What works in preventing and treating poor mental health in looked after children? Research into the needs of children in care

Boy sat on bedChildren in care have consistently been found to have much higher rates of mental health difficulties than the general population, with almost half of them meeting the criteria for a clinically diagnosable disorder. We commissioned the Rees Centre at the University of Oxford to provide an overview of the evidence about what works in preventing and treating poor mental health of children in care.

This report identifies and brings together original evidence and relevant reviews from published literature about mental health and well-being interventions for looked-after children. This is part of our Impact and evidence series.

Authors: Nikki Luke, Ian Sinclair, Matt Woolgar and Judy Sebba
Published: 2014

The report suggests that making appropriate and timely decisions around care placements is likely to help children benefit from specific interventions to improve their mental health and well-being. It identifies a number of key principles.

  • Many aspects of looked-after children’s well-being are amenable to change.
  • Early interventions are more likely to promote good mental health.
  • Developing relationships is crucial for children to make progress.
  • Carer training is a promising method for influencing children’s outcomes.
  • Continuity (in terms of permanence, stability and consistency) can influence success.
  • Efforts to improve mental health should be systematic and sustained.
  • Children and young people should be treated as individuals.
  • Professionals need to listen to children and young people.
  • Caregivers’ attitudes can affect the take-up and success of mental health services.
  • Interventions need a clear theoretical base but should be open to more than one interpretation of children’s behaviour.

The report highlights that there is evidence that some children in care do well despite challenging circumstances; this is commonly referred to as resilience. Many problems relating to mental well-being are shared by both children in care and those who are not. The research emphasises the importance of improving prevention and allocating resources for assessments and interventions that target behavioural or emotional difficulties.

The literature suggests that children in care would benefit from earlier decision-making about care placements. There is evidence that good quality levels of care, alongside specific direct interventions targeted at the child and/or carer, can help improve children’s well-being.

Robust assessments can help professionals understand the needs of individual children, as each child will respond to early adversity in a different way. Interventions need to focus on what promotes positive outcomes, rather than been seen as a way to manage challenging behaviour.

Acknowledgements 2
Executive Summary 7
Background and overview of the report 19
Assessments 69
Specific intreventions 79
Conclusions 109
References 128
Appendices 150

Please cite as: Luke, N. et al. (2014) What works in preventing and treating poor mental health in looked after children?. London: NSPCC. 

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We hold the UK's largest collection of child protection resources and the only UK database specialising in published material on child protection, child abuse and child neglect.

Search the library

New in the Library

A free weekly email listing all of the new child protection publications added to our library collection.

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