New book: The Children of Looked After Children

This blog post is originally posted at Leicestershire Cares.

A new book by Dr Louise Roberts, ‘The Children of Looked After Children: Outcomes, Experiences and Ensuring Meaningful Support to Young Parents In and Leaving Care’, was released in March 2021. The book brings together the findings of a five-year Children’s Social Care Research and Development Centre (CASCADE) research study that was funded by Health and Care Research Wales.

The book is important, I think it will shock people. Not many people know what it’s like for parents who have grown up in care. It can be so hard to get help. The numbers of children that get taken is shocking. Parents should definitely have more help.
The stigma is shocking. I think I’m like any other parent but I still have that label. I’ve lost count of the times professionals have said ‘because you were in care we need to think about this …’, ‘because you were in care we need to do this…’. I hope this book will help people understand the stigma we face and see how unfair it is.
Everyone who works with children and parents should read it! Social workers, personal advisors, managers, advocates, Welsh Government people, teachers, judges, midwives… everyone. We hope students will read it too as they can help change things for the future.
I really hope parents will read it. The book is good because you get to hear about other parents’ experiences. It can feel like you are the only person going through this and you are on your own. It really helped me when I knew this is a bigger problem. You feel less like a failure and less like a victim. By sharing experiences you realise that you can support each other and help change things. This group came about as part of the research. It would be great if the book helped make this group bigger or started new groups so parents knew they weren’t on their own.
It’s great that the book is free. Everyone likes free stuff and hopefully that will mean more people will read it.

Dr Louise Roberts

The idea for the study came from Voices from Care Cymru (VfCC), an independent organisation dedicated to upholding the rights and promoting welfare of care-experienced children and young people. The book provides some much-needed evidence about children born to young parents in and leaving care and explores the support available when young people become parents.   

Listening to parents’ views and experiences was a key priority of the study. The study included parents with different experiences: some were new parents, others were looking back on their experiences, some felt they had people to support them, others felt isolated and alone, some were living with their children, while others were separated from them. An advisory group of parents supported the study. Work is on-going and parents are currently developing a good practice charter based on the book’s recommendations. To mark the release of the book, we asked the group what they thought about the book and who they hoped would read it.

To find out more about the parents’ support group, please contact Voices from Care Cymru.

Community-based digital maternal and child health

This project is funded by the GCRF Digital Innovation for Development in Africa (DIDA)

About CoMaCH

The Co-Designing Community-based ICTs Interventions for Maternal and Child Health in South Africa (CoMaCH) Network brings together researchers and practitioners from South Africa, the UK, and beyond. We recognize that community members are rarely empowered to voice their own priorities and actively participate in the design of interventions intended to benefit them. We argue for a co-design approach, to radically include community members in the design of not only new approaches to digital Maternal and Child Health in the first 1000 days, but the design of research intended to innovate the new approaches. The aim is to establish new relationships and stimulate novel research and innovation and the network is funded by GCRF Digital Innovation for Development in Africa.

CoMaCH Webinars

There is an incredible amount of innovation happening in the space of digital Maternal and Child Health. This CoMaCH webinar series provides an opportunity to learn more from the experts about what is happening in South Africa and beyond in the area of community-based co-design of ICT interventions for Maternal and Child Health. Do join us.

Save the date and register for the next webinar:

Wed 21 April, 2-3pm SAST | 1-2p BST | 12-1p UTC
Perinatal Mental Health Project on Adjusting and Responding to COVID-19

The Webinar for March “Digitization and the Road to Health Booklet” is now available. 

Care experience & culture: a digital archive

‘Care Experience & Culture, a Digital Archive’ is the first of its kind and will feature care experienced literature, spoken word and academic material

Dr Dee Michell and Miss Rosie Canning are delighted to announce a new digital archive Care Experience & Culture. The website will launch 11th April – via Zoom, which will coincide with Care Experience History Month. Invitations to the launch will include an invitation for people to let us know their favourite care-experienced characters represented in foster care, adoption, kinship care or residential settings. ‘We’d like people to join in and advise us on care experienced literature, film, theatre, television, radio and academic material that can be included.’

Although there are occasional ‘success stories’ in the media about care-experienced people, in the main a single story is told about this group, ie, that they are over-represented in the prison, mental ill-health and homeless populations.

