Education Young people we asked to fill out fake Personal education plans as if they were there teachers so that they could consider how they felt they were seen at school. They were also asked to think about whether school was a place where their emotional well being was supported. Findings - Some young people felt they were seen as disruptive at school and their relationship with teachers was seen as negative. A few young people stated that teachers were pleased with their behaviour. Many of the young people identified that teachers would recognise that they had good relationships with other young people. Most of the young people stated that they did not feel that their emotional needs were understood or that they could talk about their emotional needs at school, especially because staff did not have experience of the care system. A few said that they felt judged and that they would like to be listened to more. Some said that they liked to keep home and school separate and that they did not want to be singled out because they were Looked After. This emerged in other discussions where some young people stated that they wanted to be thought of as “young people” rather than “Looked After Young People”.
Many young people said that despite feeling scared they tried to pretend everything was fine. Young people moving to independence or supported accommodation shared their anxieties about living with less support. They appreciated maintaining contact with their residential homes or participation workers. For young people living in a secure setting, the importance of pretending they were ok seemed significant. Some young people identified that they were scared and homesick but were more likely to lash out and get in trouble rather than share their feelings.
We asked young people to tell us what they thought about the services that are available to support their emotional well being. We wanted to explore whether there is stigma attached to mental health services. Many young people had a fairly negative perception of mental health services. Those who had not accessed services were wary and suggested that they were for people who are particularly unwell. Words such as “mad” and “mental” were used to describe who services may be aimed at. Suggestions for improvement centred on building relationships- there was a reluctance of talking to strangers and a fear of what may be discovered if they did open up. Emphasis was put on trust and young people identified that they were more likely to talk to adults working in participation services or their carers than workers within CAMHS. Young people stressed that they need time to build relationships with professionals before they access emotional support from them. Some young people had been involved with CAMHS and there was a general suggestion that those who had received a diagnosis had found it helpful but wished that they had received assessments earlier rather than waiting lengthy periods to get support
There needs to be more widespread understanding of what it means to be a Looked After Young Person. Participants repeatedly stated that the only representation of children in care that others know is the TV character Tracy Beaker and that they are tired of telling peers that they are ‘not like Tracy Beaker’. Discussions in school around equality and diversity should include conversations about where young people may live. Normalising the idea of Care so that all children understand that young people grow up in a variety different settings, including foster care and residential care, will help to alleviate some of the stigma attached to children growing up away from the family home and will improve their overall wellbeing and mental health.
Layp mental health and stigma
Looked after young people:mental health and stigmaRoger CatchpoleTraining & Development Manager
What is it about?• Setting the context• YoungMinds research on mental health, Looked After Young People and stigma• A 3 year training project
A growing issue• There were 65,520 looked after children at 31 March 2011, an increase of 2 per cent from 2010 and an increase of 9 per cent since 2007• January 2012 saw the highest ever number of care applications in a single month
Mental health• About 60% of those looked after in England have been reported to have emotional and mental health problems (NICE: 2010)• Among young people, aged 5-17 years, looked after by local authorities 45% were assessed as having a mental disorder (ONS: 2003)
The gap between needs andprovision One study in 1997 found that 80% of Looked After Children needed mental health support while 27% received it. How much has that changed? Phillips, J. Meeting the psychiatric needs of children in foster care: social workers views. Psychiatric Bulletin, 21: 601-611
Not enoughA survey of 106 looked after children concluded:• The high numbers of ‘need’ appeared unchanged• The poor needs/met ratio is still evident• Requests for help are impeded by a perceived lack of understanding/empathy/experience (of being from Care)• Few of those that feel able to ask for help would turn to mental health professionals• Professional mental health solutions are viewed as stigmatising• A clear majority choose the alternative coping strategies of increased drug/alcohol consumption A National Voice; Emotional Wellbeing Report (2010)
What the research tells us• Children and young people say their emotional wellbeing and self esteem is supported when they are cared for in an environment where they feel they belong• Stability and continuity make a difference• Foster carers want ongoing training to deal with emotional needs and more access to services, in particular mental health services Improving the emotional and behavioural health of Looked After Children and Young People: C4EO
What helps?• Comprehensive assessment of needs on entry that identifies mental health needs• Good communication and collaboration between mental health professionals and care staff• Staff with good understanding and awareness of mental health needs• Engagement and consultation with young people An evaluation of the provision of mental health services for Looked After Young People (Ofsted 2010)
“Always makes a good effort” “Very polite” ‘Very aggressive towards other young people” “Improving in Maths and English” “Doesn’t “Always concentrate well” disrupting class”How does the school see you?
Outside I Inside I Feel.......... Behave.......... “Worried” “Mature” “Lonely” “Confident” “Given up ” “Just get on with it” “No Hope” “I hate it”“Going to explode ” “Don’t trust anyone ” “Let down” “Won’t talk to anyone” “Quiet ” “I know everything ” “Happy ”
“Better than I thought” “They are not really listening and twisting“I don’t talk to other people words”about my problems” “How I see mental Health Services” “They ask too many “Why would I talk to a questions” stranger” “My voice is not heard” “It took me a long time to tell people “Judgemental” that I was in danger in my supported accommodation but in the end I got help”
In foster care I felt trapped.Residential care gave me freedom.
Mental health training• 3 years funding• Delivering subsidised training• Developing online toolkit• 360 people trained in 2011/12
The training agenda so far• Conceptual models of mental health – nature, nurture and events• Risk and Resilience• Attachment and Neuroscience• Reflective practice• Inter professional practice
Who needs training?• Any of the 60 or more practitioners and managers involved in the life of a typical Looked After Young Person including; social workers, residential child care staff, managers, foster carers, education professionals, learning mentors, learning support assistants, family court staff, GPs and other primary health care staff, A&E staff, CAMHS workers, independent visitors, YOT members, substance misuse workers, housing workers, early years professionals etc..
What we know• Priorities are different in different areas• We need to add value to existing training not duplicate it• Raising awareness and skilling up individual practitioners is important but will not achieve systemic change on its own
What we want to know• What are the priorities in your area?• Is there training that would make a real difference to the Looked After system in your area?• Might you be interested in working with us?