Establishing the need for mental health services for children and young people in care, and those who are subsequently adopted

Abstract

No other groups of children and young people in the developed world are more socially or developmentally disadvantaged than children and young people who reside in court-ordered alternate care, and those who are subsequently adopted from care. Prior to entering care, they mostly endure profound social adversity, including traumatic abuse and emotional deprivation. By and large, their pre-care adversity exceeds that endured by the much larger group of maltreated children who remain in their parents’ care. Following their entry into care and/or transition to adoption, these groups have to navigate a host of systemically driven assaults on their well-being and felt security. This book seeks to redress some important social and psychological manifestations of their disadvantage, including mental ill-health, emotional distress and behavioural difficulties – by disseminating the best knowledge we have on prevention and treatment of those difficulties for these populations, and by highlighting the present gaps in our knowledge, and the inadequacies of prevailing service models. The idea for publishing this book came about in 2010, after we had editeda special issue of Clinical Child Psychology and Psychiatry (October, 2010) on the topic of mental health services for children and young people in care and those adopted from care. The special issue generated a lot of interest and discussion, particularly from clinicians working in child welfare, alternate care and adoption fields, and from people working on mental health services policy within health and social care agencies. These populations exert exceptional demands on poorly matched, generic mental health services – a dilemma that most child welfare and child mental health jurisdictions in the developed world are presently struggling with. The response to the special issue supports our belief that the provision of appropriate and sufficient mental health services for these vulnerable populations will remain a key concern for child mental health and social care agencies over the coming decades. To that end, we set out to publish a definitive international reference guide for the design of specialised mental health services for children in care (and those adopted from care) – one that is equally useful for clinicians and clinical leaders, child mental health and social care agencies, government departments and policy makers.