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Many looked-after children have mental health problems that make life highly challenging for foster carers. In Lincolnshire a service has been set up to ensure that carers never feel isolated. Graham Hopkins reports.

As many as one in five children suffer from mental health problems. Links between this emerging and credible statistic with juvenile crime, alcohol and drug misuse, self-harm and eating disorders are not to difficult to make. Thus in recent years we have seen the rise of child and adolescent mental health services (CAMHS).

The 1999 Audit Commission briefing paper Children in Mind published a survey of children with mental health problems of whom 9 per cent were looked after by local authorities - compared with 0.5 per cent in the general population.

"It was expected that we would contribute to the mental health of looked-after children and we targeted those in children's homes," says Katie Prince, CAMHS development manager for Lincolnshire. "But they are only a very small proportion of looked-after children. The majority are in foster care - hence the progression to setting up a similar scheme for foster carers."

In April 2000, Lincolnshire appointed John Neary and Zoe Powley - both with nursing backgrounds and new to social services - as specialist community mental health workers. "We had an invaluable two-month induction, involving placements with CAMHS colleagues and other key players, planning the launch of the scheme," says Neary. "We had a pilot involving 40 carers - identified by family placement officers."

Interestingly, their brief was to work directly with the county's 290 foster carers. "This linked in with the need to provide stability in placements, preventing disruption and also about doing something positive for foster carers," says Leila Barron, fostering and adoption development manager. "That's why the focus was on them as the adults and not on the children."

The team realised that there would be a problem using words such as "mental health" or "mental illness". Barron adds: "So, we say it's 'behavioural problems' that you have to deal with as foster carers and here are two friendly people that you can have a chat to."

And chat is what they do. The sheer size of the county means that visits are made sparingly and reliance is placed on the telephone. A weekly designated time (Thursdays between 9.30am and 12.30pm) is set aside for open calls for advice, guidance and information.

"It is immensely beneficial," says Sue Heathershaw, who's been a foster carer in Lincolnshire for four-and-a-half years. "It's great that you can get reassurance that you've managed a situation well - and can talk through things. And sometimes while I'm talking, I begin to think aloud and start seeing solutions myself.

"For four years we've been managing these behaviours," she says, "and we didn't know what they were. We never had any knowledge of mental health issues before - never really thought about it. John came along and talked through things with me - it just started to make sense," she says.

"Sometimes, just being able to tell a foster carer that they've done something right is all they need," agrees Powley. "We give them a chance to think out loud and explore ideas together - two heads are better than one."

And foster carers are not alone in benefiting from the scheme. "It's also a service for us," adds Annie Pepper, family placement officer. "Often I would talk to John about children and situations to decide if it's worth intervening."

There seems little time for resting on any laurels. Powley and Neary plan to increase their training role and produce more information for carers. But, most interesting of all, given that a high number of carers have access to the internet, is the plan to offer advice through webcams. Or should that be web-camhs? Here's looking at you.

Background

Scheme: Support scheme to help foster carers understand the mental health needs of children.

Location: Lincolnshire.

Staffing: Two specialist community mental health workers.

Clients: Foster carers.

Inspiration: A development from a similar scheme for young people in children's homes.

cost: £56,000 plus about £500 printing costs for leaflets.

Resources

- For more information call John Neary on 01529 488053

- A leaflet and card advertising the scheme and a social services staff information sheet are available free of charge