Almost half of children in care in NI have behavioural difficulties, study

According to a new report by researchers at Queen’s, and based on a sample of 233 Looked After Children and Young People (LACYP) in Northern Ireland, almost half of children in care in Northern Ireland have behavioural difficulties.

The report, carried out by researchers from the School of Sociology, Social Policy and Social Work at Queen’s, has been funded by the Office of the First Minister and the Deputy First Minister.  The three-year study looked at the mental and physical health of LACYP in Northern Ireland and how the care system meets their needs.

Entitled ‘Mind your Health – the physical and mental health of looked after children and young people in Northern Ireland’, the report highlights the health challenges faced by these children and young people, how these are currently being addressed and what improvements might be made.

It is estimated that there are around 2,800 LACYP in Northern Ireland.

This is the first report of its kind to systematically assess the types of health problems that LACYP in Northern Ireland experience, and the range of initiatives being undertaken to improve health outcomes.

The research team reviewed policy and practice documents and also carried out interviews with health professionals, including senior social workers, as well as carers and young people themselves.

Key findings include:

• 40 per cent of LACYP had been diagnosed with behavioural problems; 35 per cent with emotional problems and 21 per cent with depression or anxiety;
• One third were suffering from a longstanding illness or disability;
• Young people living in residential care had a much more negative health profile than those living in foster or kinship care;
• Despite the levels of behavioural and emotional problems, most carers considered the children and young people to be ‘healthy’; indicating that notions of health tend to be physically orientated;
• Some LACYP had difficulties in accessing the services they needed, due to a range of issues including long waiting lists; lack of availability in local areas; difficulties in accessing the appropriate service and a lack of available information;
• Gaps in service provision were identified, with some having to do with lack of resources and capacity issues;
• Some positive factors were identified as currently helping to meet the children’s health needs including: priority status for LACYP in their referral to particular services; professional co-operation; placement stability and well supported foster placements; and support services from statutory and voluntary organisations.

The report makes a number of recommendations, including the development of bespoke statutory guidance for Northern Ireland. Similar guidance is currently available in England.  This would clarify the roles and responsibilities of Health and Social Care (HSC) Trusts and voluntary organisations in relation to health promotion and assist a range of professionals involved to efficiently and effectively meet the health needs of this vulnerable group.

Other recommendations include:

• Greater support for foster families to avoid breakdown in placements, especially when children have complex needs; and
• Greater emphasis to be placed on prevention, targeting vulnerable parents on the edge of care, and early intervention, including early screening of children entering care to pick up emotional vulnerabilities, or providing support to carers during the teenage years when relationships begin to come under strain.

Lead researcher and psychologist, Dr Dominic McSherry, said: “This research is first and foremost about understanding the health needs of LACYP in Northern Ireland, and highlighting ways that these can be addressed to ensure their future health and wellbeing.

“These children and young people receive limited attention in health services research, even though their poor health potentially impacts on a whole range of outcomes, including educational and economic achievement, quality of life, and future parenting. Furthermore, health problems can place significant strain on placements and lead to placement breakdowns, which itself can be emotionally costly for the young people and the families involved.

“The research we carry out at Queen’s is not just academic – it’s for the benefit of the individual and the wider community. As a University we want to make sure that our findings are used in order to make a difference to the quality of life for Looked After Children and Young People in Northern Ireland by informing legislation, policy and practice. To their credit, the NI government and Health and Social Care Board have begun to invest significantly in prevention and early intervention programmes, and in the provision of therapeutic services for LACYP, but this commitment needs to be continued and built upon”.

Co-researcher and sociologist, Dr Montserrat Fargas Malet said: “Improving the health outcomes for this vulnerable group has the potential to considerably reduce social services and government expenditure, as children in care are 10 times more likely to be excluded from school; four times more likely to be unemployed; 50 times more likely to be sent to prison and 60 times more likely to become homeless.”

Professor Panos Vostanis, Professor of Child and Adolescent Psychiatry, University of Leicester, and who was a member of the study advisory group, said: “This excellent research is the most comprehensive piece of evidence to date on the links between policy, services and practice in meeting the complex needs of looked after children.  Taking into consideration the recommendations, this report will help improve the physical and mental health care of this vulnerable young population in the health and welfare system of many countries.”

The report, ‘Mind your health – The Physical and Mental Health of Looked After ‘Children and Young People in Northern Ireland’ is available here: http://www.ofmdfmni.gov.uk/index/equality-and-strategy/equalityresearch/research-publications/esn-pubs/equality-publications-2015.html