Looked after or overlooked? An exploratory investigation of the mentalhealth issues of adolescents living in state care in Northern Ireland

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Abstract

There is consistent evidence that the rate of emotional, social and behavioural problems found in children and adolescents in out-of-home placements or state care is substantially higher than that of children and adolescents living with their families. However, with a few small-scale studies as exceptions, to date there has been little research carried out into the mental health needs of adolescents living in state care in Northern Ireland. This study aimed to examine the mental health needs of young people aged between 10 and 15 years living in state care in Northern Ireland. Data were collected on 165 adolescents via an analysis of case file data, questionnaires and interviews with social workers. It was found that the 70.3% of the young people scored within the abnormal and borderline ranges of the Strengths and Difficulties Questionnaire (SDQ) total difficulties score indicating “high risk” for meeting the criteria for a psychiatric diagnosis. Over the course of 1 year living in state care, 10 of the 165 adolescents had attempted suicide and 14 had engaged in deliberate self-harm. Nevertheless, social workers still rated the vast majority (92%) of these young people's overall health as being “as good as”, or “better than” other young people in their age. It is concluded that as this group of young people have significant contact with health and social services, potential opportunities exist to develop the therapeutic potential of the experience of being “looked after” in state care. They are a uniquely vulnerable group and their care and treatment may be considered as a minority rights issue which deserves a higher profile in the human rights agenda.
LanguageEnglish
Pages497 -506
JournalPsychology, Health and Medicine
Volume5
Issue number15
DOIs
Publication statusPublished - Oct 2010

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adolescent
social worker
mental health
minority rights
questionnaire
mobile social services
suicide
health service
human rights
Group
contact
interview
health
evidence
experience

Keywords

  • adolescents
  • mental health
  • state care
  • Northern Ireland
  • children’s rights

