The mental health.pdf

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IntroductionThis bulletin looks at how residential care homes, residential specialschools and secure accommodation services make sure that childrenand young people who are looked after away from home enjoy goodmental health. It is based on information we gathered during ourinspection, investigation and enforcement activities during 2007-08. Ithighlights what needs to be done to improve practices in these services intwo ways.• It provides information about what we have learnt from regulating and inspectingchildren’s and young people’s care homes, residential special schools and secureaccommodation services between April 2007 and March 2008.• It shares the main lessons on what needs to be done to improve practice inresidential settings and to promote healthy choices for Scotland’s children andyoung people.Who we are and what we doThe Care Commission was set up in 2002 to help improve care services in Scotland. Weregister and inspect around 15,000 services that care for more than 320,000 people in allparts of Scotland. These services include childminders, foster care and adoption services,nurseries, daycare services, care homes and private hospitals.As Scotland’s national care regulator, we register and inspect services, investigate complaintsand, where necessary, take legal action to make sure a service is meeting the standard ofcare it should be. We publish our findings in inspection reports to encourage services toimprove the quality of the care they provide.We also publish reports that give a national picture of the availability and quality of careservices.What this bulletin is aboutThis bulletin looks at the quality of service provided to children and young people who arelooked after away from home in residential services with a particular focus on their mentalhealth and well being. It is based on our work with the following services:• care homes• residential special schools• secure accommodation services.2
Why we have published this bulletinScottish Ministers have set a broad vision of expectations and aspirations for young people;namely that they are safe, nurtured, healthy, achieving, active, respected, responsible andincluded. Despite the adverse factors in the backgrounds of children and young peoplewho are looked after away from home and, the breakdowns of placement and school, thecurrent general health of these children and young people is good and this seems to improveas placements become more stable. There is, however, a high incidence of mental healthproblems, including conduct disorders. This is made worse by experience of poor parenting,trauma, bereavement or serious illness, including mental health problems in one or bothparents. The environment, deprivation and poverty also have an effect on the mental healthof children and young people. As a result, The Action Framework for Children and YoungPeople (Scottish Government 2007) 1 indicates that 40% of children and young peoplein care will have mental or emotional health problems and this is significantly higher than forthose who are not looked after. It also recognises that they are less likely than their peersto engage with health services, partly as a consequence of disruptive early family lives andsometimes due to being moved frequently when in care.There have been a number of publications which support the Ministers’ vision and whichrelate to this bulletin and its findings. In particular, Extraordinary Lives 2 highlights theimportance of creating ‘emotional warmth’ for children and young people who are lookedafter away from home and The Health of Looked After and Accommodated Childrenand Young People in Scotland 3 noted that research on the mental health of this group hasshown that they are doing less well than their peers and that a particularly vulnerable group isthose young people, still in their teens who leave care and move toindependent living. Better Health, Better Care (ScottishGovernment, 2007) 4 recognised the health needs ofchildren and young people who are lookedafter away from home and included acommitment to addressing these.The Mental Health of Children andYoung People: A Framework forPromotion, Prevention and Care(Scottish Executive, 2005) 5 setsout ways for local agencies towork together towards themental health and well being ofall children and young people.1The Action Framework for Children and YoungPeople Scottish Government 2007.2Extraordinary Lives, SWIA 2006.3The health of looked after and accommodated children andyoung people in Scotland, SWIA 2006.4Better Health, Better Care, Scottish Government, 2007.5The Mental Health of Children and Young People: A Framework forPromotion, Prevention and Care, Scottish Executive, 2005.3
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