Children’s mental health problems don’t disappear at 18, and nor should support.

Picture of Megan Davies

Megan Davies

Head of Political Engagement

Last week, organisations across the UK took part in Children’s Mental Health Week: an initiative that has been running since 2015. Sadly, we know that children in care are particularly at risk of poor mental health. Almost half of children in care have a diagnosable mental health disorder (compared to 10% of the general child population) and two-thirds have special educational needs. Quite rightly, the issue of children’s mental health is receiving increasing government attention. But what we need to ensure is that the young people’s mental health services – particularly for those who are care-experienced – do not drop off a cliff when they hit 18.

“When I was an inpatient in CAMHS [Child and Adolescent Mental Health Services] as a child – the majority of the other kids there were also children in care”, says Zahra, one of our Policy Forum members from Manchester, “Clearly, trauma and poor mental health affect a disproportionate percentage of care-experienced people, and this doesn’t stop being the case when we become adults.

“This Children’s Mental Health Week, we mustn’t forget that when children become adults, our issues don’t magically disappear. Especially for care-experienced people, the change in support you get once you hit 18 can have a profound effect on mental health. The transition to adulthood needs to be much smoother.”

Mental health needs do not disappear with adulthood 

The prevalence of mental health disorders among children in care is generally reflected in NHS services. Social work referral pathways and designated looked-after children nurses mean that those in care will often (though of course not always) get priority access to CAMHS. This is not to say that such services are perfect – indeed, many members of our Policy Forum were not satisfied with the mental health care they received as children – but there is at least a recognition from service providers that children in care need some sort of priority support.

Sadly, similar referral pathways are generally not available for care leavers. The transition from CAMHS to adult mental health services is not a smooth one. Care leavers must join the (very long) queue along with everyone else. In a system where care-experienced children receive specialised mental health support, the arguments against care-experienced adults receiving ‘special treatment’ do not stack up. What’s more, by halting specialist provision at the age of 18 – when care leavers are very often plunged into independence quite suddenly – we reinforce the feeling amongst the care-experienced community that corporate parenting stops at adulthood. That’s not how parenting is supposed to work. 

Offering adequate support is not special treatment, but good parenting 

The good news is, the care-experienced members of our nationwide Policy Forum believe they have an answer. Costing a barely noticeable fraction of the overall mental health budget, local authorities across the country could employ NHS counsellors to work specifically with care leavers. There would of course be an element of triage, with external referrals made for more specialist cases, but care leavers who need it would receive the trauma-informed, accessible talking therapy that they deserve as a minimum. By integrating mental health services into the leaving care offer, care-experienced young adults would not only face shorter waiting times, but would receive a service that better understands them and some of the unique issues that come with trauma and being in care. 

Children enter the care system to be, in the state’s own language, ‘looked after’. There is no doubt that this is a complex task, and efforts are clearly being made to ensure that the mental health needs of children in care are addressed. But these issues don’t go away in adulthood – often independence can lead to a whole new range of issues. That’s why we’re calling for specialist mental health provision for care leavers. We don’t think that’s special treatment – we think that’s just good (corporate) parenting. 

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