Reviewing the research on the mental health of looked after children: Some issues for the development of more evidence informed practice

Abstract

Recent prevalence research in the UK has identified up to half of all children in state care as having emotional and behavioural problems at clinical levels. While longitudinal research assures us that most children with such problems do not go on to have mental health problems in adult life, many are at high risk of criminal involvement and relationship difficulties. For a few, the combination of anti-social behaviour and interpersonal issues will lead them to forensic psychiatric services - where previously 'looked after' children are hugely over-represented. There are major gaps in the evidence base to inform service development which must be addressed urgently if children currently in state care are to be supported in ways that might increase their chances of a bright future. The problems of 'looked after' children are multiple, but most effectiveness research focuses on time-limited interventions for single issues. While there is increasing recognition that problems of attachment underlie many presenting behaviours in this population, there is a paucity of research on attachment interventions. In addition, research incorporating looked after children and young people's perspectives on their needs, experiences, and the value of services and approaches is extremely limited.