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

7The participation of looked-after children in decision making

Incorporating the views of looked-after children into decision making

92.The Government’s statutory guidance recommends that CCGs and local authorities should “take into account the views of looked-after children, their parents and carers, to inform, influence and shape service provision, including through Children in Care Councils and local Healthwatch where they are undertaking work in this area”.117

93.The importance of playing a “meaningful part” in decisions was reinforced in evidence from YoungMinds:

Our own experience has demonstrated that children must play a meaningful part in decisions making, which is also reflected in the new statutory guidance. […] It is essential to young people’s psychological and emotional development and significantly contributes to building the resilience they will need for the remainder of their childhood and adult lives.118

94.Lisa Harker told us that children and young people need to “have a voice through the whole process”.119 Ms Harker added that mental health professionals should focus on working from problems to solutions together with the children concerned, rather than making interventions “which see the child as the subject of that intervention”.120 Ofsted advised that based on their inspection findings local authorities could do more “to maximise opportunities to gather and learn extensively from the views of looked-after children, care leavers and their carers when designing and evaluating the impact of services”.121 They commented that Children in Care councils often fail to be representative of those in care and care leavers and are too frequently used as the only source of engagement. Ofsted argued that Independent Reviewing Officers (IROs) are in a “unique” position to take a leading role in listening to the views of children and young people.122

Private session with looked-after children and young people

95.During our private session in November 2015, several of the young people spoke about feeling that they didn’t know why decisions were being made. One care leaver told us that they felt they did not have a voice and could not understand “what was going on”.123 These feelings of isolation were most acute when they had moved foster placement and were given little explanation for the move or opportunity to decide where their next placement would be. One young person told us that it was out of their control who looked-after them and for how long.124

96.Several of the young people we met said that this failure to communicate could make the success of a placement less likely and led to problems with their emotional and mental health. One young person told us that isolation and not having someone to trust could have an enormous impact on mental health.125 The Care Leavers Association said:

Involving young people in the design of services is key. It is their life. They must have a voice and a sense of ownership. The CLA is a user- led charity and fully promotes the user led approach. We can see success when a care leaver finds their voice and becomes fully engaged in all the decisions that are happening to them.126

97.These sentiments are echoed in recommendation 13 of the NICE guidance, which says:

When making decisions about moving children or young people from existing placements: fully take into account the wishes and feelings of a child or young person.127

98.All looked-after children should play a meaningful part in the decisions made about their mental health care. They should also be empowered to have a more active role in decisions about their placements to increase the likelihood that they will be stable and successful.



118 YoungMinds (MHW 71) para 18

119 Q36

120 Q36

121 Ofsted (MHW 64) para 7.2

122 Ofsted (MHW 64) para 7.3

123 See Annex 1 for further details.

124 See Annex 1 for further details.

125 See Annex 1 for further details.

126 Care Leavers Association (MHW 55) para 6




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Prepared 27 April 2016