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

• Published in: JCPP advances 2023-06, Vol.3 (2), p.e12161-n/a
• Main Authors: Phillips, Alice R., Halligan, Sarah L., Denne, Megan, Hamilton‐Giachritsis, Catherine, MacLeod, John A. A., Wilkins, David, Hiller, Rachel M.
• Format: Article
• Language: English
• Subjects: Caregivers; Data analysis; Emotional abuse; Health services; maltreatment; Mental disorders; mental health; Mental health care; Original; Questionnaires; Sex crimes; Sexual abuse; Social skills; social work; therapy; trauma
• ISSN: 2692-9384; 2692-9384
• DOI: 10.1002/jcv2.12161

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. We examined provision of mental health support for young people in care who had elevated mental health difficulties in their first year of being in care. Using secondary data analysis of anonymised social care records, we found that mental health difficulties were recognised and acted upon quickly with referrals, but that support was difficult to access with issues evident in retention and engagement. Access to support was unrelated to changes in mental health one and 2 years later, though concerns remain around the r