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The mental health of Looked After Children is not routinely assessed either upon entering the care system or during their period in care. Many children only receive help when difficulties become entrenched and more intensive treatment is required. Often this occurs when placements are fragile or have broken down. The Department of Health, Social Services and Public Safety (DHSSPS) 2007 Consultation Paper “Care Matters in Northern Ireland—A Bridge to a Better Future” has recommended “systematic assessment of the psychological and emotional needs of children on the edge and LAC”. Prior to the focus group study outlined below, Strengths and Difficulties Questionnaire (SDQ) screening was undertaken with a sample of Looked After Children (n=76), 37 males and 39 females, in Homefirst Community Trust, aged 3–17 years (standard deviation=4.3), living with relatives or foster carers. Confirmed Neglect was recorded as the primary reason for becoming looked after in 75% (n=57) of the children screened. SDQ screening was undertaken with 76 (78%) carers, 64 (76%) teachers and 32 (87%) children aged 11+, and the findings provided to the child's social worker for consideration at the child's statutory review. Fifty-six per cent of carers, 39% of teachers and 30% of children identified significant difficulties, with 63% of carers, 35% of teachers and 45% of children stating that the difficulties had been present for over a year. Pre-test and post-test file audits were undertaken to ascertain whether SDQ screening had informed the child's care planning process. While care plans reflected an increase in referrals for further assessment and treatment in 42%, a number assessed with significant difficulties were not referred due to uncertainty about accessing appropriate services or concerns about swamping existing services. This paper outlines the findings of three focus groups with social workers and managers following SDQ screening of a sample of Looked After Children within four generic childcare teams and a team for children with special needs in Homefirst Community Trust. Participants reflected on the usefulness of the SDQ in identifying mental health strengths and difficulties to inform decision-making at Looked After Children Reviews. Participants recommended that routine SDQ screening is undertaken with all Looked After Children, with early intervention provided to children identified with some mental health difficulties and prioritisation of children with significant need. The usefulness of SDQ identification of child strengths as a foundation for promoting resilience in Looked After Children was also recognised. Recommendations were also made regarding specific service provision for Looked After Children and training for field social workers, link social workers and carers.
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