Better ‘ordinary care’ will improve mental health of looked-after children, finds NSPCC

Focusing on relationships and taking a mixed approach to care are crucial to improving the mental health treatment of looked-after children, a report from the NSPCC has found.

Tackling the question, ‘What works in preventing and treating poor mental health in looked after children?’, the literature review, carried out by the Rees Centre at Oxford University, has called for more examination of what methods promote positive outcomes for children.

It clarifies that children and young people in care are found to have much higher rates of mental health difficulties than the general population and states there is an “overemphasis on challenging behaviour” and not what promotes positive outcomes.

The report reviewed literature about ‘ordinary care’, looking at the tools to assess mental health and analysis programmes that were listed as targeting behavioural, emotional or hyperkinetic outcomes for looked-after children and young people.

Commissioned by the NSPCC, the report found mental health care for looked-after children lacking. It stated: “We lack proven models for selecting, training, supervising and quality-assuring carers and staff in such a way that the quality of care is enhanced.”

One of the authors, Nikki Luke, said she hopes social workers and practitioners will take from this, “a strong focus on ‘ordinary care’, and encourage the strength and quality of care environments, because evaluations of interventions often miss out the importance of context and children’s individual experiences”.

“It is important to think how quality of care environment and decisions made can influence well-being before using targeted (and often costly) interventions,” she added.

The report also found the quality of placements needs to be improved, “because this is the key to how the children do in care”.

Luke said she hope the report will help people to see that who children live with is key to their experience in care, saying, “everything possible should therefore be done towards enabling the right staff to be selected and then trained, supported and supervised to create an environment that will best support the child’s well being.”

The report also identifies the importance of making early decisions over whether a child should go in to care. “This needs to be set in the context of early intervention, so parents are given the best chance they can to bring up their children well, but also to ensure that children at risk are identified early,” Luke said.

She also hopes the report will help practitioners and services to select and evaluate the impact of interventions and ‘ordinary care’ services on children’s mental health.