CYC-Net

CYC-Net on Facebook CYC-Net on Twitter Search CYC-Net

Join Our Mailing List

Quote

Just a short piece ...

25 JuLY 2008

NO 1326

Mental health of looked after children

The number of children formally identified as having 'troubled and troubling' behaviour has increased considerably in most developed countries during the last five decades. The classification of 'mental disorders' has become increasingly sophisticated during this period. The original DSM (Diagnostic and Statistical Manual of Mental Disorders) published in 1952 listed 60 types and subtypes of mental disorder, while DSM-IV, the current edition, contains well over 200. The International Statistical Classification of Diseases (ICD), has been subject to equally frequent revisions. Difficulties experienced by children and young people represent one of the areas of classificatory expansion that has both reflected and inspired research interest in the field.

Differences in nomenclature, particularly the terms `emotional and behavioural problems', `mental health problems' and 'mental disorders', have developed out of the different medical and social welfare systems to which troubled children have been subject. More significantly in relation to reviewing research in the field are the plethora of definitions which have been operationalized under these broad headings. Along with variation in the ages of children studied and the different contexts in which research has been conducted, different definitions and thresholds for what constitutes 'problems', or constitutes them at clinical or concerning levels, have produced very different estimates of the number of children with emotional or behavioural difficulties.

There is also nothing fixed about the population of children in state care – changes in policy and practice alter who enters the care of the state, and how long they remain in such care, as well as how that care is provided. The 2,733 children in the care of the Greek state in 1999 cannot be compared in any simple way with the 55,000 in care in England in the same year. Therefore, inter-country comparisons of levels of mental health needs need to be treated with great caution.

What is comparable spacially and temporally is the special responsibility of the state towards their `looked after' populations and the level of emotional and behavioural difficulties of these various groups of children relative to the general population. In England the research undertaken by Howard Meltzer and colleagues for the ONS puts us in the unique position of being able to compare the levels of difficulty between those children currently looked after by the state and children in the overall population.

In The mental health of children and adolescents in Great Britain (Meltzer et al., 2000) information was collected on an assessment of 10,000 children.

In The mental health of young people looked after by local authorities in England (Meltzer et al., 2003) information was collected on 1,039 children.

Research such as this exposes the fact that 1 in 10 of all children display behaviours of the same magnitude as those currently being accepted and treated by Child and Adolescent Mental Health Services (CAMHS). This rises to almost half of all looked after children. It can therefore be read as identifying a large constituency of children in need of mental health services. Indeed it has been estimated that only 1 in 5 children in need of such services in the UK actually receive them (HAS, 1995). The answer to this need is sometimes conceived in terms of more child psychiatrists, psychologists, in-patient beds and primary mental health care workers. But we need to be cautious about rushing to apparently obvious conclusions. My review of the research suggests that in relation to the mental health needs of children in state care such provision, even if it were forthcoming, is unlikely to provide a complete solution. The reasons for this lie in the origins and causes of most emotional and behavioural difficulties in children, the position of children within the family and the inaccessibility and stigma of traditional mental health services.

SARA SCOTT

Scott, S. (2004). Reviewing the research on the mental health of looked after children: Some issues for the development of more evidence informed practice. International Journal of Child and Family Welfare, 7, 2-3. pp. 87-88.

REFERENCES

Meltzer, H.; Gatward, R.; Goodman, R. and Ford, T. (2000). Mental health of children and adolescents in Great Britain., London. TSO.

Meltzer, H.; Gatward, R.; Corbin, T.; Goodman, R. and Ford, T. (2003). The mental health of young people looked after by local authorities in England. London. TSO.

The International Child and Youth Care Network
THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK (CYC-Net)

Registered Public Benefit Organisation in the Republic of South Africa (PBO 930015296)
Incorporated as a Not-for-Profit in Canada: Corporation Number 1284643-8

P.O. Box 23199, Claremont 7735, Cape Town, South Africa | P.O. Box 21464, MacDonald Drive, St. John's, NL A1A 5G6, Canada

Board of Governors | Constitution | Funding | Site Content and Usage | Advertising | Privacy Policy | Contact us

iOS App Android App