It is well established that looked after children have high levels of health needs that are not usually met by existing services. Lisa Anderson, Panos Vostanis and Nick Spencer report on a study which aimed to establish the perceptions of health needs among children aged 6–12 years and their foster carers. Fifty-six children and their carers from two local authorities completed a health checklist, the Health of the Nation Outcome Scales for Children and Adolescents and the Strengths and Difficulties Questionnaire. Despite their young age, children were broadly aware of what constitutes and promotes good health. In contrast, they gave a range of definitions of mental illness. Children were reported to be registered with general practitioners and to be up to date with immunisations, while their contacts with primary and specialist health services were related to a variety of relatively minor problems. High levels of mental health issues were established among this group, which were significantly associated with recent admission to public care and short-term placements. The findings are discussed in the context of guidelines on the health assessment of looked after children and the need for development of accessible and designated mental health services.
AndersonLVostanisPSpencerN, Perceptions of Mental Illness Among Youth Offending Teams Attenders, Leicester: Leicester University, 2002.
2.
ArcelusJBellerbyTVostanisP, ‘A mental health service for young people in the care of the local authority’, Clinical Child Psychology and Psychiatry4, pp 1359–045, 1999.
3.
ArmstrongCHillMSeckerJ, ‘Young people's perception of mental health’, Children & Society14, pp 60–72, 2000.
4.
BarberJDelfabbroPCooperL, ‘The predictors of unsuccessful transitions to foster care’, Journal of Child Psychiatry & Psychology42, pp 785–90, 2001.
5.
BebbingtonAMilesJ, ‘The background of children who enter local authority care’, British Journal of Social Work19, pp 349–68, 1989.
BroadB, ‘Improving the health of children and young people leaving care’, Adoption & Fostering23: 1, pp 40–8, 1999.
8.
BundleA, ‘Health of teenagers in residential care: Comparison of data held by care staff with data in community child health records’, Archives of Disease in Childhood84, pp 10–4, 2001.
9.
BundleA, ‘Health information and teenagers in residential care’, Adoption & Fostering26: 4, pp 19–25, 2002.
10.
ButlerIPayneH, ‘The health of children looked after by the local authority’, Adoption & Fostering21: 2, pp 28–35, 1997.
11.
ButlerJVostanisP, ‘Characteristics of referrals to a mental health service for young people in care’, Psychiatric Bulletin22, pp 85–7, 1998.
12.
CainCBarthR, ‘Health beliefs and practices of foster parents’, Social Work in Healthcare15, pp 49–61, 1990.
13.
CallaghanJYoungBPaceFVostanisP, ‘Evaluation of a new mental health service for looked after children’, Clinical Child Psychology and Psychiatry9, pp 130–48, 2004.
14.
CarpenterE, ‘Children's health care and the changing role of the woman’, Medical Care18, pp 1208–218, 1980.
15.
Department for Education and Skills, Every Child Matters, Green Paper, London: DfES, 2003.
16.
Department of Health, The Quality Protects Programme: Transforming children's services, London: HMSO, 1998.
17.
Department of Health, Promoting Health for Looked After Children: A guide to healthcare planning, assessment and monitoring, Consultation Document, London: HMSO, 1999.
18.
Department of Health, External Working Group, Getting the Right Start: The national service framework for children, young people and maternity services, London: DH, 2003.
19.
DimigenGDel PrioreCButlerSEvansSFergusonL, ‘Psychiatric disorder among children at the time of entering local authority care: Questionnaire survey’, British Medical Journal319, pp 675–75, 1999.
20.
EnsignJ, ‘The health of shelter-based foster youth’, Public Health Nursing18, pp 19–23, 2001.
21.
GoodmanR, ‘Psychometric properties of the Strengths and Difficulties Questionnaire’, Journal of the American Academy of Child and Adolescent Psychiatry40, pp 1337–45, 2001.
22.
GoodmanRMeltzerHBaileyV, ‘The Strengths and Difficulties Questionnaire’, European Child and Adolescent Psychiatry7, pp 125–30, 1998.
23.
GoodmanRFordTSimmonsHGatwardRMeltzerH, ‘Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample’, British Journal of Psychiatry177, pp 534–39, 2000.
24.
