Introduction

Please find information regarding three projects related to looked after children and young people:

Mental Health Care Needs Assessment of Looked After Children in Residential Special Schools, Care Homes and Secure Care (2011)

Project Background

The Directors of Public Health of NHS Boards requested ScotPHN to undertake a health care needs assessment of young people in residential care and specifically the mental health care needs of such looked after young people.

All Local Authorities have a significant number of children and young people accommodated in residential care. Often these are in the private sector and many are out of area or even out of Scotland.

Anecdotal evidence across Scotland suggested that the health care received by these children and young people is highly variable and there is evidence of inequity. In particular, the problems of providing Children and Adolescent Mental Health (CAMH) input to residential care has been long running and affects several, if not the majority, of NHS Boards. There should be a more rational approach to this provision which would allow NHS CAMH services to plan and provide a better level of mental health support.

Policies to address these issues are being put in place, for example embedding the Getting it Right For Every Child (GIRFEC) approach in meeting all children’s needs is a priority.

More specifically, “Looked After Children & Young People: We can and Must Do Better (Jan 2007)” recommends that each NHS Board will assess the physical, mental and emotional health needs of all looked after children and young people for whom they have responsibility and put in place appropriate measures which take account of these assessments. Further recommendations are laid out in CEL 16 (2009) requiring each NHS Board to nominate a Board Director to take a corporate responsibility for looked after children and young people. Appropriate care plans are to be delivered and co-ordinated with annual reporting to the Scottish Government on the health outcomes of the assessments.

The financing of these services is complex, for example there are cross boundary issues, both geographical and between service providers, children and young people may be moved an number of times between different types of accommodation.

Definitions:

Residential Care: The steering group has agreed to use the definition for residential care used by the Care Commission.

Children: Children of all ages up to 21 years cared for in this accommodation.

Mental health: The project will investigate mental health needs in their broadest sense. To include those with learning disabilities, substance misuse problems as well as forensic mental health.

This area is a significant contributor to both current and potential future health inequalities. It is hoped that by concentrating initially on a specific assessment of the mental health needs of looked after children in residential schools there will be lessons learned to help tackle the wider problems experienced by this vulnerable population.

Aim of Project

• To clarify and set the context of this work.
• To investigate and map the policy context and the work currently taking place in this area and how it links with that of public health departments.
• To identify the level of need and map current service provision.
• To identify the inequalities resulting from current service provision.

Lead Author

Dr Maggie Lachlan, Consultant in Public Health Medicine – NHS Greater Glasgow and Clyde.

Steering Group

Anne Maree Wallace – Director of Public Health (Chair and project sponsor)

Moray Paterson – Looked After Children Policy Manager -Scottish Government

Jane Park -Clinical Specialist – NHS Highland

Judith Furnivall – Lecturer, Advice and Consultancy -Scottish Institute for Residential Child Care

Lawrie Davidson – Regional Manager – Care Commission

Elaine Samson -Policy and Research Analyst – Care Commission

Phil Mackie – Lead Consultant – ScotPHN

Ann Conacher – Network Coordinator – ScotPHN

Nick Putnam – Health Improvement Specialist – NHS Fife

Lorna Watson – Consultant Public Health Medicine -NHS Fife

Andrew Fraser – Director of Health and Care SPS

Bryan Livingston – Development Manager, Children’s Services – Care Commission

Deirdre McCormick – Nursing Officer for Children, Vulnerable Families and Early Years – Scottish Government

Lisa Tyrrell – Senior Administrator – ScotPHN

Looked After Children in Glasgow and Scotland: A Health Needs Assessment (2013)

Further to the mental health needs assessment of looked after children in residential settings, NHS Greater Glasgow & Clyde and the Glasgow Centre for Population Health have undertaken a health needs assessment of looked after children and young people on behalf of the ScotPHN. This looks at looked after children in Glasgow and Scotland.

The aims of this needs assessment were to:

• establish what local health intelligence systems for looked after children and young people exist across the 14 territorial health boards in Scotland and within Information Services Division (ISD);
• understand the limits of what we can currently say about the health of looked after children and young people from recent academic and grey literature, accessible data sources and expert opinion; and
• make recommendations on what health outcome and contextual indicators it would be useful to measure and how this measurement might be achieved in the future.

Members of the Steering Group:

Guidance for the Scottish Directors of Public Health (2014)

Further to the two needs assessment reports John O’Dowd, Consultant in Public Health Medicine, produced guidance for the SDsPH.

All reports can be found in ‘Related Documents’.

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