Transitioning care-leavers with mental health needs: 'they set you up to fail!'

BACKGROUND: Children in the UK care system often face multiple disadvantages in terms of health, education and future employment. This is especially true of mental health where they present with greater mental health needs than other children. Although transition from care - the process of leaving the local authority as a child-in-care to independence - is a key juncture for young people, it is often experienced negatively with inconsistency in care and exacerbation of existing mental illness. Those receiving support from child and adolescent mental health services (CAMHS), often experience an additional, concurrent transfer to adult services (AMHS), which are guided by different service models which can create a care gap between services. METHOD: This qualitative study explored care-leavers' experiences of mental illness, and transition in social care and mental health services. Twelve care-leavers with mental health needs were interviewed and data analysed using framework analysis. RESULTS: Sixteen individual themes were grouped into four superordinate themes: overarching attitudes towards the care journey, experience of social care, experience of mental health services and recommendations. CONCLUSIONS: Existing social care and mental health teams can improve the care of care-leavers navigating multiple personal, practical and service transitions. Recommendations include effective Pathway Planning, multiagency coordination, and stating who is responsible for mental health care and its coordination. Participants asked that youth mental health services span the social care transition; and provide continuity of mental health provision when care-leavers are at risk of feeling abandoned and isolated, suffering deteriorating mental health and struggling to establish new relationships with professionals. Young people say that the key to successful transition and achieving independence is maintaining trust and support from services.

Widening the care gap? An international comparison of care leaving in the time of COVID-19.

Following COVID-19, young people who transitioned to adulthood from different types of alternative care (care leavers) experienced an exacerbation of the challenges they had before the pandemic. The purpose of this international survey was to explore the range of policy and service responses that have or have not been implemented around the world to support care leavers during COVID-19. Responses were collected from care-leaving researchers from 19 countries toward the end of 2020. Half of the participating countries reported that the state had issued directives about measures that should be taken to support care leavers following COVID-19 outbreak, but only three reported actual changes in legislation. Additionally, nongovernmental organizations (NGOs) in various countries took steps to guide and support care leavers, while two thirds reported on special initiatives that were mounted. The most common change in practices during COVID-19 was the postponement of exits from care, and the second was an increase in contact from workers. These findings are critically discussed in relation to the impact of policy changes on an already vulnerable group. In particular, we indicate that there appears to be a widening care gap: Some countries with stronger leaving care legal and policy frameworks pre-COVID-19 were more inclined to introduce additional supportive measures during the pandemic, whereas some with underdeveloped services tended not to increase the support. By contrast, other countries used this crisis to develop services that were not available before. The creativity and flexibility in the services provided during the COVID-19 outbreak are required on an ongoing basis and thus should be implemented overall. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Nurturing children's development through healthy eating and active living: Time for policies to support effective interventions in the context of responsive emotional support and early learning.

Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to improving health equity for children and their families. Our goal is to ensure that all families are free from structural inequality and oppression and are empowered to nurture their children's growth and development through healthy eating and physical activity within the context of responsive emotional support, safety and security, and opportunities for early learning. To date, there have been disparate approaches to promoting these objectives across the health, community service, and education sectors. The crucial importance of our collective work is to bring these priorities for early childhood together through multisectoral interventions, and in so doing tackle head on siloed approaches. In this Policy paper, we draw upon extensive research and call for collective action to promote equity and foster positive developmental trajectories for all children. We call for the delivery of evidence-based programs, policies, and services that are co-designed to meet the needs of all children and families and address structural and systemic inequalities. Moving beyond the "what" is needed to foster the best start to life for all children, we provide recommendations of "how" we can do this. Such collective impact will facilitate intergenerational progression that builds human capital in future generations.