Pathways to and from state care: The experiences of eight young people

2006 ◽  
Vol 31 (3) ◽  
pp. 34-41 ◽  
Author(s):  
John Frederick ◽  
Chris Goddard

Children enter state care because their parents are unable to care for them or because of abuse and neglect. Invariably they experience considerable distress and emotional trauma with many having clinically significant mental health problems. Few, however, receive the assessment, counselling and supportive services that they need. When they leave care, many experience extensive problems including mental health difficulties, unemployment, poverty, homelessness, drug abuse, relationship difficulties and lack of social support.This paper will discuss the findings of a qualitative study utilising in-depth interviews with young people who have been in state care. Illustrations of their pathways to and from care will highlight their experiences, and direct quotations from the participants will provide particular insights into the complex issues they have had to confront.The paper will outline key opportunities for prevention and intervention approaches at various points along these pathways.

2021 ◽  
pp. archdischild-2019-318577
Author(s):  
Sophie D Bennett ◽  
Isobel Heyman ◽  
Anna E Coughtrey ◽  
Sophia Varadkar ◽  
Terence Stephenson ◽  
...  

ObjectiveThis study aimed to conduct a randomised pilot trial to assess the feasibility of a randomised controlled trial (RCT) to investigate the effect of telephone-guided self-help for the treatment of mental health difficulties in children with neurological conditions.DesignPreliminary RCT. The primary outcome measure was the Strengths and Difficulties Questionnaire.SettingNeurology clinics in a national tertiary paediatric hospital.PatientsYoung people attending neurology clinics who met criteria for mental health difficulties according to the Development and Wellbeing Assessment.Interventions12 weeks of telephone-guided self-help based on a modular approach to psychological therapy for children delivered to children and/or their parents (n=17; eight males; mean age 12.04 years, SD=3.34) or a waiting list for telephone-guided self-help with no additional intervention over 12 weeks (n=17; nine males; mean age 10.53 years, SD=3.14).Results124 participants completed the DAWBA, and 34 children and young people were entered into the trial. 65% of those randomised to the intervention arm completed the full intervention, and the intervention was acceptable to those completing it. However, there were significant problems related to lack of data completion (38% data loss for primary outcome measure), choice of control comparator and outcome measures. Due to significant loss of data at follow-up, the effect size findings are considered unreliable.ConclusionsFurther feasibility work should be conducted to improve data completeness before progression to a definitive trial of guided self-help for mental health problems in children with neurological conditions can be recommended.Trial registration numberISRCTN21184717.


2019 ◽  
Vol 215 (3) ◽  
pp. 565-567 ◽  
Author(s):  
Jessica Deighton ◽  
Suzet Tanya Lereya ◽  
Polly Casey ◽  
Praveetha Patalay ◽  
Neil Humphrey ◽  
...  

SummaryCurrent mental health provision for children is based on estimates of one in ten children experiencing mental health problems. This study analyses a large-scale community-based dataset of 28 160 adolescents to explore school-based prevalence of mental health problems and characteristics that predict increased odds of experiencing them. Findings indicate the scale of mental health problems in England is much higher than previous estimates, with two in five young people scoring above thresholds for emotional problems, conduct problems or hyperactivity. Gender, deprivation, child in need status, ethnicity and age were all associated with increased odds of experiencing mental health difficulties.Declarations of interestNone.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1907 ◽  
Author(s):  
Alice Welch ◽  
Roz Shafran ◽  
Isobel Heyman ◽  
Anna Coughtrey ◽  
Sophie Bennett

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.


2021 ◽  
Vol 12 ◽  
Author(s):  
Eva Rens ◽  
Pierre Smith ◽  
Pablo Nicaise ◽  
Vincent Lorant ◽  
Kris Van den Broeck

Background: The outbreak of the COVID-19 pandemic in 2020 and its associated measures led to high levels of mental distress in the general population. Previous research indicated that young people are especially vulnerable for a wide range of mental health problems during the pandemic, but little is known about the mechanisms. This study examined mental distress and its contributing factors among young Belgian people.Methods: An online survey was widely distributed in Belgium during the first wave of COVID-19 in March, and 16–25-year-olds were selected as a subsample. Mental distress was assessed using the 12-item General Health Questionnaire (GHQ-12), and a threshold of ≥4 was used to discriminate mental distress cases from non-cases. Bivariate and multivariable logistic regression analyses were performed to evaluate possible predictors of mental distress, including demographics, chronic condition, history of mental health problems, social support, exposure to COVID-19, and several changes in everyday activities.Results: A total of 2,008 respondents were included, of which the majority was female (78.09%) and student (66.82%). The results indicate that about two thirds (65.49%) experienced mental distress. In the multivariable regression model, significant (p < 0.01) predictors of mental distress were female gender (OR = 1.78), low social support (OR = 2.17), loneliness (OR = 5.17), a small (OR = 1.63), or large (OR = 3.08) increase in social media use, a small (OR = 1.63) or large (OR = 2.17) decrease in going out for drinks or food, and a decrease in doing home activities (OR = 2.72).Conclusion: Young people experience high levels of mental distress during the COVID-19 pandemic. Our findings indicate that mental distress was highest among women, those experiencing loneliness or low social support and those whose usual everyday life is most affected. The psychological needs of young people, such as the need for peer interaction, should be more recognized and supported.