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@article{e3c5ddc712334234a610ea27a67c2428,
title = "Looked after or overlooked? An exploratory investigation of the mentalhealth issues of adolescents living in state care in Northern Ireland",
abstract = "There is consistent evidence that the rate of emotional, social and behavioural problems found in children and adolescents in out-of-home placements or state care is substantially higher than that of children and adolescents living with their families. However, with a few small-scale studies as exceptions, to date there has been little research carried out into the mental health needs of adolescents living in state care in Northern Ireland. This study aimed to examine the mental health needs of young people aged between 10 and 15 years living in state care in Northern Ireland. Data were collected on 165 adolescents via an analysis of case file data, questionnaires and interviews with social workers. It was found that the 70.3{\%} of the young people scored within the abnormal and borderline ranges of the Strengths and Difficulties Questionnaire (SDQ) total difficulties score indicating “high risk” for meeting the criteria for a psychiatric diagnosis. Over the course of 1 year living in state care, 10 of the 165 adolescents had attempted suicide and 14 had engaged in deliberate self-harm. Nevertheless, social workers still rated the vast majority (92{\%}) of these young people's overall health as being “as good as”, or “better than” other young people in their age. It is concluded that as this group of young people have significant contact with health and social services, potential opportunities exist to develop the therapeutic potential of the experience of being “looked after” in state care. They are a uniquely vulnerable group and their care and treatment may be considered as a minority rights issue which deserves a higher profile in the human rights agenda.",
keywords = "adolescents, mental health, state care, Northern Ireland, children’s rights",
author = "Wendy Cousins and Laurence Taggart and Sharon Milner",
note = "Reference text: 1. Bamford Review of Mental Health and Learning Disability (Northern Ireland) (2006) Mental health and well-being - A personal, public and political issue. — Retrieved April 12, 2010, from www.rmhldni.gov.uk/pubs/mhp_committee/mhp_committee.pdf 2. Cousins, W. , McGowan, I. and Milner, S. (2008) Self harm and attempted suicide in young people looked after in state care. Journal of Children's and Young People's Nursing 2:2 , pp. 51-53. 3. Cousins, W. and Milner, S. (2006) Children's rights: A cross-border study of adolescent residential care. Irish Journal of Psychology 27:1-2 , pp. 88-96. 4. Department of Health Social Services and Public Safety Northern Ireland (2003) Mental health services. — Retrieved April 12, 2010, from http://www.dhsspsni.gov.uk/he-chapter_7.pdf 5. Department of Health Social Services and Public Safety Northern Ireland (2009) Looked after children. — Retrieved April 12, 2010, from http://www.dhsspsni.gov.uk/statistics_and_research-cib_looked-after-children 6. Dickey, W. C. and Blumberg, S. (2004) Revisiting the factor structure of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 43:9 , pp. 1159-1167. [ pubmed ] [ crossref ] 7. Goodman, R. (1997) The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry and Allied Disciplines 38 , pp. 581-586. [ csa ] [ pubmed ] [ crossref ] 8. Goodman, R. (1999) The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry and Allied Disciplines 40 , pp. 791-799. [ csa ] [ pubmed ] 9. Goodman, R. , Meltzer, H. and Bailey, V. (1998) The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry 7 , pp. 125-130. [ csa ] [ crossref ] 10. Goodman, R. and Scott, S. (1999) Comparing the strengths and difficulties questionnaire and the child behaviour checklist. Is small beautiful?. Journal of Child Psychology and Psychiatry and Allied Disciplines 40 , pp. 17-24. 11. Kelleher, C. C. (2003) Mental health and “the Troubles” in Northern Ireland: Implications of civil unrest for health and wellbeing. Journal of Epidemiology and Community Health 57 , pp. 474-475. [ csa ] [ pubmed ] [ crossref ] 12. Lindsay, M. J. (2003) Towards a theory of “careism”: Discrimination against young people in care. Children's rights in residential care The Centre for Residential Childcare , Glasgow 13. Mathai, J. , Anderson, P. and Bourne, A. (2003) Use of the strengths and difficulties questionnaire as an outcome measure in a child and adolescent mental health service. Australasian Psychiatry 11 , pp. 334-337. [informaworld] 14. Mellor, D. and Strokes, M. (2007) The factor structure of the strengths and difficulties questionnaire. European Journal of Psychological Assessment 23:2 , pp. 105-112. [ crossref ] 15. Meltzer, G. , Corbin, T. , Gatward, R. , Goodman, R. and Ford, T. (2003) The mental health of young people looked after by local authorities in England: Summary report The Stationery Office , London 16. Meltzer, H. , Gatward, R. , Goodman, R. and Ford, F. (2000) Mental health of children and adolescents in Great Britain The Stationery Office , London 17. Mullan, C. , Rollock, F. , McAlister, S. and Fitzsimons, L. (2007) “Don't be so formal, I'm normal”: A research report on the mental health of looked after children/care leavers in Northern Ireland VOYPIC , Belfast 18. Northern Ireland Commissioner for Children and Young People (2006) NICCY calls for action on mental health services. — Retrieved April 12, 2010, from http://www.4ni.co.uk/news.asp?id=53816 19. Orbell, S. , Trew, K. and McWhirter, L. (1990) Mental illness in Northern Ireland; A comparison with Scotland and England. Social Psychiatry and Psychiatric Epidemiology 25 , pp. 165-169. [ pubmed ] 20. O'Reilly, D. and Stevenson, O. (2003) Mental health in Northern Ireland: Have “the Troubles” made it worse?. Journal of Epidemiology and Community Health 57 , pp. 488-492. [ csa ] [ pubmed ] [ crossref ] 21. Pecora, P. J. , White, C. R. , Jackson, L. J. and Wiggins, T. (2009) Mental health of current and former recipients of foster care: A review of recent studies in the USA. Child and Family Social Work 14 , pp. 132-146. [ crossref ] 22. Rutter, M. (2000) Children in substitute care: Some conceptual considerations and research implications. Children and Youth Services Review 22:9/10 , pp. 685-703. [ crossref ] 23. Taggart, L. , Cousins, W. and Milner, S. (2007) Young people with learning disabilities living in state care: Their emotional, behavioural and mental health status. Child Care in Practice 13:4 , pp. 401-416. [informaworld] 24. Teggart, T. and Linden, M. A. (2006) Investigating service users' and carers' views of child and adolescent mental health services in Northern Ireland. Child Care in Practice 12:1 , pp. 27-41. [informaworld] 25. Teggart, T. and Menary, J. (2005) An investigation of the mental health needs of children looked after by Craigavon and Banbridge health and social services trust. Child Care in Practice 11:1 , pp. 39-49. [informaworld] 26. United Nations (1989) Convention on the rights of the child. — Retrieved April 12, 2010, from http://www.unicef.org/crc/files/Rights_overview.pdf 27. World Health Organization (1948) Constitution of the World Health Organization.In. Handbook of basic documents 5th ed, WHO , Geneva",
year = "2010",
month = "10",
doi = "10.1080/13548506.2010.487110",
language = "English",
volume = "5",
pages = "497 --506",
journal = "Psychology, Health and Medicine",
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TY - JOUR

