There are currently 91,000 Looked-after Children (LAC) in the UK. LAC have greater health needs than other children, but often struggle to access services. Previous studies have shown 45% of LAC have mental health problems (MHPs), but only 44% of these children are known to Child and Adolescent Mental Health Services (CAMHS). This study aims to identify health problems in LAC in one of the most deprived boroughs in England and to determine whether these health needs are being addressed based on regular health assessments, immunisation status and access to relevant services.
Case notes of 297 LAC were analysed for demographic information and the presence of physical, emotional and mental health problems. Data indicating whether services were accessed and if statutory guidelines were met were also collected.
55% of children were reported to have a physical health problem with asthma being the most common problem in 10% of children. 86% of children were fully immunised, 99% were registered with a GP and 97% with a dentist at the time of their review assessment. 48% of LAC were found to have a MHP based on their Strength and Difficulties Questionnaire (SDQ) score. 12% of children had an emotional problem, with 41% having a clinically significant conduct disorder and 20% a hyperactivity or concentration disorder. Despite this, only 40% of children with MHPs were in contact with CAMHS. Just 30% of children had a SDQ score available from the previous year. The mean waiting time for an initial assessment was 144 days (statutory guidance states this should be completed within 31 days of a care order being granted).
This study is the first of its kind to investigate the demographic profile of all LAC in this highly deprived borough and demonstrates the considerable presence of physical, emotional and mental health problems in this population. Further research is needed to explore why so few LAC, particularly those with a MHP, are able to access services. This study also highlights the need for improvements in information sharing between health, social care and CAMHS to encourage a healthy and successful future for LAC.