MH-CAT: A longitudinal survey of the mental health of children in State Care in England through the COVID-19 pandemic
Lead Research Organisation:
University of Bristol
Department Name: Sch for Policy Studies
Abstract
The impact of the current Covid-19 pandemic on the vulnerable group of children growing up in State Care is unknown. This research, which maps on to the UKRI Covid-19 priority of establishing 'social and psychological impact upon vulnerable groups', aims to establish new information on the impact of the Covid-19 pandemic on mental health of children in State Care through a prospective, longitudinal survey. At any given time in England, there are nearly 80,000 children being looked after by the State. Children in Care constitute a most vulnerable group of children in society, with more than 60% of these children having histories of severe maltreatment such as abuse or neglect. Fifty percent of children in Care have a diagnosable mental health concern, when compared with 12% of children in the general population, with research further indicating poor adult mental health outcomes. Despite this, there is a dearth of knowledge on the longitudinal patterns of mental health and the impact of a pandemic situation on children in Care. This research aims to fill this gap in knowledge with information collected directly from children in Care aged 11-18 years, over an 18-month period, through the Covid-19 pandemic. The results, covering a wide range of practice and policy relevant questions about children's mental health and the influence of their placement, schooling, social work support, strength of support networks and their contact with birth families, will be useful to local-level managers, practitioners and national-level policy makers in making key decisions about children in Care.
Organisations
Publications
| Description | Confirming findings from previous research, the results of the two surveys indicated that children and young people in care are significantly more likely to experience mental ill health when compared with those in the general population. Scores on the Strengths and Difficulties Questionnaire showed that of the 11-18-year-old children and young people in care who responded to the survey, 22% in Wave 1 and 24% in Wave 2 were at high risk of experiencing mental ill health. The results of analyses also showed that, controlling for other factors, various individual characteristics and contextual factors were significantly associated with the mental health of children and young people in care. These findings have implications for policy and practice. Promoting placements with siblings and kin: As seen in previous research, the results of the surveys indicate that being placed with siblings and kin generally acts as a protective factor for the mental health of children and young people in care. This supports the current statutory guidance to place children and young people who need a placement in State care with relatives (or friends/other connected persons) and siblings where possible (Section 22, Children Act 1989). Importance of positive relationships: The results also showed that children and young people in care who had positive relationships with their carer(s), friend(s) and social worker(s) were more likely to have better mental health, irrespective of the length of time they had spent in care or the number of previous placements they had had. This highlights the importance of ensuring the continuity, stability, and quality of relationships with key people throughout children and young people's time in care. These results have direct implications for addressing the high prevalence of placement instability and the ongoing high turnover rate of social work staff. It also emphasises the importance of facilitating better matching of foster carers with the children and young people; ensuring that children and young people are supported to settle into new placements and schools; and ensuring the continuity of important relationships when changes in placements or schools are necessary. Optimum contact with social workers: This research also highlights the importance of maintaining optimum contact levels with social workers, which requires stability of the social worker workforce and has direct implications for addressing the current and ongoing high turnover rate of social work staff. It also shows the importance of periodically consulting children and young people on their wishes and feelings about social work contact. Positive school environments: The results from the survey analyses have some implications for school-related practices. Children who have positive feelings about their school were more likely to have better mental health; while, as has been seen in the general population and other research studies, those excluded and those who had been bullied at school were negatively impacted. This has implications for how school exclusions of children in State care are managed and how children and young people who have been bullied are supported. Furthermore, younger adolescents in secondary education were more likely to have mental health difficulties, which might have implications for how children in care are supported (more) during their primary to secondary school transitions. Healthy behaviours: The research findings also highlight the benefits of promoting healthy behaviours for better mental health, such as reducing screen time; not engaging in risky behaviours (smoking, drinking, taking drugs); and having opportunities to develop hobbies. Other risk factors: Complex structural issues around risk factors affect children and young people in care as well as their peers in the general population. This research found that, when all other factors are held constant, girls and children and young people who identified their ethnicity as white were more likely to be at higher risk of mental ill health. This mirrors trends in the general population, where for example, it has been shown girls were more than twice as likely as boys of the same age to experience mental ill health and that children and young people who were white were most likely to experience mental ill health compared to those from all other ethnic groups. Impact of multiple risk factors: Children and young people who are impacted by multiple risk factors identified by this research would be more likely to be at risk of mental ill health than those who are impacted by fewer or no risk factors. This has implications on how these risks are monitored and managed by carers, schools/virtual schools and children's social care teams when assessing and supporting the mental health of children and young people in care. |
| Exploitation Route | This research provided the first insight into the impact of the Covid-19 pandemic on the mental health of children growing up in State care in England, through two surveys carried out during the pandemic, with responses from 1,356 children from 18 Local Authorities in England. As well as a national report, the team produced individualised, local authority-level reports that were shared with the local authorities. Some local authorities have created 'Action Plans' based on the research output ; and some are using the findings to influence decisions being made by the Corporate Parenting Boards on mental health service provision for children and young people in care. The PI continues to train social workers and senior managers in local authorities on how mental health service provision can be improved. The PI was also invited to present the results from the surveys to the team conducting the Independent Review of Children's Social Care in England and the Department for Education Policy and Analyses Teams. The research output was used as evidence in the final report of the National Independent Review of Children's Social Care in England (2022). The research output is therefore useful for national-level policy making as well as local-level and individual social work decision making in terms of signposting children who might be most at risk and in need of additional support and for promoting of protective factors. |
| Sectors | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
| URL | https://mhcat.blogs.bristol.ac.uk/ |