T1 - Looked after or overlooked? An exploratory investigation of the mentalhealth issues of adolescents living in state care in Northern Ireland

AU - Cousins, Wendy

AU - Taggart, Laurence

AU - Milner, Sharon

N1 - Reference text: 1. Bamford Review of Mental Health and Learning Disability (Northern Ireland) (2006) Mental health and well-being - A personal, public and political issue. — Retrieved April 12, 2010, from www.rmhldni.gov.uk/pubs/mhp_committee/mhp_committee.pdf 2. Cousins, W. , McGowan, I. and Milner, S. (2008) Self harm and attempted suicide in young people looked after in state care. Journal of Children's and Young People's Nursing 2:2 , pp. 51-53. 3. Cousins, W. and Milner, S. (2006) Children's rights: A cross-border study of adolescent residential care. Irish Journal of Psychology 27:1-2 , pp. 88-96. 4. Department of Health Social Services and Public Safety Northern Ireland (2003) Mental health services. — Retrieved April 12, 2010, from http://www.dhsspsni.gov.uk/he-chapter_7.pdf 5. Department of Health Social Services and Public Safety Northern Ireland (2009) Looked after children. — Retrieved April 12, 2010, from http://www.dhsspsni.gov.uk/statistics_and_research-cib_looked-after-children 6. Dickey, W. C. and Blumberg, S. (2004) Revisiting the factor structure of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 43:9 , pp. 1159-1167. [ pubmed ] [ crossref ] 7. Goodman, R. (1997) The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry and Allied Disciplines 38 , pp. 581-586. [ csa ] [ pubmed ] [ crossref ] 8. Goodman, R. (1999) The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry and Allied Disciplines 40 , pp. 791-799. [ csa ] [ pubmed ] 9. Goodman, R. , Meltzer, H. and Bailey, V. (1998) The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry 7 , pp. 125-130. [ csa ] [ crossref ] 10. Goodman, R. and Scott, S. (1999) Comparing the strengths and difficulties questionnaire and the child behaviour checklist. Is small beautiful?. Journal of Child Psychology and Psychiatry and Allied Disciplines 40 , pp. 17-24. 11. Kelleher, C. C. (2003) Mental health and “the Troubles” in Northern Ireland: Implications of civil unrest for health and wellbeing. Journal of Epidemiology and Community Health 57 , pp. 474-475. [ csa ] [ pubmed ] [ crossref ] 12. Lindsay, M. J. (2003) Towards a theory of “careism”: Discrimination against young people in care. Children's rights in residential care The Centre for Residential Childcare , Glasgow 13. Mathai, J. , Anderson, P. and Bourne, A. (2003) Use of the strengths and difficulties questionnaire as an outcome measure in a child and adolescent mental health service. Australasian Psychiatry 11 , pp. 334-337. [informaworld] 14. Mellor, D. and Strokes, M. (2007) The factor structure of the strengths and difficulties questionnaire. European Journal of Psychological Assessment 23:2 , pp. 105-112. [ crossref ] 15. Meltzer, G. , Corbin, T. , Gatward, R. , Goodman, R. and Ford, T. (2003) The mental health of young people looked after by local authorities in England: Summary report The Stationery Office , London 16. Meltzer, H. , Gatward, R. , Goodman, R. and Ford, F. (2000) Mental health of children and adolescents in Great Britain The Stationery Office , London 17. Mullan, C. , Rollock, F. , McAlister, S. and Fitzsimons, L. (2007) “Don't be so formal, I'm normal”: A research report on the mental health of looked after children/care leavers in Northern Ireland VOYPIC , Belfast 18. Northern Ireland Commissioner for Children and Young People (2006) NICCY calls for action on mental health services. — Retrieved April 12, 2010, from http://www.4ni.co.uk/news.asp?id=53816 19. Orbell, S. , Trew, K. and McWhirter, L. (1990) Mental illness in Northern Ireland; A comparison with Scotland and England. Social Psychiatry and Psychiatric Epidemiology 25 , pp. 165-169. [ pubmed ] 20. O'Reilly, D. and Stevenson, O. (2003) Mental health in Northern Ireland: Have “the Troubles” made it worse?. Journal of Epidemiology and Community Health 57 , pp. 488-492. [ csa ] [ pubmed ] [ crossref ] 21. Pecora, P. J. , White, C. R. , Jackson, L. J. and Wiggins, T. (2009) Mental health of current and former recipients of foster care: A review of recent studies in the USA. Child and Family Social Work 14 , pp. 132-146. [ crossref ] 22. Rutter, M. (2000) Children in substitute care: Some conceptual considerations and research implications. Children and Youth Services Review 22:9/10 , pp. 685-703. [ crossref ] 23. Taggart, L. , Cousins, W. and Milner, S. (2007) Young people with learning disabilities living in state care: Their emotional, behavioural and mental health status. Child Care in Practice 13:4 , pp. 401-416. [informaworld] 24. Teggart, T. and Linden, M. A. (2006) Investigating service users' and carers' views of child and adolescent mental health services in Northern Ireland. Child Care in Practice 12:1 , pp. 27-41. [informaworld] 25. Teggart, T. and Menary, J. (2005) An investigation of the mental health needs of children looked after by Craigavon and Banbridge health and social services trust. Child Care in Practice 11:1 , pp. 39-49. [informaworld] 26. United Nations (1989) Convention on the rights of the child. — Retrieved April 12, 2010, from http://www.unicef.org/crc/files/Rights_overview.pdf 27. World Health Organization (1948) Constitution of the World Health Organization.In. Handbook of basic documents 5th ed, WHO , Geneva