Children and young people in social care, and those who have left, are often subject to stigmatisation and discrimination. Being stigmatised and discriminated against can impact negatively on mental health and wellbeing not only during the care experience but often for many years after too.

The project aims to contribute towards changing community attitudes towards care-experienced people as a group. Instead of only being seen through the current single lens (that they are over-represented in the prison, mental ill-health and homeless populations), they will be seen as a creative group, despite (and/or because of) often experiencing hardship and trauma.

Rosie Canning (UK) and Dee Michell (Australia) are scholars with lived experience of care and a lifelong passion for books. They’ve experienced many benefits from reading as a pastime and are aware of the historical representations of care experience over time. Both are influenced by Lemn Sissay’s Origin Stories and Superman was a Foundling exhibition at The Foundling Museum in London. Rosie and Dee are collaborating to develop a Digital Archive, a one-stop accessible site with information about care-experienced characters in fiction and on-screen, as well as care-experienced writers, artists and actors.

For children and young people in care, and their carers, social workers, teachers, and so on, Care Experience & Culture will provide a significant source of material to which children and young people can be directed for characters they can relate to. As Ryan McCuaig who was in care has said, characters like Harry Potter are for those who’ve left care too. He was in his twenties when a conversation with another care-experienced person about Harry Potter made him realise that he “was already part of something bigger” whereas he’d often struggled with not fitting in.

There are many other care-experienced characters the sector may not be aware of but which will be found in the Digital Archive.

Care Experience & Culture will be a boon to educationalists and researchers too. Researchers could, for example, select characters other than Harry Potter and run research projects to find out how children and young people are affected by them. They can also analyse representations of care experience over time and in different fora.

Jamie Crabb, Psychotherapist and care-experienced, will advise on the design and maintenance of the website. Rosie and Dee, would like to thank the The Welland Trust, a charity founded by Jan Rees OBE in 2019, for the financial contribution they have made which has enabled Care Experience & Culture to be launched.  Sarah Saunders a Trustee from the Welland Trust said “we are proud to support the development of such a creative and exciting project that we believe will be of great benefit to many people”. Welland Trust supports projects and initiatives that benefit adults who have experienced care.

How to find us:
Email: careexperienceandculture@gmail.com
Twitter: @CareExp_Culture
Facebook: Care Experience & Culture
Website: 11th March preview and overview of what will be on offer

Taking Hold of Our Heritage: the digital book

This post was provided by Leicestershire Cares.

This book project gave the narrative power back to care-experienced young people so they can tell the stories they want heard about their lives. Care-experienced young people are often required to talk about their traumatic past to professionals, support services and sometimes their peers. Telling the same stories over and over again can start to imprint on their identity and heritage. Young people in care often move several times which can result in photographs and family keepsakes being misplaced and lost.

This project aimed to encourage care-experienced young people to reflect on positive memories to change the narrative they tell about their lives, and recreate their own heritage artefacts. In this book, care-experienced young people have investigated the complex nature of their identity through this project and produced an archive of artefacts including oral histories, art and photovoice.

The young people have investigated the memories and experiences of Leicestershire’s leaving care community, by looking at themselves, but also interviewing and documenting other care-experienced young people’s lives.

The Taking Back Our Heritage project is funded through the Y Heritage project, Leicester, which is part of the Heritage Lottery Fund’s pioneering “Kick the Dust” funding programme.

The digital book is available for download.

Care review England: wonder and rigour turn despair into hope

This post was originally published by Leicestershire Cares.

Care Review: How wonder and rigour can enable our communities to turn despair into hope

The long awaited review into children’s social care has finally been launched and as might have been expected is already subject to “debate” as various stakeholders seek to ensure their views are listened to and heard. For those with lived experience, this is not a mere academic, exercise. Such discussions can open old and current wounds, exacerbate feelings of neglect, hurt and injustice. Which is why it is so important that the voice of care experienced people has a central role in developing and driving the review.

“Services are old, it needs to change and be consistent with today’s environment. Love and feeling wanted does play a big part and it’s ok not to succeed the first time round. But someone needs to be there to help and pick the child or young person up so they can try again. Money does play a part but commitment is vital. Children and young people should feel a part of the community.” Sara, a care-experienced young woman

“Levelling up our communities: proposals for a new social covenant sets out a vision for a more local, more human, less bureaucratic, less centralised society in which people are supported and empowered to play an active role in their neighbourhoods.” Danny Kruger, MP

“For there is always light, if only we’re brave enough to see it. If only we’re brave enough to be it.” Poet Amanda Gorman

The long awaited review into children’s social care has finally been launched and as might have been expected is already subject to “debate” as various stakeholders seek to ensure their views are listened to and heard. For those with lived experience, this is not a mere academic, exercise. Such discussions can open old and current wounds, exacerbate feelings of neglect, hurt and injustice. Which is why it is so important that the voice of care experienced people has a central role in developing and driving the review.

