Care pathways and outcomes: The teenage years

Across the UK, when children enter care, they live in a range of different placements, such as foster care, kinship care (with relatives or friends), adoption or with their birth parents. However, adoptive placements are much less likely than foster or kinship placements to break down in the mid to late teenage years (Rock et al., 2013).

The proposed study is a fourth wave of a longitudinal study that has been following a population of children who entered care at a young age. This group represents all 374 children who were under five years old and in care in Northern Ireland on the 31st March 2000. The study has been tracking where these children end up living, and how they are getting on. At this stage, they are in their mid to late teenage years, when the risk of placement breakdown increases. The proposed study aims to compare how these young people are progressing in their different placement types. It also seeks to explore the levels of stability and placement breakdown that has occurred, and to identify the reasons for this. These factors will then be discussed in reports and workshops for social care and legal practitioners in Northern Ireland and Great Britain, where the systems are very similar, so as to directly impact upon policy and practice.

In order to fulfil these objectives, firstly all the children's placements will be identified on the 31st March 2015, when the young people will be between 15 and 19 years old. This will be the fifth time (2000, 2002, 2004, 2007, 2015) that the placement profile for the full population will have been specified. No other study in the world has been able to track a population of young children in care in this way.

Secondly, an attempt will be made to recruit the total population of young people for data collection via two home visits. However, on the basis of previous research in this area, we anticipate that approximately 213 young people and their parents/carers will take part in direct interviews. In the first visit, the young person will complete an electronic questionnaire on a computer tablet, whilst at the same time their parents/carers will complete a manual questionnaire. This will involve the collection of purely quantitative data. In the second visit, the young person will engage in a verbal interview with researchers, facilitated by materials presented on the computer tablet, and at the same time the parents/carers will take part in a semi-structured interview. These interviews will allow for a detailed comparisons to be made between groups of young people in different types of placements (i.e. foster care, kinship care, adoption, living at home), and also between those young people who have remained within long-term stable placements and those who have experienced instability and placement breakdown.

This is a unique study and is very well placed to further our understanding of the benefits, costs, and wider impact of a range of placements provided to children who enter care at a young age, especially during the often challenging mid to late teenage years.

There will be a number of beneficiaries of this research.
Academics: The findings that emerge from this study will make a significant contribution to our understanding of the pathways that young children follow through the care system, and what factors are important for understanding short, medium and longer-term outcomes. This knowledge will benefit the academic community working in this area nationally and internationally, particularly as they uniquely derive from a longitudinal population study of young children in care. The methods developed for interviewing mid to late teenagers, an should be generalisable to other jurisdictions.
Practitioners and policy makers: These findings will be highly beneficial to practitioners working with these young people on the ground, and to policy makers attempting to establish systems that enhance the health and wellbeing of these young people in their teenage years. A key challenge is that the normal tensions that can emerge during the teenage years, can become magnified to the extent that placements break down, which can be catastrophic for everyone involved. This study will provide a unique insight into the lives of a population of young people across the different placement types, and will identify the factors that appear to be related to placement stability in the face of the pressures of the teenage years. This will assist practitioners and policy makers to intervene and prevent placement breakdowns on the basis of the presence or absence of particular risk and protective factors, and also to develop training programmes for carers/parents that are centred on what appears to work best for foster and adoptive families in the teenage years.
Young people in care and adopted from care: The lessons learned from the findings of this study, and when applied to practice, will benefit young people in care and adopted from care by reducing the likelihood that their placements will break down, which can have a devastating impact upon their long-term health and quality of life.
Carers, birth and adoptive parents: The findings of the study will be summarised in the form of a report for parents/carers. This will focus on what appears to work best for teenagers in care to ensure that their placements do not break down as a result of the normal tensions of the teenage years, and that they can remain health and have a good quality of life.
General public: Given the similar legislative frameworks that underlie policy and practice in this area in Northern Ireland and Great Britain, the findings of this study will be generalisable across the UK. When placements do break down in the teenage years, it can be very difficult to find alternative long-term family placements, and more commonly a residential care placement is identified. Recent statistics provided by the Department of Health (2011) in England and Wales indicated that residential care provision costs approximately £140,000 per annum per child. This suggests that if the findings that emerge from this study help prevent only six long-term placements from breaking down, it will have been value for money. However, it is anticipated that the identification of factors that can support or undermine long-term placements will benefit a much larger proportion of long-term placements in Northern Ireland, and across the UK. Placement breakdown also involves huge emotional costs for the whole family: the children, siblings, long-term carers, birth and adoptive parents; and the wider family network. These problems can manifest themselves in poor performance or absence from school; sick leave by parents/carers due to stress/anxiety; young people engaging in anti-social behaviour; and young people and parent/carer deterioration in health. These all have financial implications that place pressure on the health system. These costs can be avoided by ensuring that long-term placements remain stable throughout the mid to late teenage years.