PY - 2010/10

Y1 - 2010/10

N2 - There is consistent evidence that the rate of emotional, social and behavioural problems found in children and adolescents in out-of-home placements or state care is substantially higher than that of children and adolescents living with their families. However, with a few small-scale studies as exceptions, to date there has been little research carried out into the mental health needs of adolescents living in state care in Northern Ireland. This study aimed to examine the mental health needs of young people aged between 10 and 15 years living in state care in Northern Ireland. Data were collected on 165 adolescents via an analysis of case file data, questionnaires and interviews with social workers. It was found that the 70.3% of the young people scored within the abnormal and borderline ranges of the Strengths and Difficulties Questionnaire (SDQ) total difficulties score indicating “high risk” for meeting the criteria for a psychiatric diagnosis. Over the course of 1 year living in state care, 10 of the 165 adolescents had attempted suicide and 14 had engaged in deliberate self-harm. Nevertheless, social workers still rated the vast majority (92%) of these young people's overall health as being “as good as”, or “better than” other young people in their age. It is concluded that as this group of young people have significant contact with health and social services, potential opportunities exist to develop the therapeutic potential of the experience of being “looked after” in state care. They are a uniquely vulnerable group and their care and treatment may be considered as a minority rights issue which deserves a higher profile in the human rights agenda.

AB - There is consistent evidence that the rate of emotional, social and behavioural problems found in children and adolescents in out-of-home placements or state care is substantially higher than that of children and adolescents living with their families. However, with a few small-scale studies as exceptions, to date there has been little research carried out into the mental health needs of adolescents living in state care in Northern Ireland. This study aimed to examine the mental health needs of young people aged between 10 and 15 years living in state care in Northern Ireland. Data were collected on 165 adolescents via an analysis of case file data, questionnaires and interviews with social workers. It was found that the 70.3% of the young people scored within the abnormal and borderline ranges of the Strengths and Difficulties Questionnaire (SDQ) total difficulties score indicating “high risk” for meeting the criteria for a psychiatric diagnosis. Over the course of 1 year living in state care, 10 of the 165 adolescents had attempted suicide and 14 had engaged in deliberate self-harm. Nevertheless, social workers still rated the vast majority (92%) of these young people's overall health as being “as good as”, or “better than” other young people in their age. It is concluded that as this group of young people have significant contact with health and social services, potential opportunities exist to develop the therapeutic potential of the experience of being “looked after” in state care. They are a uniquely vulnerable group and their care and treatment may be considered as a minority rights issue which deserves a higher profile in the human rights agenda.

KW - adolescents

KW - mental health

KW - state care

KW - Northern Ireland

KW - children’s rights

U2 - 10.1080/13548506.2010.487110

DO - 10.1080/13548506.2010.487110

M3 - Article

VL - 5

SP - 497

EP - 506

JO - Psychology, Health and Medicine

T2 - Psychology, Health and Medicine

JF - Psychology, Health and Medicine

SN - 1354-8506

IS - 15

ER -