Monday, November 27, 2006
Children and Mental Health
I have been reading an interesting report by National Statistics into the Mental Health of young people looked after by local authorities in England.
It points out for example that for 5-10 years olds 42% of the children (looked after by local authorities) are thought to have a "mental disorder" as opposed to 8% of "private household children".
There is a question as to why. Clearly there are two potential sources of cause. One is the experiences of the child before becoming formally "looked after". The other the the effect of being "taken into care".
The only way of checking out this situation and finding out what are the key drivers is to have controls. The only available controls are other countries. It is clear that a substantial number of children are taken into care who should not be. What is not clear is what proportion of those taken into care fall into that category.
Another useful piece of information is that which looks at the prevalence of mental disorder compared to the time in the current placement.
This shows a gradual reduction in disorders as the time in a particular placement extends. The figures are under 1 year 49.4%, 2 47.4, 3 45.4, 4 39.6, 5 39 over 5 years 31%.
In a sense this justifies the argument that the process of being taken into care causes problems for children.
It remains, however, that the stress caused to children by being taken away from their home when nothing was actually wrong in the first instance should not be ignored.
It is difficult to make the finely balanced decisions as to when to intervene. However, what is very clear is that on average intervention notwithstanding the good efforts of foster parents, is damaging. posted by John Hemming ¶ 4:50 pm
It points out for example that for 5-10 years olds 42% of the children (looked after by local authorities) are thought to have a "mental disorder" as opposed to 8% of "private household children".
There is a question as to why. Clearly there are two potential sources of cause. One is the experiences of the child before becoming formally "looked after". The other the the effect of being "taken into care".
The only way of checking out this situation and finding out what are the key drivers is to have controls. The only available controls are other countries. It is clear that a substantial number of children are taken into care who should not be. What is not clear is what proportion of those taken into care fall into that category.
Another useful piece of information is that which looks at the prevalence of mental disorder compared to the time in the current placement.
This shows a gradual reduction in disorders as the time in a particular placement extends. The figures are under 1 year 49.4%, 2 47.4, 3 45.4, 4 39.6, 5 39 over 5 years 31%.
In a sense this justifies the argument that the process of being taken into care causes problems for children.
It remains, however, that the stress caused to children by being taken away from their home when nothing was actually wrong in the first instance should not be ignored.
It is difficult to make the finely balanced decisions as to when to intervene. However, what is very clear is that on average intervention notwithstanding the good efforts of foster parents, is damaging. posted by John Hemming ¶ 4:50 pm
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There are probably a number of factors at play here.
It is likely that families of children with mental disorders are more likely to find it a struggle.
It is likely that children are more likely to develop mental disorders, or for mental disorders to worsen, in families that are struggling.
It is likely that the process of being taken into care (whether it is the right thing or not) will exacerbate/cause mental disorders.
It is likely that being in care will exacerbate/cause mental disorder in some children.
A key question for me is to what extent the first two factors could be reduced or avoided by more effective support for the families concerned rather than taken the child into care.
Similarly what can be done to reduce the impact of being taken into or being in care on mental disorder.
It would be interesting to see a comparison between those who remain in some form of institution, those that are fostered and those that are adopted.
It is likely that families of children with mental disorders are more likely to find it a struggle.
It is likely that children are more likely to develop mental disorders, or for mental disorders to worsen, in families that are struggling.
It is likely that the process of being taken into care (whether it is the right thing or not) will exacerbate/cause mental disorders.
It is likely that being in care will exacerbate/cause mental disorder in some children.
A key question for me is to what extent the first two factors could be reduced or avoided by more effective support for the families concerned rather than taken the child into care.
Similarly what can be done to reduce the impact of being taken into or being in care on mental disorder.
It would be interesting to see a comparison between those who remain in some form of institution, those that are fostered and those that are adopted.
The problem is that your populations are statistically skewed. Kids with greater problems are less likely to be adopted.
Surely kids who have mental disorders (or live in environments likely to cause mental disorders) are more likley to be taken into care than those who don't. Therefore could the reduction in such disorders the longer a child is in care not be due to the child being removed from a mentally distruptive environment and placed in a more supportive environment? The assertion in your post seems rather like saying that because most sick people in hospitals get better the longer they stay in, the act of going into hospital makes people ill.
I know a number of child social workers. So far as I am aware they do not have a weekly quota for children they have to put into care to achieve a CPA KPI. If anything they are encouraged (or even compelled) to do everything in thier power to avoid removing a child for anything less than imminent physical danger. I wonder if the number of children taken into care who need not be is that large, even significant compared with the number of children who really should be in care but their isn't any space for them in the system or the professional judgement of the social worker involved is overruled by unqualified managers?
I know a number of child social workers. So far as I am aware they do not have a weekly quota for children they have to put into care to achieve a CPA KPI. If anything they are encouraged (or even compelled) to do everything in thier power to avoid removing a child for anything less than imminent physical danger. I wonder if the number of children taken into care who need not be is that large, even significant compared with the number of children who really should be in care but their isn't any space for them in the system or the professional judgement of the social worker involved is overruled by unqualified managers?
Stephen: What you say in your post conflicts with the documentary evidence that I have. I only yesterday raised an issue with Birmingham Child Protection team about two children that should not be taken into care that they were starting proceedings on. I am aware of a number of similar cases across the country.
You are right in that there are a number of potential causes of mental disorders.
You are right in that there are a number of potential causes of mental disorders.
Stephen: Your thesis, however, is partially disproven because the timing is not from when children are taken into care, but the start of their current placement.
Remember the key point that about 70% of children who leave care because they hit 16 return to their parents. (even if for a few days)
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Remember the key point that about 70% of children who leave care because they hit 16 return to their parents. (even if for a few days)
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