By Leila Maza, research assistant for services for adolescents and families in Enfield
Research has revealed a high prevalence of mental health issues in looked after children. One study found that looked-after children are five times more likely to suffer from a mental health disorder compared to other children.
These disorders are theoretically treatable, but in practice they often go undetected and untreated. That’s why effective mental health screening tools for this group are vital.
Since 2008, the government has placed an onus on local authorities to monitor the emotional wellbeing of looked-after children via a tool called the strengths and difficulties questionnaire (SDQ). The SDQ has many benefits. It works well as a quick, easy tool for measuring the basic difficulties a child may be going through. Yet it is also limited by the fact it only gives a numerical assessment or score.
In Enfield, over the past six years we have developed and used a screening programme that builds on the SDQ’s strengths but also aims to offer a fuller, more meaningful assessment to social workers than SDQ scores alone can provide. In designing the programme, we were especially interested in developing an assessment that supported the younger, quieter children whose problems sometimes go unnoticed.
The result was our emotional behavioural and health assessment (EBH). The assessment brings together information from a variety of sources: the SDQ sent to the child’s foster carer, the SDQ sent to the child’s teacher, the SDQ sent to the young person (if over 11) and (finally) the gathering of background history from social services records and feedback from social workers.
By including the school perspective (SDQ to Teacher), the young person’s perspective (SDQ to Young Person) and the background history, we provide social workers with a fuller assessment than if we’d relied purely on a single SDQ score from the foster carer.
We designed the EBH assessment as a one page report which includes a brief overview of the child’s history, where they are currently, the SDQ results and recommendations for possible CAMHS referrals. We designed it like this so as to give a whole picture of the child in a meaningful and succinct way.
Social workers have said they find the EBH reports helpful. We are hoping that this EBH assessment report can be extended to other authorities as we believe it is a useful tool to be used alongside SDQs in monitoring the mental health of looked-after children.
Leila Maza is also psychologist assistant at the Tavistock & Portman NHS Trust