Looked-after children need flexible mental health services

Mental health services need to be more flexible in order to support looked-after young people with mental health problems, an expert working group has said.

Formal services should be more flexible in who they will allow to support the young person, acknowledging that support can come from a range of services and places. Health, education and social services need to work collaboratively to achieve this recommendation, the group added.

The Expert Working Group was set up to ensure that the emotional and mental health needs of children and young people in care are met.

“One of the key issues that we recognised was that good quality ongoing assessment must be the foundation of a comprehensive strategy of support and services,” said the report. “One of the strongest views of the Expert Working Group was that local areas need to be able to provide consistent care and support for a child, with an understanding that their diagnosis and therefore the type of support services they need can change. Therefore, assessment and services must be responsive and flexible. Mental health is a continuum and cannot be seen as a one-off diagnosis.”

The group recommends that the Strengths and Difficulties Questionnaire should be supported by a broader set of measures which can trigger a comprehensive mental health assessment. There are a range of tools in use that could support the assessment depending on the need of the young person.

Assessments should focus on understanding the individual’s mental health and emotional wellbeing in the context of their current situation and past experiences, rather than solely focusing on the presenting symptoms. A needs-based model is the best way to support and respond to young people, the report adds.

The group also urges that everyone working directly with looked-after children should be trained in children and young people’s mental health after it emerged that those working directly with young people do not always receive sufficient training to support complex mental health needs.

Caregivers also need to be informed of which statutory and non-statutory services are available when support is needed for the child or young person.

In addition, every school should have a designated teacher with the training and competence in identifying and understanding the mental health needs of all their pupils who are looked-after.

Clinical Commissioning Groups should ensure commissioning is informed by a Joint Strategic Needs Assessment (JSNA) which addresses the mental health and wellbeing needs of looked after children and care leavers. This should be reflected in Local Transformation Plans.

“Change needs to happen now, and it is our hope that this report provides a platform for that change and the necessary call for action,” the report concluded.

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