We asked for views on the topics to include in a new study about the prevalence of mental health conditions among children and young people who are looked-after by the local authority, previously looked-after children and care leavers.
Seventy four responses were received. The majority of these were from clinicians and local authorities. Charities and voluntary organisations, public sector organisations at local, regional and national levels and academic researchers also replied. Read the report summarising the replies.
We thank everyone who took the time to participate in this consultation. The feedback you sent will be used to inform the next steps for the study.
Children and young people who are looked-after by the local authority such as in foster care, residential care, unaccompanied asylum seekers and youth offenders, and those no longer in care are at much greater risk of experiencing poor mental health than those in the general population and often their mental health issues are severe and/or complex[1]. If their issues are not addressed effectively, this significantly reduces their life chances, and increases their need for long term support from health and social care services (often into adulthood and through their life time).
The last survey for Mental Health of Children Looked After (MHCLA) was carried out in 2002 (http://www.ons.gov.uk/ons/rel/psychiatric-morbidity/mental-health-of-young-people-looked-after-by-local-authorities/2002-survey/mental-health-of-young-people-looked-after-by-local-authorities-in-england.pdf ) so the findings, which inform policy and commissioning decisions for this group at local and national level, are now considerably out of date. It found that among young people, aged 5–17 years looked after by local authorities, 45% were assessed as having a mental disorder; 37% had clinically significant conduct disorders; 12% were assessed as having emotional disorders (anxiety and depression) and 7% were rated as hyperactive. A recent children and young people mental health survey on the general population in England (https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017) found that overall around one in eight (12.8%) 5 to 19 year olds had at least one mental disorder when assessed in 2017
The new survey will not only cover currently looked after children, but also those children that have recently ceased to be looked after. As well as providing an update on the prevalence of mental health conditions in this subset of children, the survey will be further developed to help improve understanding of the drivers of poor mental health in looked after children, and to inform how their wider mental health needs can be better met. It is hoped that the survey will provide information that will help inform the development of local services for looked after children and future training for professionals involved in their care (including social workers, foster carers and residential care staff).
[1] http://doc.ukdataservice.ac.uk/doc/5280/mrdoc/pdf/5280userguide.pdf
The new survey will use the same data collection methods, screening and diagnostic tools as used in the 2002 survey. Interviewing of multiple participants, whereby several people are interviewed or complete a questionnaire (parents, child/young person and teacher), rather than relying on one self-report account for information, allows for a more complete picture of the behaviour and mental health of the child or young person.
The data collection methods will include:
• face to face interviews with carers (or foster parents or parents) taking 95-130 minutes, including a carer self-completion component;
• face-to-face interview taking on average 45-55 minutes, including a self-completion component for children aged 11-16;
• face-to-face interview taking on average 50-60 minutes, including a self-completion component for children aged 17+;
• a postal and online self-completion questionnaire for teachers.
It is expected that the survey will include most of the topics covered in the 2002 survey to allow for the assessment of change over time. We are also looking to add some new topics and update the survey to allow for comparisons with the wider general population, as seen in the 2017 Mental Health of Children and Young People survey2].
For each of the questionnaires, the diagnostic tool for assessing child mental health – Development and Wellbeing Assessment (DAWBA) https://www.dawba.info/ and the Strengths and Difficulties Questionnaire (SDQ) https://sdqinfo.org/ comprise a large part of the questionnaire. It is important to note that the Strengths and Difficulties Questionnaire (SDQ) and the Development and Well-Being Assessments (DAWBA) constitute the core of the survey series and are essential for estimating the prevalence of mental disorders. This content is therefore not considered for review.
NHS Digital is undertaking this consultation to review the content of the survey and are consulting with users to ensure the survey continues to be relevant and to meet users’ needs.
Your views are important to us and will help determine what information on the mental health of children looked after is collected through this survey and how it is reported. Please note that this version of the questionnaire has been created so that respondents can see the questions beforehand and submit a combined response.
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