Yet, we also know as I have written elsewhere, “Over the last 30 years there have been numerous laws, policy reviews, enquiries and working groups all designed to improve the care and transitional support offered to care experienced young people” and sadly despite, all this effort, investment and good intention the system is still far from perfect. In the words of the Children Rights commissioner “The truth is while the state can be a great parent – it can also be a really bad one. In fact, sometimes so negligent that it would risk having its children taken into care if it was an actual parent.” Why is this? What is going so wrong? Why given all the attention and substantial investment does the care system still fail so many vulnerable children and young people?

I would like to suggest that one of the issues, is that often, debates and discussions about the care system get fixated on the way we currently do things. Much of the so called “thinking” about the system is often just a reworking of existing policy and practice. So, you might often hear calls for more participation, a rights-based approach, greater investment, and more social workers. Which might be summarised as saying if only we invested more heavily in what we already do and think, then things would be much better.

There may well be some truth in that, but I would like to suggest that all too often “social services” is based on a top down model of fixing problems. Elsewhere, I have noted “that many bigger organisations have become over bureaucratic and systematised, and tied into following targets and KPI’s and applying agreed procedures. Risk taking is not encouraged and as such there is a tendency to do things the way they have always been done. This often goes hand in hand with top down management structures. In such a set up staff often focus on compliance and not rocking the boat. In addition, there is often relatively few opportunities for the people who are on the receiving end of services to have influence and control over them.”

As Hilary Cottam in her recent book “Radical Help” suggests, 21st century welfare should “start where you are and instead of commanding change or trying to fix you it offers support to grow capability. It includes as many people as possible given that it is our relationships that help us find work, keep healthy and care for one another.” This approach suggests a much more organic, relationship based approach where people become creators rather than just consumers of services and ideas. Do we need to rethink how social services are structured, could we seek to remove red tape, encourage creativity, partnership and decision making at the point of delivery?

When it comes to prevention, the lockdown has clearly shown, that across our communities, business sector and local authorities there is a huge amount of creativity and commitment that is willing to step up and support those in need. Much of this has been powered by creative use of social media. Neighbours who had never really spoken now belong to community WhatsApp and Facebook groups, where they seek to support each other. As the government’s own levelling up agenda suggests, this local knowledge and creativity is a huge asset. If we can build on this goodwill and mobilise it to support families, children and young people it could be a real force for good. In doing so, we will be showing what many people already know, it takes a village to raise a child.

Could we imagine a system of support for at risk and care experienced children which sought to draw much more strongly on these principles. Where we relooked at the skills and experiences that you need to support vulnerable and isolated young people.  Could we imagine, having groups of inspiring, creative, entrepreneurial staff who can easily build relationships with young people, network across business and communities and build partnerships. Might workers like this, offer that spark that young people often need, to see beyond the immediate and turn despair into hope.

Do we also need to work much harder at having an evidence based approach to developing and evaluating services? Do we need to ask questions as to why some councils seem to perform much better than others in similar circumstances? With the commissioning of services now so much part of the job, are we confident that commissioners have the skills and abilities to negotiate good deals, are we confident that providers have the best interest of the children at heart?

Are we confident, that councils and charities are willing and able to take risks, to trial new approaches, knowing that some will fail, or is there a tendency to go with the way it has always been done? Are we confident that there is an institutional commitment to reflection and learning across the statutory and voluntary providers, or is much reporting, a red tape compliant, box ticking exercise? Are we confident that managers across social services, have the skill set so they, can motivate, inspire, deal with under performance and spot and develop talent? Are we confident that local councillors understand what being a corporate parent means and are passionate in their efforts to ensure “their” looked after children get the best support and provision possible?

If we really are going to review children’s services then we do need to step back from “group think” and be prepared to open our minds. This does not mean we do not have our say but does mean we are humble enough to know we all have much to learn from others.

