Mental health and stability of children and young people in the care system

Introduction: Children and young people (CYP) in the care system are a vulnerable population within society. Most enter care following early adversity and are at-risk of further traumatic experiences once in care. Instability within placements and relationships are known risk factors for poor mental health; however, more research is required to disentangle the impact of early adversity and care experiences on CYP’s outcomes. This is required, since adverse experiences both prior to CYP entering care and while in care can increase their vulnerability to long-term mental health difficulties and involvement in criminal activity. Currently, there is an over-representation of CYP with prior experience of being in care within the criminal justice system. The child welfare system needs to capture the voices of CYP to explore their subjective experiences following early adversity, to guide service provision, empower them through inclusivity in their care pathway and work in collaboration to prevent trajectories to offending pathways. Aims and methodology: The overall aim of this thesis is to explore CYP’s care experiences and factors that influence their mental health and stability. This can add to the forensic and social care fields by determining ways to improve vulnerable CYP’s experiences of stability and their mental health and reduce the risk of involvement with criminality and negative outcomes. The quantitative research project, whereby I analysed a local authority database, aimed to explore the relationship between Adverse Childhood Experiences (ACEs) and mental health. Secondly, the psychometric critique aimed to explore the utility of the Strengths and Difficulties Questionnaire (SDQ) for CYP in care. The systematic review aimed to identify risk and protective factors for CYP’s mental health, specifically those that occur for CYP residing in nonkinship foster care. Lastly, the qualitative research project aimed to gain insight into CYP’s care experiences and highlight strategies to improve the stability of future CYP in care. Results: The thesis highlighted that there was no relationship between number of ACEs and mental health. Instead, the number of placements, ethnicity and exposure to domestic violence were significantly related to SDQ scores. The SDQ was critiqued for its lack of sensitivity to trauma-related difficulties, despite being a mandatory assessment for CYP in care and the high rates of trauma and attachment that are reported in this population. The systematic review identified that personal assets and interpersonal characteristics influenced CYP’s mental health; however, limited research that controls for pre-care factors, alongside methodological weaknesses impeded on robust conclusions. Lastly, CYP’s accounts of their care experiences relayed the negative impact of instability on their sense of self, others and their future. Discussion: This thesis highlighted the implications that physical and relational instability can have on a CYP’s sense of self, mental health and resilience. There is significantly more needed to ensure CYP are provided a secure base within the care system and that their needs and wishes are advocated for. In addition, higher quality research and improved data collection is warranted. The findings from this thesis alongside practice and research implications, highlight a need for a more preventative and less reactive care system. They aim to encourage future investigation and early responsivity to factors that contribute to relational and environmental instability, mental health and poorer outcomes including criminality for CYP in care.