Children in care often left without effective mental health support, say researchers

A new project aims to increase access to evidence-informed mental health service provision for children in care in England.

Developed by a coalition of leading universities and expert organisations including National Institute for Health and Care Research Applied Research Collaborations (NIHR ARCs), the initiative centres around 20 recommendations which seek to address long-standing gaps in access to high-quality, trauma-informed mental health services for some of the country’s most vulnerable young people.

Currently, more than 80,000 children are in care in England – a number that continues to rise. Many have experienced significant early adversity, including abuse, neglect, poverty, domestic violence, and parental mental ill-health.

These early experiences, coupled with the instability of multiple placement changes and separation from family networks, mean that children in care are at least four times more likely than their peers to experience diagnosable mental health conditions such as anxiety, depression, PTSD, or behavioural conditions.

Yet despite the clear need, access to appropriate mental health care remains inconsistent and inadequate.

“Too often, children in care are left without the timely, compassionate, and effective mental health support they need to heal and thrive,” Project lead, Rachel Hiller, Professor in Child & Adolescent Mental Health at University College London (UCL) and Co-Director, UK Trauma Council, said.

“Children in care are individuals. They do not all have the same mental health needs. They have a right to access and expect best-evidenced support for their mental health.

“With the right commissioning, joined-up leadership, and a shared understanding of and buy-in to evidence-based practice, change is possible. There are already examples of excellent practice that we can learn from and scale, so all children in care, no matter where they are based, can access high-quality mental health care.”

The recommendations span key areas including commissioning that prioritises long-term, evidence-based approaches, and integrated service delivery that brings together health and social care. Researchers said that workforce development would also need to be rethought, with a strong emphasis on evidence-based practice.

Commenting on the report, Rachael Wardell, ADCS President said: “What’s clear from the report is the urgent need for stable placements, trusting relationships with carers and social workers, and timely access to mental health support that truly understands trauma. Access to Child and Adolescent Mental Health Services (CAMHS) is absolutely critical, but is a post code lottery, with too many children in care facing long waits or inconsistent support. Early help matters because most mental health challenges begin in childhood, and the impact can last a lifetime.”

“Local authorities are committed to finding loving, stable homes and ensuring we have enough social workers to give children the care and support they deserve. But to make this a reality, a nationally led, well-funded effort is needed to build and sustain a strong workforce across all children’s services and partner agencies. Alongside this, central government must continue to strongly push for reform of the children’s placement market, so that local authorities have the tools and flexibility to offer the stability children need to feel safe, and flourish.”