At Leicestershire cares, we believe that creativity, agility, kindness and empathy are the heart and soul of being able to develop, deliver and adapt effective services. In her book “The creativity leap” Natalie Nixon, set out how humans are hard wired to be creative. Inquiry, improvisation and intuition are the building blocks that lead to creativity and these are competencies that can be learnt. Her definition of creativity is the ability to toggle between two different capacities — wonder and rigor. Wonder is the ability to be awed and “ask big audacious questions, and rigour is the realm of “discipline, practice, skill, and honing your technique by spending lots of time on tasks.” Creativity requires analytical rigor, according to Nixon, “and analysis requires a capacity for wonder.”

Surely, we all owe it to our children to look at the care system with wonder and rigour, putting aside, “egos, silos and logos” in the knowledge that none of us have all the answers but all of us have the answers. If we can strive to do this whilst, ensuring the best interest of the child and not our organisations are paramount, then I am confident we can offer our children and young people a far brighter future.

#TogetherWeCan

Kieran Breen has worked in development in Africa, Latin, Central, North America and the UK. He is currently the CEO of Leicestershire Cares and lectures on youth and global issues at De Montfort University.

School meetings: be prepared!

Many foster carers attend meetings with schools as part of their role. The below list is a reflection of all the things that I have found useful over the years, from the meetings I’ve attended. I hope these points will act as a guide and a checklist for other foster carers, and support them in the future, when preparing for a meeting.

  • Write a list of questions you want answered.
  • Ensure you will be speaking to someone who can make things change or implement new ideas (Deputy Head, Assistant Head, Head of Year (minimum)).
  • Ensure you have the contact details of people in the meeting.
  • Take notes at any meetings, who is doing what and by when, and why.
  • Don’t be afraid to speak. If necessary take a deep breath.
  • Ensure your facts are correct, if in doubt say I believe, I was told, I understood.
  • Always chase up actions not completed by the school, and let the school know of results you have.
  • Ensure you action anything you say you are going to do or let someone know why it is not happening.
  • Take social workers along to meetings.
  • Keep your social worker updated.
  • Be prepared to take managers along to meetings.
  • Befriend receptionists – they can often get you in at short notice.
  • Be prepared to acknowledge your child is not always co-operative at school.
  • Sanctions/consequences for actions that happen in school stay in school.
  • Let your child know when you are going to school and why.
  • When incidents have occurred ensure you have all the details. Names, places, actions etc.
  • Be prepared to defend or acknowledge your child’s actions.
  • Be prepared to explain actual age vs emotional age or developmental age.
  • Ensure your logs reflect the meeting accurately.
  • If you don’t understand something, ask. School speak takes some getting used to.
  • Try and foster a good relationship with the school, however, your child comes first and if necessary, sacrifice the relationship for the good of the child.
  • Any child can go to any school by law.
  • Know your rights.

Advice for young people in meetings is also available in the Getting Your Voice Heard in Your Review Meeting guide.

Self harm and foster carers’ role

December’s ExChange workshop was a collaboration between Colin Turner from The Fostering Network, Dr Rhiannon Evans and Stephen Jennings from DECIPHer. The workshop looked at self-harm and suicide amongst care experienced young people. The focus was on the experiences of foster carers and residential workers and the support needed for management and prevention.

The session began with an introduction by Colin Turner, the director in Wales at The Fostering Network. He discussed that The Fostering Network has supported the research and circulated reports they had published on “Emotional and mental health of looked after children in wales”:

“1 in 10 children have a diagnosable mental health disorder. For children looked after it’s 1 in 5. Young people leaving care are 5 times more likely to attempt suicide.”

Colin talked about his role as a foster carer. Having trained as a social worker and spent much of his career in social care, Colin and his wife were inspired by other Foster Carers and adopters to become carers themselves, particularly for children with complex needs:

“I really believed I knew what it was like to be a foster carer,but honestly I didn’t have a clue. There were challengesand difficulties I didn’t see coming.”

Colin discussed his direct experience of fostering young people and children that struggled with self-harm. His talk was emotive and passionate and really highlighted the vital role of Foster Carers. Colin discussed the importance of training and support for Foster Carers. He learnt many management techniques to support his foster children by talking to more experienced Foster Carers, and of the importance and challenges of working with other agencies, such as CAMHS or schools to put the necessary things in place.

