increasing awareness of the mental health needs of this vulnerable population.
The prevalence of mental health disorders in looked after children is much higher than the general population (42% compared with 8% among 5 to 10 year olds and 49% compared with 11% among 11 to 15year olds). In particular, looked after children in the UK have a higher prevalence of psychosocial adversity, psychiatric disorders and generally poorer outcomes, compared to the most socio-economically disadvantaged children living in private households (Ford et al, 2007). These differences are beginning to be understood in the context of a number of factors, both biological and environmental and have led to awareness of the 'cumulative risk' for a number of poor outcomes like mental health problems and educational failure. These negative outcomes persist into adulthood. Despite this, it is recognised that the mental health needs of looked after children are often overlooked, the provision of service patchy and the understanding and the expertise necessary to deal with the complex issue these children/young people face lacking, in the absence of dedicated specialist services. Clinical practice with this vulnerable group of children and young people is very diverse and access to mainstream CAMHS has been traditionally poor, which has led to the establishment of some dedicated specialist services, though these services, where present, operate with varied staffing, expertise and different models of care and team skill mix.
- promoting access and accessibility for both mainstream and specialist clinical services
- contributing to the ongoing discussion about targeting resources for the diverse needs of children and young people in the care system
- conducting a mapping exercise of service provision for looked-after children, examining variation in service delivery
- promoting the establishment of a good evidence base for treatment interventions
- facilitating further thinking about specific outcome measures in looked-after children
- linking in with other professional networks focusing on this client base
The format of regular forum meetings offer a presentation of different service models and an academic (research, audit, etc) talk, followed by discussion. Topics have been of comprehensive relevance, and have included:
- non-violent resistant parenting group for foster carers
- NICE-SCIE guidelines on the physical and emotional health and wellbeing of looked-after children and young people
- training program for carers on attachment
- screening and intervention for looked after children 0-5 years
- managing behaviour with attachment in mind
- nature and nurture: genetic and social determinants of mental health
- working creatively with leaving care and after care young people within CAMHS
- transition between CAMHS and AMHS for looked after children
- putting theory into practice: helping fostered children
All meetings have been very well attended, generating lively discussions and facilitating excellent opportunities for networking, liaison and sharing. The number of different professional groups across the UK engaged with LAC services is impressive and this is reflected in the SIG’s growing membership which comprises around 180 members. The group has actively sought to make contact with chairs of other special interest groups in the filed of LAC, and has successfully joined forces with the long-standing Special Interest Group based at the Tavistock Centre in organising the last meeting. Promising exchanges with the British Psychological Society Special Interest Group (CPLAAC) have also offered further avenues for exploration.
A substantial number of SIG members are based outside London and, in order to engage their valuable involvement, a web-based discussion forum will be created, which will offer an exciting opportunity to host a virtual meeting point for professionals working with LAC, share resources, link up with colleagues more easily, and disseminate up-to-date information on the latest updates and developments. In addition to this, a conference to showcase the interesting work that is being undertaken in this field is also in the pipeline and members will be invited to suggest potential topics and ideas.