Estimating the social care needs of looked after children and those at risk of being in care: Utilising anonymised linked data (Escalate)
Lead Research Organisation:
Swansea University
Department Name: Institute of Life Science Medical School
Abstract
Looked after children (LAC) have poorer social and health outcomes compared to those not in care. They underperform in educational assessments, are more likely to be unemployed, have higher rates of teenage pregnancies, illicit drug and alcohol abuse, self-harm and other mental health problems. The number of LAC continues to increase, as does the burden and costs placed on social and health care systems. Providing more targeted care whilst in the care system and designing appropriate care packages for leaving care have the potential to improve the long term social and health outcomes of LAC. The aim of this project is to increase knowledge and understanding of the needs of LAC and those at risk of being in care by exploring electronic anonymised data.
The key research questions are:
Does being looked after result in poorer health, educational and social care outcomes?
Can we determine when LAC may be most at risk?
We will use mixed methods (qualitative interviews and anonymised linked data) to provide a picture of the needs of LAC and when these needs occur. We will initially work with policy, social care and NHS partners to identify what are regarded as poor outcomes in LAC and the potential risk factors for being 'looked after'. We will then use the Welsh Electronic Cohort for Children (WECC) to examine social, health and educational outcomes of LAC and compare these to those matched controls who are not looked after and to try and identify periods of significant need. These outcomes will include: formal educational assessments; school absenteeism; Special Educational Needs status; frequency of school and residential moves; health outcomes (inpatient admissions, avoidable hospital admissions, length of inpatient stays); drug and substance misuse; mental health problems (self-harm, suicide, attempted suicide, anxiety, depression); teenage pregnancy rates; and contraceptive use.
It is envisaged that by identifying periods of risk and risk factors may make it possible to better target care, inform the design of appropriate care packages and identify key social priority areas.
The key research questions are:
Does being looked after result in poorer health, educational and social care outcomes?
Can we determine when LAC may be most at risk?
We will use mixed methods (qualitative interviews and anonymised linked data) to provide a picture of the needs of LAC and when these needs occur. We will initially work with policy, social care and NHS partners to identify what are regarded as poor outcomes in LAC and the potential risk factors for being 'looked after'. We will then use the Welsh Electronic Cohort for Children (WECC) to examine social, health and educational outcomes of LAC and compare these to those matched controls who are not looked after and to try and identify periods of significant need. These outcomes will include: formal educational assessments; school absenteeism; Special Educational Needs status; frequency of school and residential moves; health outcomes (inpatient admissions, avoidable hospital admissions, length of inpatient stays); drug and substance misuse; mental health problems (self-harm, suicide, attempted suicide, anxiety, depression); teenage pregnancy rates; and contraceptive use.
It is envisaged that by identifying periods of risk and risk factors may make it possible to better target care, inform the design of appropriate care packages and identify key social priority areas.
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| ES/P00069X/1 | 01/10/2017 | 30/09/2027 | |||
| 2097815 | Studentship | ES/P00069X/1 | 01/10/2018 | 31/12/2021 | Nicola Heady |
| Description | Looked after children (preferred name 'care experienced children') remain to date, one of our most vulnerable populations in society and positioned at the forefront of government policy and legislation. Yet, research continues to depict a bleak future for these children predicting inauspicious health and social outcomes even though they are embedded in a multi-disciplinary group of professionals and services. Poor outcomes associated with mental health, mental disorders, disability, suicide, criminal system involvement, teenage parenthood, substance misuse and educational attainment have become the predicted 'norm' for these children. A significant amount of literature has highlighted a high prevalence of mental, behavioural, and developmental in this population, depicted under broad, umbrella categories which are frequently associated with poor health and social outcomes. Limited in literature and a significant gap in research knowledge are studies that have explored neurodevelopmental disorders (NDDs) in Lac and how they may impact on the health and social wellbeing of this population. A systematic review and meta-analysis were conducted which explored the prevalence of NDDs in Lac and compared rates to their non-lac peers. Eleven studies met eligibility. Findings from five studies that compared LAC to non-LAC found that Attention-deficit hyperactivity disorder (ADHD) had a prevalence of RR = 2.54 [1.29, 5.00] and autism spectrum disorder (ASD) RR = 4.18 [1.14, 15.32]. Where data was limited and did not enable a moderation analysis to be conducted, risk factors associated with the Lac with a NDD emerged from the findings. Findings suggest that Lac have a higher prevalence rate of ADHD and ASD compared to their non-Lac peers. Furthermore, those diagnosed with these NDDs including bipolar, experience differential risks compared to their peers in areas of higher mental health service usage, physical and emotional abuse, higher medication prescription, foster care involvement and criminal justice involvement. Subsequently, from the results of the review and additional relevant literature, a semi-structured questionnaire was fashioned to gain a unique, insight into the perspectives, perceptions and opinions of social workers on the subject of NDDs. Overarching themes and sub themes emerged from the findings in areas of perceptions of NDDs, perceptions of diagnosis, access to service provision, impact on care settings, impacts on health and social wellbeing and parental capacity, mental and social wellbeing. ADHD, ASD, dyslexia and dyspraxia were the more prominent conditions discussed. Finally, the results attained, combined with existing literature informed the data linkage study which explored health and administrative datasets held in the 'Secured Anonymised Information Linkage (SAIL) databank at Swansea University. Preliminary results are still being validated. |
| Exploitation Route | The findings contribute to further understanding and knowledge of Lac and build upon existing literature. They further raise important questions for policy and stakeholders involved in the care and support of this vulnerable population. Research is needed from a nationwide context, to further explore areas of prevalence, diagnostic screening, training, resources, access to relevant specialist health, educational and social support services and more urgently the potential health and social risks associated for the Lac with a NDD. |
| Sectors | Communities and Social Services/Policy,Digital/Communication/Information Technologies (including Software),Education,Healthcare,Government, Democracy and Justice |