‘They shouldn’t have to ask’: Exploring the need for specialist mental health services for care experienced and adopted children and their families

This article reports on an original study designed to elicit the views of fostering and adoption stakeholder groups regarding the mental health needs of children and young people and their families. This includes: young people themselves; adoptive parents; foster carers; professionals who routinely refer to mental health services (including Social workers, nurses, Education Welfare Officers and Family Support Workers); professionals providing mental health services (including CAMHS, Social Work, Nursing, and Primary Care Psychology); and Senior Service managers. The site for the study was counties Louth and Meath in the Republic of Ireland. Focus group methodology was employed to ascertain participant views. The focus group data was analysed thematically by the research team. The study is contextualised within the relevant literature in Ireland, the United Kingdom and internationally.
Key findings include: the reported need for a universal offering of mental health services to this population; the importance of an attachment and trauma informed approach, incorporating a ‘whole family’ perspective; the struggle for many families to access timely and appropriate services causing frustration, and at times destabilising placements; tension in the professional systems between an urgent need for crisis response versus the development of longer-term therapeutic support; the widespread recognition of poor levels of communication and collaboration between existing services; and an aspiration to see a dedicated therapeutically focused service open to all foster and adoptive children and their families. The findings are illustrated by direct quotations from study participants and discussed in light of the literature. Existing models of good practice for providing integrated mental health services are noted and the barriers to significant change noted. The aspiration of many participants for universal access to specialist longer-term mental health services that support the ‘ordinary care’ setting, alongside quick access to CAMHS settings is supported and a range of recommendations made.