient units

SERVICE DESIGN: A pilot project is aiming to bring greater integration to children’s mental health services and break the “disconnect” between community and inpatient care.

The West London CAMHS pilot is one of two projects in the sector with devolved commissioning powers to create new care models for tertiary mental health services.

The scheme is a partnership between West London Mental Health Trust; Central and North West London Foundation Trust; Priory Group; and the region’s clinical commissioning groups.

West London Mental Health’s director of business and strategy, Chris Hilton, said the pilot project will bring together tier three (community and outpatient services) and tier four (inpatient services) CAMHS to provide more care in the community, reducing admissions and lengths of stay.

Plans for the pilot project include:

  • tier three and four staff creating joint care plans for every child and young person admitted to inpatient beds;
  • community teams to work with tier four staff to work out what care is needed to help discharge a patient as quickly as clinically possible; and
  • working with out of area inpatients and tier four teams to develop plans to bring them back to local services where clinically appropriate.

Read the full article here

Further information on the Priory CAMHs services can be found here

Extended Foster Care for Transition-Age Youth: An Opportunity for Pregnancy Prevention and Parenting Support

Putnam-Hornstein, E. et al. Journal of Adolescent Health. Available online: 4 February 2016

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Image source: Tatiana Vdb

Purpose: This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal legislation extending foster care beyond age 18 years.

Methods: Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N = 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ethnicity.

Results: One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years.

Conclusions: Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support.

Read the abstract here