| Description | This research provided the first insight into the impact of the Covid-19 pandemic on the mental health of children growing up in State care in England, through two surveys carried out during the pandemic, with responses from 1,356 children from 18 Local Authorities in England. As well as a national report, the team produced individualised, local authority-level reports that were shared with the local authorities. Some local authorities have created 'Action Plans' based on the research output ; and some are using the findings to influence decisions being made by the Corporate Parenting Boards on mental health service provision for children and young people in care. The PI continues to train social workers and senior managers in local authorities on how mental health service provision can be improved. The PI was also invited to present the results from the surveys to the team conducting the Independent Review of Children's Social Care in England and the Department for Education Policy and Analyses Teams. The research output was used as evidence in the final report of the National Independent Review of Children's Social Care in England (2022). The research output is therefore useful for national-level policy making as well as local-level and individual social work decision making in terms of signposting children who might be most at risk and in need of additional support and for promoting of protective factors. |
| First Year Of Impact | 2021 |
| Sector | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
| Impact Types | Societal,Policy & public services |
| Description | National Independent Review of Children's Social Care |
| Geographic Reach | National |
| Policy Influence Type | Citation in other policy documents |
| URL | https://www.gov.uk/government/groups/independent-review-of-childrens-social-care |
| Description | National Independent Review of Children's Social Care |
| Geographic Reach | National |
| Policy Influence Type | Contribution to a national consultation/review |
| URL | https://www.gov.uk/government/groups/independent-review-of-childrens-social-care |
| Description | Dissemination of findings to a Corporate Parenting Board (ID9) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses).Dinithi Wijedasa (PI) presented the findings of the survey at a meeting of the Corporate Parenting Board of the local authority. Post presentation, there was a discussion about how the results of the survey support the activities in the local authority and how they will continue to support: Placement stability meetings (involving all parties, including VSH, carers. Specific team (Compass team) is there to support relationships. In discussing the importance of sibling relationships, 'Together and apart' assessment to promote contact when when sib placements not possible. School relationships monitored through virtual school heads and PEP (personal educational plans). In terms of health and wellbeing provision, children and young people have access to Kooth; there is a specialist LAC CAMHS worker; there are also plans around what to do with borderline/abnormal scores- currently team managers are involved. Re social worker relationship with children and young people, it is part of the LA pledge to improve this, for example, through 'goodbyes and intros' to new social workers. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Dissemination of findings to the Department for Education Policy and Research Teams |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Invited by the Department to present the findings from the two surveys of mental health of children in State care to policy and research teams. Event: Department for Education and University of Bristol seminar: Mental health, vulnerabilities and wellbeing in schools. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Invited presentation to the team conducting the National Review of Children's Social Care |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Invited to present the emerging findings from the survey to the review team. Was asked to share the briefing paper/final report with the review team, which was later cited in the final review report. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Meeting with the Assistant Director of Children's Social Care to discuss how the survey can be used within the local authority to promote mental health of children in State care (ID10) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | Discussion whether the survey results can be introduced as part of the the reviews of children in State care. This local authority has indicated that they are would like to opt-in to an evaluation to check feasibility of this. Also want to do a workshop with children in care. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Presentation of findings to local authority managers (ID3) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses). The PI also offered training events to all local authorities. This meeting was attended by Local Authority Social Care Team Managers. The managers agreed to cascade the information down to their teams on the importance of monitoring children's mental health. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Presentation to the Corporate Parenting Board (ID11) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses).Dinithi Wijedasa (PI) presented the findings of the survey at a meeting of the Corporate Parenting Board of the local authority. The Corporate Parenting Board agreed to create a workstream linked to the findings of the survey. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Presentation to the Corporate Parenting Board (ID2) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Policymakers/politicians |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses).Dinithi Wijedasa (PI) presented the findings of the survey at a meeting of the Corporate Parenting Board of the local authority. The Corporate Parenting Board agreed to create a workstream linked to the findings of the survey. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Training of senior local authority managers (1D11) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses) that were shared with the local authorities The PI also offered training events to all local authorities. This meeting was attended by Senior Managers in the Children's Social Care Team. They pledged to incorporate the findings on the mental health of children in care towards their strategy to improve socio-emotional and mental health of children looked after by the State. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Training of senior local authority managers (1D4) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses) that were shared with the local authorities The PI also offered training events to all local authorities. This meeting was attended by Senior Managers in the Children's Social Care Team. They pledged to incorporate the findings on the mental health of children in care towards their strategy to improve socio-emotional and mental health of children looked after by the State.(Study ref ID4). |
| Year(s) Of Engagement Activity | 2021 |
| Description | Training of senior local authority managers (1D5) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses). The PI also offered training events to all local authorities. This meeting was attended by Senior Managers in the Children's Social Care Team. They pledged to incorporate the findings on the mental health of children in care towards their strategy to improve socio-emotional and mental health of children looked after by the State.(Study ref ID4). |
| Year(s) Of Engagement Activity | 2021 |
| Description | Training of senior local authority managers and social work staff (ID1) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | As well as a national report, on the mental health of children growing up in State care in England, the team produced individualised, local authority-level reports (where the numbers were sufficient for analyses). The PI also offered training events to all local authorities. This meeting was attended by the Assistant Director of children's services, IRO (Independent Reviewing Officers), Quality Assurance Team Manager, Assistant Team Managers, Specialist Nurses and social workers. It was discussed that the results of the survey align with their Pledge to improve the mental health of children in care. |
| Year(s) Of Engagement Activity | 2021 |