Colin highlighted the need to consider the language used with and around children and young people. Finally he talked about how important it was for Foster Carers to take care of themselves. What is the risk of thoughts of suicide, suicide attempt and suicide amongst care-experienced children and young people? This session was led by Dr Rhiannon Evans from DECIPHer sharing the findings and discussions from her own research.

Some facts from the research:

  • In 2017 there were 72,670 “looked-after” children in England (3% increase 2016) and 5,954 in Wales (6% increase 2016).
  • Children and young people who have experienced care may be at elevated risk of suicide-related outcomes: More than 3 times as likely to attempt suicide as non-care populations.
  • Children and young people more likely to be exposed to known risk factors for suicide-related outcomes: More than 5 times as likely to have a diagnosable mental health condition.
  • Maltreatment (such as physical abuse/sexual abuse/supervisory neglect) is a risk factor for suicide attempt.
  • There remains limited evidence if pre-care or care exposure is the main risk for suicide-related outcomes.

How do foster carers and residential carers understand self-harm amongst the children and young people they care for, and how do these understandings inform their approach to management and prevention?

Rhiannon discussed how carers defined self-harm, their understandings of why children and young people in their care self-harmed and their strategies for management.

Defining self-harm: Serious vs superficial;

Authentic vs inauthentic; Invisible vs visible

The challenge is that superficial is sometimes seen as attention seeking, but any self-harm should be taken seriously. Key themes for understanding self-harm: Survival: Resistance, role conflict and chaosSignalling: Relationship rituals, relationship repairSecurity: Can you keep me safe? And emotional safety “Some young people may use self-harm after an incidentto show they need help. It may be a way of testingrelationships – testing whether a carer willshow nurture and keep them safe”

Management Strategies:

Carers focus on socially informed understanding of self-harm, about relationships, rather than the bio-medical approach of clinicians.

This includes developing safe and trusting relationships; emotionally open and available relationships; acceptance of their place in the care system.

“We need to pay more attention to how different groups understand the causes of self-harm and how it informs practice”

Workshop Discussion

How do we currently prevent/manage self-harm and suicide among care-experienced children & young people? What are the challenges with current approaches?

“Information sharing”

“safety plan”

“Coming together to share concern – collective working together”

“Core of all growing up is relationships, carers play a huge part in this”

“We’re fighting fires not focusing on prevention”

Ways forward?

“Considering societal factors, understanding self-harm in terms of relationships.”

“Realistic risk assessments, not treating children differently.”

“Looking at new technology or apps that can be used to support young people. Communicate with them in a way they’re comfortable. Not always expecting children and young people to conform to adult processes.”

“Formality doesn’t always work, we hear more from young people in the car or when out for a walk, not in formal review meetings.”

“There is a huge gap in support for kinship carers.”

How do carers work with social care and health professionals to manage and prevent self-harm, and how can current inter-professional working be improved?

The final session was run by Stephen Jennings, discussing his research findings. Stephen discussed the experiences of foster and residential carers working with other professionals to manage and prevent self-harm.

The main points introduced:

The perceptions of expert knowledge: Carers had mixed feelings about expertise, where they either deferred to or contested the theoretical knowledge of clinicians. Carers provided alternative perspectives on expertise based around familiarity.

Feeling marginalised within inter-professional teams: Carers felt their contributions were often not valued and recognised.

Experience of stigma: Young people’s complex health needs left both them and carers stigmatised at hospital visits after self-harm.

Positive accounts, where rapport has been established with other professionals involved: Where carers could demonstrate that they had expertise and a valuable contribution to make, this led to positive working in inter-professional teams, and this was often the result of longer-term relationships.

The session was wrapped up thinking about some final points. Carers make a distinct contribution in terms of preventing and managing self-harm, and they should be given a voice and an opportunity to contribute to decisions which affect those they care for. Foster and residential carers view themselves as professionals, and their perspectives should be considered as such by others working within these teams. Either formal qualifications or informal status raising for carers were seen as potential ways of improving self-harm management and prevention in inter-professional teams.

The workshop allowed for some interesting discussions on attendees’ current professional strategies and the research posed some interesting questions that need to be considered in practice. The inclusion of the lived experience of a foster carer bought to life all of the positives, challenges and realities of caring for children or young people with complex needs. It grounded the research findings in some first-hand stories that I was thoroughly captivated by. It was a real privilege to hear and learn from these experiences.

