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Vulnerable children turned away from mental health treatment report finds

28 April 2016

The Education Committee's report on the mental health and well-being of looked-after children notes that a significant number of local authorities and health services are failing to identify mental health issues when children enter care.

Almost half of children in care have a diagnosable mental health disorder, with looked-after children four times more likely than their non-looked after peers to have a mental health condition.

Young people turned away by mental health services

Looked-after children face significant challenges in getting access to mental health support. The report finds child and adolescent mental health services (CAMHS) are turning away vulnerable young people in care because they have not met high thresholds for treatment or because the children are without a stable placement.

This is contrary to statutory guidance which states that looked-after children should never be refused a service on the grounds of their placement. To help tackle this inflexibility, the report recommends looked-after children be given priority access to mental health assessments by specialist practitioners, with subsequent treatment based on clinical need.

Chair's comment

Neil Carmichael, Chair of the Education Committee, said:

"Local authorities have a special responsibility for the welfare of looked-after children. In spite of this duty, it's clear that many looked-after children in England are not getting the mental health support they need. At present, CAMHS are not assessing or treating children in care because these children do not have a stable placement.

Given children in care may have unstable family lives and are frequently moving foster or residential placement, this inflexibility puts vulnerable children in care at a serious disadvantage in getting the support they deserve. This must change. We recommend children in care be given priority access to mental health assessments and never refused care based on their placement or severity of their condition"

Relocation an obstacle to effective provision of services

Highlighting the issues faced by children in care, the Education Committee heard from a sixteen-year old woman in foster care who said she had been waiting for CAMHS for over two and a half years but had been unable to access services because she had moved thirteen times during that time period. The Committee heard that CAMHS are often unwilling to begin treatment if a child moves placement, even when this is within the same local authority.

Extending access to CAMHS after leaving the care system

Leaving the care system can be a time of significant upheaval and disruption, and this period is likely to be even more unsettling for care leavers with mental health concerns. Young people leaving care in the UK are five times more likely to attempt suicide than their peers. They are also more likely to enter the criminal justice system. The Committee finds current support for young people leaving care is inadequate and based too heavily on inflexible age restrictions.

The Committee recommends care leavers should be able to access CAMHS up until the age of 25 (rather than 18 at present) and recommends that initial assessments of those entering care should be more thoroughly and consistently carried out.

'Whole school approach' and initial teacher training

The report recognises the important role which schools and teachers have in supporting looked-after children but is clear that schools and teachers should not be not be administering specialist advice or acting as the sole source of support for their students. However, the Committee does recommend schools take a 'whole-school approach' to better support the mental health of their students.

The report also recommends improvements in training for teachers, and for foster and residential carers. The Committee recommends that through initial teacher training (ITT) all teachers should be trained in mental health and well-being.

Chair's comment

Neil Carmichael, Chair of the Education Committee, said:

"As part of this inquiry, we heard the direct experiences of care leavers and children in care as they talked about the challenges they face in the care system and what makes for good mental health care [see annex 1 of report]. It's crucial that the voice of young people is at the heart of the care planning and services looked-after children receive.

Social services need to do more to empower children in care to have an active role in decisions about their placements to increase the likelihood that they will be stable and successful. Coordination between local health, education and social services is another vital element of effective support for looked-after children with mental health difficulties. This integration needs strong leadership and we recommend that each local area employs a senior mental health professional to drive this forward."

Committee recommendations

Tackling lack of reliable data

The report urges the Government to address the lack of reliable data about the state of children's and young people's mental health. The report expresses disappointment that it has been 12 years since the last prevalence survey on children's mental health was conducted.

Funding ONS and effective outcomes monitoring

The Committee calls on the Government to return to funding ONS prevalence surveys on children and young people's mental health on a five-yearly basis. The report also recommends investment in outcomes monitoring to better understand the challenges that young people face whilst in and when leaving the care system.

Further information

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