“Great day! But now what?” Adolescents’ and foster carers’ experiences of a comprehensive health assessment for children in out-of-home care

Abstract

Children in out-of-home care have extensive mental and physical health care needs. Best practice guidelines recommend comprehensive health assessments to all children entering out-of-home care, as their needs are often unidentified and unmet. The aim of this study was to explore adolescents’ and foster carers’ experiences and expectations after participating in a comprehensive multi-disciplinary health assessment. Within two weeks of the assessment day, nine adolescents (aged 11–17 years), and 12 foster carers were interviewed, and asked to share what they thought about the encounters and the tasks from the assessment day. Based on these experiences, further conversations explored relevant issues from contemporary life, and prospects for the future. Through Interpretative Phenomenological Analyses, three major themes were identified as the main findings. First, the participants felt seen and involved, taken care of and taken seriously throughout the assessment day. Adolescents and carers had concordant views on what made the environment feel safe, despite the potentially demanding comprehensiveness and topics of the assessment. Second, the assessment was perceived as relevant, and gave access to enhanced understanding, although the adolescents and the carers expressed divergent views on the perceived importance of the assessment and how it related to their daily lives. The third theme referred to feeling hopeful, but powerless facing the future, and the uncertainty regarding what would happen with the identified needs and recommendations for services. Our results suggest that the assessment day was manageable, understandable and acceptable, but the engagement and involvement from the assessment day did not transfer to the expectations for follow-up.