Provision of mental health services for care leavers: transition to adult service

The Children (Leaving Care) Act 2000 (CLCA) came into force in October 2001. Amongst other things, it was designed to address the wide variation in local authority provision for care leavers. The Act was in line with the objectives of Quality Protects (Department of Health, 1998). This stated that young people in care must derive maximum life chance benefits from education, health and social care, and aimed to ensure that those leaving care participate socially and economically, and are not isolated in society (Cameron et al., 2007). The Act also sought to promote a more ‘holistic’ or multi-dimensional approach to the process of leaving care and emphasised the corporate parenting responsibilities of local authorities.

Local authorities are therefore likely to have implemented a number of changes to their provision for care leavers. Indeed, the Every Child Matters Agenda (ECM) (2003) and the Children Act (2004) will have facilitated any service developments arising from the CLCA 2000. Research has begun to explore how useful care leavers find health, education, housing and other services. Interestingly, research by Cameron et al. (2007) revealed a high level of need for health services, particularly mental health services, but that provision for these needs was not well developed. However, research conducted more recently has suggested that, post CLCA 2000, there have been tentative improvements in services for care leavers (Harris and Broad, 2005) and that proactive links with health are being developed.

A review of how health services, particularly mental health services, are coordinated and provided for care leavers is therefore timely. Additionally, research into the contribution of voluntary services in supporting care leavers will complement and build upon earlier research.

Research questions

The overall aim of the research is to examine the extent to which developments since the Children (Leaving Care) Act (2000) have improved outcomes for young people leaving care, particularly those with mental health issues. In particular, the research is designed to:

• examine the coordination and availability of services to support care leavers with mental health needs
• explore how outcomes are measured for young people leaving care, particularly regarding mental health
• explore the views of both services users and providers towards the services available and their perceived outcomes
• examine the coordination and contribution of services for care leavers offered by voluntary organisations.

Impact and outcomes

A final report will be produced by the end of February, 2009. Short summaries of the research will be written for local authority staff and for health practitioners in primary care trusts (PCTs). On completion of the research, four regional workshops for practitioners and decision makers in local authorities and PCTs will be held to share key findings.

Research design and methods

The research will use a case-study approach. Three local authorities will be invited to participate. These will be selected through analysis of local authority documents, to include their 2007 Children and Young People’s Plan (CYPP), their Annual Performance Assessment (APA), and Ofsted reports. The key contact in each local authority (for example, a member of the leaving care team) will be asked to identify four care leavers for inclusion in the research. These will ideally be young people who have left care within the last year and who have recognised mental health needs.

A researcher will spend two one-day visits in each local authority, during which the following will take place:

• During visit one, audit trails will be explored for each of the four care leavers in focus. Their individual care records/plans will be used in conjunction with an audit template to record the service provision around each individual care leaver.
• During visit two, thirty minute interviews will take place with each of the case study care leavers, in which the services accessed since leaving care will be examined, as will the levels of support experienced, satisfaction with services, reasons for or against accessing services, and additional support required.
• Also during visit two, or over the telephone at a more convenient time, thirty minute interviews will be carried out with up to four service providers for each case-study care leaver. Emphasis will be placed on securing interviews with providers from both statutory and voluntary services to support young people’s mental health at both low and high levels. Interviews will explore the nature of the service provided, outcomes data, level of integration with other services and difficulties in providing the service for care leavers.

Audience(s)

The research will be of interest to local authority staff across a range of services, but particularly those working within health, and in services to support looked after children. It will also appeal to practitioners in PCTs, specifically those concerned with support for young people’s mental health.

Time scale

July 2008 - February 2009

References

Cameron, C., Bennert, K., Simon, A. and Wigfall, V. (2007). Using Health, Education, Housing and Other Services: a Study of Care Leavers and Young People in Difficulty (DCSF Research Brief). London: DCSF.

Department of Health (1998). Quality Protects [online]. Available:
http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/LocalAuthorityCirculars/AllLocalAuthority/DH_4004387 [29 July, 2008]

Harris, J. and Broad, B. (2005). In My Own Time: Achieving Positive Outcomes for Young People Leaving Care (CFRU Monograph No. 6). Leicester: DeMontford University.