Secondary data analysis of social care records to examine the provision of mental health support for young people in care

Alice R Phillips; Sarah L Halligan; Megan Denne; Catherine Hamilton-Giachritsis; John A A MacLeod; David Wilkins; Rachel M Hiller

doi:10.1002/jcv2.12161

Secondary data analysis of social care records to examine the provision of mental health support for young people in care

JCPP Adv. 2023 Mar 28;3(2):e12161. doi: 10.1002/jcv2.12161. eCollection 2023 Jun.

Authors

Alice R Phillips¹, Sarah L Halligan¹, Megan Denne¹, Catherine Hamilton-Giachritsis¹, John A A MacLeod^{2

3}, David Wilkins⁴, Rachel M Hiller^{5

6}

Affiliations

¹ Department of Psychology University of Bath Bath UK.
² The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust Bath UK.
³ Centre for Academic Primary Care Bristol Medical School The University of Bristol Bristol UK.
⁴ Children's Social Care Research and Development Centre School of Social Sciences Cardiff University Cardiff UK.
⁵ Division of Psychology & Language Sciences University College London London UK.
⁶ Anna Freud Centre for Children and Families London UK.

Abstract

Background: Young people in care are much more likely to experience mental health difficulties than the general population, yet little is known about the provision of mental health support for this group in the United Kingdom.

Methods: Using routinely collected social care data, we explored the provision of mental health support for 112 young people in care in the UK. We identified young people experiencing elevated internalising or externalising difficulties in their first year in care (based on strengths and difficulties questionnaire scores) and extracted data on mental health referrals and provision. We generated descriptive statistics relating to provision of mental health support and used regressions to examine predictors of mental health provision, and associations between support and mental health outcomes one and 2 years later.

Results: Eighty-one percent of the children (n = 79) were referred to mental health services in their first year of being in care. Referrals were usually for emotional or conduct problems. Those with higher externalising symptoms were more likely to be referred than those with higher internalising symptoms (OR = 1.2, (95% confidence interval (CI): 1.01, 1.38)). Females were more likely to access support than males (OR = 3.82 (95% CI: 1.2, 13.3)). Sixty-eight percent of children (n = 66) accessed mental health services in their first year of being in care. Of those who accessed services, support ended prematurely for 29 (44%) of them, often due to placement instability or disengagement. Accessing support in the first year of care was not associated with changes in mental health 1 year (OR: 2.14 (95% CI: 0.62,7.29)), or 2 years after entering care (OR: 0.72-8.57, (95% CI: 0.72, 8.57)), although methodological limitations are noted.

Conclusions: Mental health difficulties for children in care are recognised quickly, but mental health support may be difficult to access, with issues evident in retention and engagement.

Keywords: maltreatment; mental health; social work; therapy; trauma.