GowersSHarringtonRWhittonALelliottPBeevorAWingJJezzardR, ‘Brief scale for measuring the outcomes of emotional and behavioural disorders in children: Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA)’, British Journal of Psychiatry174, pp 413–16, 1999a.
25.
GowersSHarringtonRWhittonABeevorALelliottPJezzardRWingJ, ‘Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA): Glossary for HoNOSCA score sheet’, British Journal of Psychiatry174, pp 428–31, 1999b.
26.
HarmanJChildsEKelleherK, ‘Mental health care utilisation and expenditures by children in foster care’, Archives of Paediatrics and Adolescent Medicine154, pp 1114–17, 2000.
27.
HatfieldBHarringtonRMohamadH, ‘Staff looking after children in local authority residential units: The interface with child mental health professionals’, Journal of Adolescence19, pp 127–39, 1996.
28.
HillCMatherM, ‘Achieving health for children in public care’, British Medical Journal326, pp 560–61, 2003.
29.
HillCWrightVSampeysCDunnettKDanielSO'DellLWatkinsJ, ‘The emerging role of the specialist nurse: Promoting the health of looked after children’, Adoption & Fostering26: 4, pp 35–43, 2002.
30.
McCannJJamesAWilsonSDunnG, ‘Prevalence of psychiatric disorders in young people in the care system’, British Medical Journal313, pp 1529–30, 1996.
MinnisHDevineC, ‘The effect of foster carer training on the emotional and behavioural functioning of looked after children’, Adoption & Fostering25, pp 44–54, 2001.
33.
MinnisHPelosiAKnappMDunnJ, ‘Mental health and foster carer training’, Archives of Disease in Childhood84, pp 302–06, 2001.
34.
MintyB, ‘Outcomes in long term family foster care’, Journal of Child Psychology & Psychiatry40, pp 991–99, 1999.
35.
MunroE, ‘Empowering looked after children’, Child & Family Social Work6, pp 129–37, 2001.
36.
National Lottery Charities Board, Improving the Health of Socially Excluded Young People, London: The Children's Society, 1998.
37.
ParkerKForestD, ‘Attachment disorder: An emerging concern for school counsellors’, Elementary School Guidance and Counselling27, pp 209–15, 1993.
38.
PayneH, ‘The health of children in public care’, Current Opinion in Psychiatry13, pp 381–88, 2000.
39.
PhillipsJ, ‘Meeting the psychiatric needs of children in foster care’, Psychiatric Bulletin21, pp 609–11, 1997.
40.
PolnayLGaserAVidyaR, ‘Better health for children in resident care’, Archives of Disease in Childhood75, pp 263–65, 1996.
41.
RichardsonJJoughinC, The Mental Health Needs of Looked After Children, London: Gaskell, 2000.
42.
RushforthH, ‘Nurses' knowledge of how children view health and illness’, Pediatric Nursing8, pp 23–27, 1996.
43.
SaundersLBroadB, The Health Needs of Young People Leaving Care, Leicester: DeMontfort University, 1997.
44.
SimsMHalfonN, ‘The healthcare needs of children in foster care: A research agenda’, Child Welfare73, pp 505–24, 1994.
45.
SpencerNCoeC, ‘Validation of the Warwick Child Health and Morbidity Profile in routine child health surveillance’, Child: Care, Health and Development26, pp 323–36, 2000.
46.
StreetEDaviesM, ‘Constructing mental health services for looked after children’, Adoption & Fostering26: 4, pp 65–75, 2002.
47.
ThompsonRAuthierKRumaP, ‘Behaviour problems of sexually abused children in foster care’, Journal of Child Sexual Abuse3, pp 79–91, 1994.
48.
VesseyJBraithwaiteKWiedemannM, ‘Teaching children about their internal bodies’, Pediatric Nursing16, pp 29–33, 1990.
49.
WardHJonesHLynchMSkuseT, ‘Issues concerning the health of looked after children’, Adoption & Fostering26: 4, pp 8–18, 2002.
50.
WebberI, ‘Reaction of the child and family to illness and hospitalisation’, in CampbellSGlasperA (eds), Whaley and Wong's Children's Nursing, London: Mosby, 1995.
51.
WilliamsJJacksonSMaddocksACheungWYLoveAHutchingsH, ‘Case-control study of the health of those looked after by local authorities’, Archives of Disease in Childhood85, pp 280–85, 2001.
