Many looked-after children are being turned away by child and adolescent mental health services (CAMHS) or do not have their mental health needs identified on entering care, a report by the Commons Education Committee has found.
While almost half of children in care have a diagnosable mental health disorder – and are four times more likely than their non-looked after peers to experience mental ill health – many face significant challenges in getting access to mental health support.
The Committee’s report found CAMHS are turning away young people in care because they have not met high thresholds for treatment or they are without a stable placement. This is contrary to statutory guidance which states that looked-after children should never be refused a service on the grounds of their placement, the report notes.
To help tackle this inflexibility, the report recommends looked-after children be given priority access to mental health assessments by specialist practitioners, with subsequent treatment based on clinical need.
Neil Carmichael, chair of the Education Committee, said: "Local authorities have a special responsibility for the welfare of looked-after children. In spite of this duty, it’s clear that many looked-after children in England are not getting the mental health support they need. At present, CAMHS are not assessing or treating children in care because these children do not have a stable placement.
“Given children in care may have unstable family lives and are frequently moving foster or residential placement, this inflexibility puts vulnerable children in care at a serious disadvantage in getting the support they deserve. This must change. We recommend children in care be given priority access to mental health assessments and never refused care based on their placement or severity of their condition."
The report found that current support for young people leaving care is inadequate and based too heavily on inflexible age restrictions and recommended that care leavers should be able to access CAMHS up until the age of 25 – rather than 18 at present. It acknowledged that leaving the care system can be a time of significant upheaval and disruption, and is likely to be even more unsettling for care leavers with mental health concerns. Young people leaving care in the UK are five times more likely to attempt suicide than their peers and are also more likely to enter the criminal justice system.
It recommends that initial assessments of those entering care should be more thoroughly and consistently carried out.
The report also recognised the role of schools and teachers in supporting looked-after children but was clear that they should not be not be administering specialist advice or acting as the sole source of support for their students. However, the Committee recommended schools take a 'whole-school approach' to better support the mental health of their students.
Additionally, the report recommended improvements in training for teachers and foster and residential carers. The Committee recommends that through initial teacher training all teachers should be trained in mental health and wellbeing.
"As part of this inquiry, we heard the direct experiences of care leavers and children in care as they talked about the challenges they face in the care system and what makes for good mental health care,” added Carmichael. “It’s crucial that the voice of young people is at the heart of the care planning and services looked-after children receive.
“Social services need to do more to empower children in care to have an active role in decisions about their placements to increase the likelihood that they will be stable and successful. Coordination between local health, education and social services is another vital element of effective support for looked-after children with mental health difficulties. This integration needs strong leadership and we recommend that each local area employs a senior mental health professional to drive this forward."