Mental health and well-being of looked-after children Contents



1.The mental health of looked-after children is significantly poorer than that of their peers, with almost half of children and young people in care meeting the criteria for a psychiatric disorder.1 In comparison one in ten non-looked-after children and young people suffer from a diagnosable mental health disorder.2 In November 2014, the Health Committee published a report on Child and Adolescent Mental Health Services (CAMHS).3 The report revealed problems throughout the system from early intervention to the transition to adult services. The Committee concluded that “there are serious and deeply ingrained problems with the commissioning and provision” of CAMHS.4

2.Since the publication of the Health Committee’s report the Department of Health (DH) and the Department for Education (DfE) have published new statutory guidance on Promoting the health and well-being of looked-after children.5 On the same day the Children and Young People’s Mental Health Taskforce released their report Future in Mind.6 Both of these publications are part of a wider focus on mental health by the Government, most recently demonstrated through the commissioning of a report by the independent Mental Health Taskforce, The Five Year Forward View for Mental Health.7 The Government has stated that it will invest £1.4 billion in children and young people’s mental health services over the course of the Parliament.8

3.Children in care and care leavers are more likely to experience poor health, educational and social outcomes.9 Young people leaving care in the UK are five times more likely to attempt suicide than their peers.10 They are also more likely to enter the criminal justice system. 23% of adult prisoners have been in care, and 40% of prisoners under 21.11 Research by Loughborough University and the NSPCC suggested that the consequences of a lack of support for looked-after children’s mental health and well-being can be more expensive than investing in specialist services.12 Their analysis showed that:

One child’s unstable and unsupported experience of care cost £22,415 more per year (including health, social care and criminal justice costs) than another child’s stable and well supported care journey.13

Our inquiry

4.The work of the Health Committee, and subsequent Government commitments on mental health prompted us to conduct an inquiry focusing specifically on looked-after children.

5.We launched our inquiry on 18 September 2015 with a call for written evidence in respect of the following issues:

6.We received 58 written submissions during our inquiry including written evidence submitted jointly by DfE and DH. We took oral evidence on three occasions, including from Rt Hon Alistair Burt MP, Minister of State for Community and Social Care, and Edward Timpson MP, Minister of State for Children and Families. We also held an informal, private meeting with a group of young people in care and care leavers.14 We are grateful to the NSPCC and The Who Cares? Trust for helping us organise this session and to the young people who attended. In January 2016 we visited Trafford Metropolitan Borough Council as an example of an integrated service for looked-after children. We are grateful to the staff there for accommodating us, and to all whom we met.

7.During the inquiry we benefited from the advice of Professor David Berridge OBE and Marion Davis CBE as our standing advisers on children’s services, as well as Dr Matt Woolgar, a Consultant Clinical Psychologist, who acted as a specialist adviser for this inquiry.15

2 Office of National Statistics, Mental health of children and young people in Great Britain, 2004 (August 2005), p xxi

3 “CAMHS is used as a term for all services that work with children and young people who have difficulties with their emotional or behavioural well-being. Local areas have a number of different support services available. These might be from the statutory, voluntary or school-based sector, such as an NHS trust, local authority, school or charitable organisation”. NHS Choices, ‘Child and adolescent mental health services (CAMHS)’, accessed 6 April 2016

4 Health Committee, Third Report of Session 2014-15, Children’s and adolescents’ mental health and CAMHS, HC 342, p 3

5 Department for Education and Department of Health, Promoting the health and well-being of looked-after children, March 2015

6 Department of Health and NHS England, Future in Mind, March 2015

7 Independent Mental Health Taskforce, The Five Year Forward View for Mental Health (February 2016)

8 Youth Select Committee, Young People’s Mental Health (November 2016), p 6. The Youth Select Committee is a British Youth Council initiative, supported by the House of Commons. The eleven committee members are aged 13-18 and include two Members of the UK Youth Parliament, two youth councillors, a Young Mayor, one elected representative from each of the devolved nations and three reserved seats.

9 Essex County Council (MHW 25) para 1.5

10 Children and Young People’s Health Outcomes Forum, Report of the Children and Young People’s Health Outcomes Forum- Mental Health Sub-Group (July 2012), p 2

11 The Who Cares? Trust, ‘The statistics’, accessed 6 April 2016

14 See Annex 1 for further details.

15 Professor David Berridge, Professor of Child and Family Welfare, University of Bristol, declared interests as a member of the Bristol City Council Corporate Parenting Panel, research grants from DfE, research councils, trusts, voluntary organisations and others. He declared his involvement at the University of Bristol in educating and training qualifying and advanced social work, and other, students. Marion Davis declared interests as a Trustee of Children and Families across Borders (CFAB), a member of the Improvement Board for Children’s Services in Northamptonshire County Council, an external adviser to the Safeguarding Board of Northern Ireland in respect of a thematic review of Child Sexual Exploitation, and author of a Serious Case Review for Sutton local safeguarding children board. Dr Matt Woolgar declared interests as an employee of the National Adoption and Fostering Service at the Maudsley Hospital, SLAM NHS Foundation Trust, and co-author of the Fostering Changes programme. He declared funding from National Institute for Health Research and the Children and Young People’s Improving Access to Psychological Therapies Programme.

© Parliamentary copyright 2015

Prepared 27 April 2016