Study to examine mental health support for children with social work involvement

A major research project has launched to investigate the effectiveness of mental health support and treatment provided to children and young people who have involvement with social workers.

The four-year CAMHS Referrals and Outcomes for Adolescents and Children with Social Workers (COACHES) study will examine data from more than 70,000 young people across two NHS trusts in South London and Cambridgeshire and Peterborough.

The collaboration brings together the University of Cambridge, Kingston University, King’s College London, the National Children’s Bureau (NCB), the British Association of Social Workers (BASW) and the Care Leavers Association.

Researchers will investigate what influences whether referrals to Child and Adolescent Mental Health Services (CAMHS) are accepted or rejected, which treatments are most effective, and the cost-effectiveness of different interventions.

The study will also examine how children and young people with social care involvement are represented in CAMHS case notes, and explore their experiences of receiving treatment.

Young people and parents with direct experience of mental health and wellbeing interventions within the social care system will contribute qualitative evidence to the research, with the Care Leavers Association facilitating their involvement.

Taliah Drayak, an Expert-by-Experience co-investigator on the project, said: “Children with social workers are already identified as having faced challenges and adversities which are additional stressors to mental health. CAMHS has a vital role to play in improving these children's lives and this research is a unique opportunity to better understand what is working well and what needs to change.”

Robbie Duschinsky, Head of the Applied Social Science Group within the Primary Care Unit, and Director of Studies in Sociology at Sidney Sussex College, University of Cambridge, said the project would address gaps in understanding about the mental health care received by children and young people who also have contact with social services.

“Many children and young people who receive social services support experience mental health difficulties. And yet we know too little about the mental health care they receive from CAMHS, which treatments lead to positive change and how much these treatments cost. This project will lay essential foundations for the improved provision of mental health services for children and young people who may also have safeguarding needs.”

Rick Hood, Professor of Social Work at Kingston University, said: “Access to effective mental health provision is crucial for improving outcomes for vulnerable children, and requires robust evidence to underpin the partnership between children’s social care and CAMHS. This study will go a long way to providing that evidence and encouraging policies to strengthen services in this vital area.”

The NCB will lead on engaging with policymakers and parliamentarians, sharing the project's aims and findings and providing evidence about which CAMHS interventions work well for children and young people with social work involvement.

Anna Feuchtwang, Chief Executive of the NCB, said: “I am excited that NCB is co-ordinating the learning and communications from this ground-breaking programme. Decision makers in government need the evidence that joined up support across professional teams at an early stage actually makes a difference and is cost effective. This programme will provide us with the crucial evidence about how mental health teams and social workers collaborating can provide better support for children and young people in the care system, evidence that could change policies and strengthen the system that children in care rely on.”

The project is funded by What Works for Children’s Social Care and the National Institute for Health and Care Research (NIHR).

The research follows recognition by the Independent Review of Children’s Social Care that mental health is a key issue for young people who are in care or leaving care.

The COACHES team said its first research outputs were anticipated in 2023. These were expected to include analysis of the different forms of adversity experienced by young people with and without social care involvement, inequalities in access to CAMHS for young people with safeguarding needs, and an examination of CAMHS case notes co-conducted with Experts-by-Experience.

The project also forms part of a wider expansion of support for social care research. The NIHR had announced that its Research for Social Care scheme would run twice a year, backed by £5m annual investment, with an expanded remit to include children’s social care. The NIHR Academy was also offering funding for Masters and PhD study relating to local authority research.

The COACHES partners said they hoped the findings would help shape the delivery of social care and mental health services for children and young people over the coming years.