Presentations

Trawsnewid: A new LGBTQ+ youth project (16-25)

About the project:

Join Cerian, a youth engagement facilitator for Amgueddfa Cymru- National Museum Wales, for a new project called Trawsnewid focusing on LGBTQ+ young people aged 16-25 on the theme of transformations. Throughout this project we will be exploring trans and gender non-conforming figures in Welsh history and lived experiences today. This is an exciting opportunity for young LGBT+ people to socialise, learn about queer Welsh history, and to create work that will be exhibited.

There will be further events in a bi-weekly format of meetings and workshops with young people, and these sessions will be creative workshops exploring the theme of the project. Guest speakers will join sessions alongside the facilitator, and there will be an opportunity for the participants to also run their own sessions.

Pride young person

Throughout the project we will be working towards putting on our own events such as a museum takeover at the Waterfront Museum in Swansea and an exhibition of the work created throughout the project. The project will be tailored to the interests of the group, whether that’s history, art, creative writing, performance, and so on. 

The project will begin with an online session on the 24th February at 6pm, where we will be introducing the project, getting to know each other, and designing our own postcard inspired by the museum’s LGBT+ Collection. Visit the Family and Community events section to find out more about the February 24th activity.

If you would like to get involved in the project, find out any more information about the project or know of any young people who would be interested please email Cerian. Please note that anyone is able to join the project, even after the initial workshop on the 24th, simply email Cerian for further information.

Pathways to University: the Journey through Care

Care-experienced people represent only a tiny proportion of the student population in the UK, and as a result, those who go on to access higher education are widely celebrated within the sector. There is a temptation to assume that care leavers who achieve this type of educational success have had more positive and supportive journeys through the care system than most. Yet, as our latest research findings show, many care-experienced students have difficult and unstable care histories and have progressed to higher education despite the challenges they faced.

Our research, funded by the Leverhulme Trust, includes the voices of 234 care-experienced students from 29 universities across England and Wales. Exploring the challenges faced by these care leavers allows us to reflect upon the significant relationships and decision-making processes that shape care for all young people, regardless of their education and career choices.

Many of our participants described confusing and upsetting introductions to the care system, childhoods marked by instability caused by placement and school moves, and frequently changing social workers and personal advisors. Their stories often painted a picture of bureaucratic systems in which mental health support was lacking and the stigma of being care-experienced was perpetuated or left unchallenged.

Our second Findings Report from the ‘Pathways to University’ project puts forward 20 recommendations aimed at Local Authorities, Government and Policy Makers – urging them to accelerate support and promote achievement for all those with care experience.

The following animation captures the key findings from our second report and shares the experiences of young people as they journey through care.

View the ‘Pathways to University: the Journey through Care’ film:

Mental health and young people and the pandemic

Philippa Watkins, Senior Research Officer, Senedd Cymru

In 2018, the Children, Young People and Education (CYPE) Committee said a ‘step change’ was needed in emotional and mental health support for children and young people in Wales:

“We state that the urgent challenge now lies at the “front end” of the care pathway – emotional well-being, resilience and early intervention – and that addressing this should be a stated national priority for the Welsh Government. Failure to deliver at this end of the pathway will lead to demand for specialist services outstripping supply, threatening their sustainability and effectiveness.”

The Committee’s follow up report – Mind over matter: Two years on (October 2020), says that in the face of the coronavirus pandemic – and its impact on children and young people’s wellbeing – delivery of the Committee’s 2018 recommendations is more important than ever.

How is the pandemic affecting young people’s mental health?

During the pandemic, young people have reported a range of issues including increased anxiety, loneliness and isolation, loss of support networks, and more limited access to mental health and other services they usually rely on. A Mind Cymru survey found that three quarters of young people said their mental health was worse in the early months of the pandemic. A third of young people who tried to access mental health support were unable to do so.

Modelling by the Centre for Mental Health (for England) estimates that 1.5 million children and young people will need new or additional mental health support due to the pandemic (this represents 15% of children aged 5-19 in England). CYPE Committee’s interim report (July 2020) on the impact of the pandemic on children and young people cautions that there is an important balance to be struck between recognising and supporting mental health problems, and not ‘medicalising’ natural responses to a frightening situation.

Longer term impact

It is however, now widely recognised that children and young people are disproportionately affected by the social and economic consequences of the pandemic. There is significant concern about the potential long-term impact on young people’s mental health and wellbeing. The disruption to their education, employment and training opportunities is a key contributing factor here.