Author(s):  
Gargie Ahmad ◽  
Sally McManus ◽  
Laia Bécares ◽  
Stephani L. Hatch ◽  
Jayati Das-Munshi

Abstract Purpose The relationship between ethnicity and adolescent mental health was investigated using cross-sectional data from the nationally representative UK Millennium Cohort Study. Methods Parental Strengths and Difficulties Questionnaire reports identified mental health problems in 10,357 young people aged 14 (n = 2042 from ethnic minority backgrounds: Mixed n = 492, Indian n = 275, Pakistani n = 496, Bangladeshi n = 221, Black Caribbean n = 102, Black African n = 187, Other Ethnic Group n = 269). Univariable logistic regression models investigated associations between each factor and outcome; a bivariable model investigated whether household income explained differences by ethnicity, and a multivariable model additionally adjusted for factors of social support (self-assessed support, parental relationship), participation (socialising, organised activities, religious attendance), and adversity (bullying, victimisation, substance use). Results were stratified by sex as evidence of a sex/ethnicity interaction was found (P = 0.0002). Results There were lower unadjusted odds for mental health problems in boys from Black African (OR 0.15, 95% CI 0.04–0.61) and Indian backgrounds (OR 0.42, 95% CI 0.21–0.86) compared to White peers. After adjustment for income, odds were lower in boys from Black African (OR 0.10, 95% CI 0.02–0.38), Indian (OR 0.40, 95% CI 0.21–0.77), and Pakistani (OR 0.49, 95% CI 0.27–0.89) backgrounds, and girls from Bangladeshi (OR 0.18, 95% CI 0.05–0.65) and Pakistani (OR 0.63, 95% CI 0.41–0.99) backgrounds. After further adjustment for social support, participation, and adversity factors, only boys from a Black African background had lower odds (OR 0.16, 95% CI 0.03–0.71) of mental health problems. Conclusions Household income confounded lower prevalence of mental health problems in some young people from Pakistani and Bangladeshi backgrounds; findings suggest ethnic differences are partly but not fully accounted for by income, social support, participation, and adversity. Addressing income inequalities and socially focused interventions may protect against mental health problems irrespective of ethnicity.


F1000Research ◽  
2020 ◽  
Vol 7 ◽  
pp. 1907
Author(s):  
Alice Welch ◽  
Roz Shafran ◽  
Isobel Heyman ◽  
Anna Coughtrey ◽  
Sophie Bennett

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.


2019 ◽  

Physical exercise is increasingly being recommended as part of management for children and young people with mental health problems. There is a growing evidence base that shows physical exercise is associated with improvements in functioning for conditions such as attention deficit hyperactivity disorder (ADHD), although studies are small, they are signifcant. 


Author(s):  
Miranda Wolpert

This chapter aims to guide the thinking of practitioners who might be involved in developing services to meet the needs of children and young people with mental health difficulties. Anyone involved in this challenging but vital endeavour will need to address the following questions: ♦ Who should the service be for? ♦ What sort of interventions should be provided? ♦ How should the service be structured? ♦ Who should the staff be? ♦ How can the service be made most accessible? ♦ How can service quality be ensured? This chapter will look at each of these issues in turn to explore how each might best be approached.


2020 ◽  
Vol 25 (4) ◽  
pp. 909-921 ◽  
Author(s):  
Anna Bratt ◽  
Ing-Marie Gralberg ◽  
Idor Svensson ◽  
Marie Rusner

Shame and self-stigmatisation are common in adolescents with mental health problems, and can hinder their recovery. Compassion-focussed therapy (CFT) help people address challenging experiences and emotions with courage, wisdom, and care. However, no previous studies have examined whether CFT is helpful for adolescents with mental health problems. The present study aimed to describe lived experiences regarding group-based CFT based on the perspectives of a sample of adolescent girls who were recruited from a child and adolescent psychiatric outpatient clinic in Sweden. In-depth interviews were conducted with six girls, aged 15 to 17, using a reflective lifeworld research approach. The results showed that participating in group-based CFT means gaining the courage to see and accept oneself through meeting with peers who are experiencing similar difficulties. When sharing experiences in a group, new perspectives and an acknowledgement that mental and emotional struggle are normal arise, and a sense of inner peace and belonging emerges. Instead of hiding from society, it is possible to participate in everyday life, ask for help, and asserting oneself. CFT can provide a promising method for empowering young people with mental health problems, helping them feel connected with others, and fostering in them the strength to show their true personalities.


2016 ◽  
Vol 6 (3) ◽  
pp. 661-677 ◽  
Author(s):  
Helen Forbes-Mewett ◽  
Anne-Maree Sawyer

Since the early 2000s, reports of increased rates of mental ill health among young people worldwide have received much attention. Several studies indicate a greater incidence of mental health problems among tertiary students, compared with the general population, and higher levels of anxiety, in particular, among international students compared with domestic students. Australia is host to many thousands of international students of an age when mental illnesses are most likely to surface. However, this issue has received little attention from Australian researchers. This article reports on in-depth interviews with 16 professionals working with international students at an internationalized university.


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