The mental health of children looked after before and during the Covid-19 pandemic: A cross-sectional study using propensity score matching

Introduction Evidence indicates that for some children and young people, levels of mental health difficulties increased over the initial years of the Covid-19 pandemic. Aim We examined whether levels of carer-reported mental health difficulties and wellbeing were different between 2019 (pre-pandemic) and 2020 and between 2019 and 2021 for children looked after. Method We conducted a repeated cross-sectional secondary analysis using propensity score matching. Mental health difficulties and wellbeing were measured using the 87-item BERRI assessment tool. Overall, N = 593 young people (7–26 years) were included from 23 settings. Results Between 2019 and 2020, carers reported lower levels of behavioural (coefficient=-9.85, 95% CI = -15.84, -3.85), emotional (coefficient=-10.27, 95% CI -17.38, -3.16), relationship (coefficient=-12.31, 95% CI = -21.45, -3.17) and overall (coefficient=-46.43, 95% CI = -76.77, -16.09) difficulties for young people. Between 2019 and 2021, carers reported only lower levels of behavioural difficulties for young people (coefficient=-8.25, 95% CI = -14.14, -2.35). Discussion Although levels of mental health difficulties decreased over the first year of the pandemic, by the second year they had for the most part returned to pre-pandemic levels. Implications for practice The present research on the mental health and wellbeing of children looked after during the early stages of the Covid-19 pandemic remains relevant to help understand and contextualise the longer-term psychosocial impacts we are seeing today.