According to research by the Mental Health Foundation and Swansea University, nearly 7 in 10 British teenagers fear the pandemic will make the future worse for people their age. The Prince’s Trust highlights the link between poor mental health and not being in employment, education or training (NEET). It fears that, without mitigating action, a ‘lost generation’ of young people are facing long-term unemployment and lasting damage to their mental wellbeing.

In recent evidence, Professor Ann John (Swansea University) told the Health, Social Care and Sport (HSCS) Committee:

“What we want to avoid is what we call a cohort effect, where there’s a particular insult dealt to a generation and those vulnerabilities follow them through in the long term. So, it really is about leveraging protections and services and access to care.”

Role of schools

In 2018, Mind over matter identified the key role schools play in building an emotionally-resilient population of young people. It called for a whole-school approach to reducing stigma and promoting good mental health. It also described the planned reform of the curriculum in Wales as a ‘once-in-a-generation opportunity’ to embed wellbeing into children’s lives.

The Curriculum and Assessment (Wales) Bill was introduced in July 2020. There’s been considerable discussion among stakeholders about whether the legislation makes explicit enough provision about mental health. CYPE Committee’s stage 1 report (4 December 2020) recommends that the Bill be amended to include specific reference to mental health and wellbeing on the face of the legislation.

“Valuing mental health equally with physical health is vital, especially for our children and young people. As a society, we still have a significant distance to travel before mental health has parity of esteem. While we do not doubt that this Bill aims to address these issues, we believe that a “belts and braces” approach is needed, much like the approach adopted for RSE [Relationships and Sexuality Education]. We need to make sure that the importance of mental health and well-being in our curriculum is plain for all to see now and in the future.”

Whole-system approach

Schools however, are only one element of the ‘whole-system’ approach called for by the Committee. Its Two years on report says that continued commitment and leadership from Welsh Government and sector leads will be essential to drive the system-wide, joint working needed:

“While we are reassured that progress in education is visible and can be evidenced, we are far less confident that the pace of change in health and local government (including social services) is sufficient.”

Responding to this report, the Welsh Government acknowledges the Committee’s concerns about progress in the areas of health and social services. It has agreed to expand the scope of the existing ministerial task and finish group on the whole-school approach to encompass the ‘whole system’, enabling it to provide leadership across all relevant sectors.

Access to mental health services

Mind over matter: Two years on highlights the Committee’s concerns that too many children and young people with mental health needs are still facing difficulties accessing appropriate, timely care. The report makes specific recommendations in relation to:

  • crisis and out of hours support;
  • inpatient services;
  • psychological therapies;
  • the transition from child and adolescent mental health services into adult services, and;
  • support for looked after and adopted children.

While mental health services have been categorised as essential services since the start of the pandemic, both CYPE and HSCS Committees have heard consistent evidence from third sector services and professionals about people struggling to access support. This appears to be the case across the spectrum of need – from early intervention/primary mental health support services through to more specialist services and crisis care.

Missing middle

One of the key areas of concern for the CYPE Committee is that there is still a big gap in provision for what it calls the ‘missing middle’. This term refers to the significant numbers of children and young people who need mental health support, but who may not be unwell enough to need – or meet criteria for – help from specialist services.

The Welsh Government’s response to the Committee’s report highlights the work of the refocused Together for Children and Young People (T4CYP) programme. T4CYP is an NHS-led programme to improve the emotional and mental health support available to children and young people in Wales. One of its three workstreams – ‘Early help and enhanced support’ (EHES) aims to address the needs of the missing middle. The programme’s other key areas of focus are neurodevelopmental services, and regional partnership boards.

T4CYP’s own response to the Committee’s report said it is aiming to finalise the EHES Framework, and undertake preparatory work for its implementation, by March 2021.

Next steps and further information

The Committee recognises the progress that’s been made to date, particularly in respect of schools. And while improvements are now being seen at the ‘front end’ of the care pathway, concerns remain about a lack of provision for children and young people who need more specialist support, those with complex needs, and those who need help in a crisis. The Committee says that ‘significant and urgent’ work remains to be done to ensure that the foundations of the whole-system approach called for are in place by the end of this Senedd. The Committee’s Mind over matter: Two years on report will be debated in Plenary on 16 December 2020. You can watch this on Senedd.tv.

Also of note: