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Care system not to blame for children being more at risk of mental health issues

Being in care is not the only reason why 'looked after' children are more likely to have mental health difficulties than others in the wider population, according to new research from the University of York. 

The study, led by Professor Nina Biehal and funded by the Economic and Social Research Council (ESRC), suggests that mental health issues can also be down to a child’s treatment before they entered local authority care. 

"Our study shows that mental health issues in young children, who are looked after due to abuse and neglect, are likely to be at least partly due to their experiences before entering care. They are not solely a result of the time they spend being looked after," said Professor Biehal.

The study analysed the mental health of nearly 400 children who had either been in foster care or supported at home on a child protection plan but had never been in care. All were aged under 10 years old and had experienced abuse or neglect, or were at high risk of these forms of harm in a minority of cases. 

More than a third (34%) of those who had ever been in care were assessed as having emotional and behavioural difficulties. This compares with the one in ten (10%) children in the general population who have difficulties of this kind. 

The study found that the experience of being in care is not the main reason why looked after children have these difficulties. More than a quarter (26%) of those exposed to abuse or neglect who had not entered care were also assessed as having emotional and behavioural issues.  

The children who had previously experienced more types of abuse or neglect were more likely to be showing signs of mental health problems. This is compared to those who had experienced fewer types.  

The children were followed up on average four years after they were first referred to social workers. The researchers found that at this point the family context in which the children were living also had a bearing on their mental health. Children were more likely to have emotional or behavioural problems if their current caregivers had mental health difficulties.  

However, children who had a loving relationship with their caregivers were less likely to have these problems. This highlights the vital importance of paying attention to the mental wellbeing of those who look after vulnerable young people, says Professor Biehal. The quality of relationships these children experience, as well as those living with their families, should also be monitored she says. 

Further information

Notes for editors

  1. This release is based on the findings from the ‘Outcomes for Maltreated Children’ study funded by the Economic and Social Research Council and carried out by Nina Biehal and colleagues Helen Baldwin, Linda Cusworth and Jim Wade at the University of York’s Department of Social Policy and Social Work.
  2. Methodology: The project involved data from 390 children. A total of 216 were either in care or had been at some stage because of maltreatment (the care group), and 174 were on a child protection plan but had never been in care (the home group). The average age of the children was six years when the researchers interviewed them or their parents. Children’s mental health was measured using the Strengths and Difficulties Questionnaire (SDQ), which was administered with children’s parents or foster carers, according to where they were living at the time of follow-up. Data on their histories was collected via a survey of their social workers. A standardised measure of maltreatment was used, the Modified Maltreatment Classification System (MMCS).
  3. The Economic and Social Research Council (ESRC) is the UK’s largest funder of research on the social and economic questions facing us today. It supports the development and training of the UK’s future social scientists and also funds major studies that provide the infrastructure for research. ESRC-funded research informs policymakers and practitioners and helps make businesses, voluntary bodies and other organisations more effective. The ESRC also works collaboratively with six other UK research councils and Innovate UK to fund cross-disciplinary research and innovation addressing major societal challenges. The ESRC is an independent organisation, established by Royal Charter in 1965, and funded mainly by the Government.


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