Children in care denied mental health services because of placement ‘uncertainty’

    Education committee finds 'significant number' of councils failed to identify mental health issues for children entering care

    Children in care are being denied access to mental health services because their placement is seen as unstable, MPs have warned.

    The education committee’s inquiry into the mental health of looked-after children found “a significant number” of councils were failing to identify mental health issues for children entering care and turning away young people for not meeting thresholds.

    It was told “uncertainty” about placement stability meant Child and Adolescent Mental Health Services (CAMHS) were “unwilling to begin therapeutic treatment until they can ensure that a child will be based in the same location for a significant period of time”.

    Inflexibility

    Neil Carmichael, the committee’s chair, said the “inflexibility” put vulnerable children at a serious disadvantage in getting support.

    A young woman told the inquiry she had waited for more than two-and-a-half years for CAMHS support but had been unable to access services because her placement had moved 13 times.

    According to statutory guidance on promoting the health and wellbeing of looked-after children support should not be denied because of a child’s placement.

    “Looked-after children should never be refused a service, including for mental health, on the grounds of their placement being short-term or unplanned,” the guidance said.

    The committee said CAMHS should not refuse to see children and young people without a stable placement, or delay access to their services.

    It also said that, upon entering care, all children should have a Strengths and Difficulties Questionnaire completed and the government should amend statutory guidance to ensure this requirement is made clear.

    “In addition, all looked-after children should have a full mental health assessment by a qualified mental health professional. Where required this should be followed by regular assessment of mental health and well-being as part of existing looked-after children reviews,” the report said.

    Voice of child

    The committee recommended children in care have access to CAMHS up to the age of 25, and that support for foster and residential carers should include training on mental health and emotional well-being.

    Looked-after children should also play a meaningful part in the decisions made about their mental health care, the report said.

    Javed Khan, chief executive of Barnardo’s, said some of the £1.4 billion being invested in CAMHS throughout this parliament should be earmarked for children in care.

    “Every child should get the support they need for coping with a mental health issue, but services are stretched to the limit,” Khan said.ted during this Parliament should be earmarked to support children in care and care leavers with mental health needs.”

    Anne Longfield, the children’s commissioner for England, said:  “It is right that the committee has put a spotlight on the mental health needs of children in care who are likely to have not only experienced real difficulties and sometimes trauma in their lives but also unlike most of us, don’t have their family to fall back on for support.

    “Many children who are in care tell me that they need better access to help with their mental health and offering each one a mental health assessment when they come into care would help in identifying the support they need.”

     

     

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    6 Responses to Children in care denied mental health services because of placement ‘uncertainty’

    1. David Steare April 28, 2016 at 12:29 pm #

      When I worked in CAMHS this inflexibility appeared to be common among therapists who seemed to be incapable of working with any child who didn’t fit their preferred referral criteria (e.g. YAVIS = Young, Attractive, Verbal, Intelligent, Successful). On the other hand I loved working with these youngsters (I drew on my experience of fostering) and specialised in working with disaffected behaviour (my article ‘managing mr angry’ is online.

      Another thing: When the LA introduced a specialist LAC-MH programme based at one of their major children’s homes I was seconded from Specialist CAMHS. It only lasted a year. I suspected it was because of the high costs involved. I have lots of happy memories working with these youngsters and with some of the residential staff. However, other professionals within the LA seemed opposed to my way of working. I devised a self-completed version of Gateshead’s ‘Signs of Well-Being’ and would use this routinely when meeting a youngster for the first or second time. Some youngsters would use this form to express very strong views about being in care and away from home for their own protection. One service manager objected to this being highlighted by a youngster in a LAC review and complained (unsuccessfully) to my CAMHS manager. My conclusion from this year’s work was that children’s needs and views were not as important as the needs and views of LA managers.

      My third point is that it is unlikely than many LA social workers or residential staff have sufficient training to recognise let alone respond to specific mental health needs, especially as youngsters tend to hide their distress by acting it out via disaffected behaviour. So, if children in care are going to receive the mental health care they need then some radical changes may be needed e.g. CAMHS professionals being based in LAC teams, LAC social workers / residential workers being seconded into CAMHS, routine screening via ‘Strengths & Difficulties’ questionnaire with follow-up session with CAMHS, etc., and taking action on the basis that mental health needs can be caused as much by the ‘protection and care systems’ as by home and community.

      • loiner May 15, 2016 at 10:12 am #

        l agree and professionals are telling families we will decide what therapy is needed and when, l happened to ask a worker are you trained in mental health……….answer l know how to deal with children, so l said you arent trained yes was the reply………….another point is many professionals have low or little training on active listening, although they say they do………….active listening is an important tool for anyone working with vulnerable people

    2. Ruth Cartwright April 30, 2016 at 9:59 am #

      The notion that professionals who could help a child with mental health issues do not do so because the child is not in a stable placement (and of course this lack of certainty and insecurity will only be making their problems worse) is very sad. Are resources so stretched they are looking for reasons not to help children and young people?

      • loiner May 15, 2016 at 10:14 am #

        its not a matter of resources its more a matter of professionals making decisions that they are not trained to do

    3. Anonymous May 10, 2016 at 1:57 pm #

      This is why I hate being young. The mental health services only waste my time. They just want to help young, attractive people. They don’t care about the elderly, or the autistic, or the disabled. Yet my social worker is very quick to praise them. She would be, it’s in her contract. I, however, do not trust these services anymore. I hope all of the mental health trusts get shut down by the CQC. We all deserve better. Do you have any idea, how many times I phoned my local crisis team, only to find that me being suicidal wasn’t enough to hospitalize me? So now, unless you go to ridiculous lengths, to have to get it through to them about how suicidal you are, they won’t believe you. They deny it. That’s sickening. I’m disgusted. And also disgusted with my mental health team, my social worker, and my CPN who is too nosy for her own good. And if none of us try to do anything remotely practical about this, the mental health system will keep treating us as if we’re just another name and number to them. Well we are. Enough with social integration. They’ve got it so wrong. They can’t even see it. Staff are too blind to see what’s falling, because they’re too busy watching their own bank accounts. Oh and god help anyone trapped in Supported-living accommodation, because that’s no better. You get treat like a financial and domestic slave. Let this be a warning to anyone wanting to live in supported housing. Anyway, the government are going to shut down supported housing in april next year, so I’ll be celebrating when these good-for-nothing supported living flats get written off. I’m all in favour of care homes myself, because staff treat you far better. And I’m disgusted at how my agoraphobia isn’t taken into consideration. It’s all very well hiring home carer’s to help me, but that only teaches me to rely on them. What about when they leave my life? Am I supposed to just get on with it, knowing that can hardly step foot outside, on my own? Very funny. I was sexually assaulted. And when you’ve been through such traumatic experiences, you can’t always alter the brain to “just forget it”. So it’s a waste of my time being in Supported-living, and hiring home carer’s. Some of these carers have terrible communication skills. Some just don’t know how to conversate, or are just looking at their i-phones most of the time. That isn’t good. Remember, there’s power in numbers. Why are we settling for being treat like less than human? I get why Baby P was abandoned by the “good” old social services. If I know what I know about social workers. They don’t give options. They just expect us to be robots. Some of us are way more on-the-ball than anyone will truly ever know. Because if I’M not going to speak for other mentally ill people who else will? Something else to consider, I am concerned, because I’m constantly getting harassed by two SUPPOSED friends. They’re both male, and they’ve both tried to make sexual moves on me. They make my skin crawl. I was promised some safeguarding. Yet typically didn’t recieve any. I knew that even when I went to the police about it, they’d get away with it, because we all know how “fair” the lousy justice system is. Nothing this bad ever happened to me, while I was living in the care home. So two much older men, know that I’m a vulnerable young woman, living in a flat, on my own. How WOULDN’T i be a target for these sorts? Stupid and unwise to put inexperienced young people in their own homes. You can’t just put someone in a flat and hope for the best. How careless and naive that idea is. We’re not all the same. We have lived through VERY different experiences. So this doesn’t work. It’s also naive, to expect me to “engage with my community”, when I have social anxiety.

    4. loiner May 15, 2016 at 10:07 am #

      l know young children (3-4)who have been denied access to any form of therapy, because the professionals (not mental health workers) decided that the child will recieve therapy when they are placed permently………….children in question have been in care for three years………………every professional working in medical/mental health knows the longer you leave a problem the harder it is to solve