Mental, physical and emotional well-being of young people are essential preconditions for successful learning. The Journey to Excellence, HMIE 2006

The physical and mental health of looked after children and young people is often poor when compared with their peers who are not in care, and this may affect their ability to benefit from education and other life-enhancing opportunities and have serious implications for their health and well-being in adulthood. NCB Healthy Care Training Manual

..it is clear that the primary cause of poor health outcomes for this group of young people is not the state of the child's health on the day they enter the care system. It is rather the history of unmet need prior to being accommodated.. The Residential Care Health Project 2004 Lothian

These are compounded by the lack of our current health care systems to adapt to the needs of a mobile population, by difficulties of tracking children and young people, and of communication between and within agencies. The Residential Care Health Project 2004 Lothian

Impact of multiple caretakers in residential care Because a child in care lacks one single person intimately familiar with his medical history, symptoms which normal caring parents would be in a position to observe and interpret may go unnoticed, so that they may suffer from non/acute but serious problems such as hearing or sight defects or other long-standing conditions such as asthma or diabetes. Younger children in particular may miss out on the proper series of inoculations and dental treatment may be unduly intermittent Barbara Kahan Child Care Research and Practice 1989

speech or language problems (12% bed wetting (14%) Two-thirds of all looked after children were reported by their carers to have at least one physical complaint. The most commonly reported physical complaints were: speech or language problems (12% bed wetting (14%) difficulty with co-ordination (10 %) asthma (12 %) eye and/or sight problems (19%) The mental health of young people looked after by local authorities in Scotland Meltzer et al ONS 2004

Forgotten Children 82% had problems with physical health 74% of these had not been recognised 41% had developmental or growth problems 54% of these had not been recognised 71 % had incomplete routine immunisations The Residential Care Health Project 2004 Lothian

The general health of children seemed to improve as their placement became more secure. About two-thirds of children who had been in their current placement for a year or more (67 per cent) were assessed as having very good health, compared with just over half (55 per cent) of those who had been in their placement for less than a year The mental health of young people looked after by local authorities in England Meltzer et al ONS 2003

Mental Health A 2004 ONS survey of Scottish looked after children found that 45% of those aged 5-17 had a mental health disorder. A multidimensional study completed in 2012 concluded that between 33% and 47% of looked after children had mental health difficulties. Looked after children are more likely to self-harm and commit suicide. Sources: Meltzer et al (2004) The mental health of young people looked after by local authorities in Scotland, Edinburgh Rees, P (2012) ‘The mental health, emotional literacy [etc.] of looked after children’, British Journal of Clinical Psychology

reading (37% compared with 19%) mathematics (35%compared with 20%) Children with a mental disorder looked after by local authorities were nearly twice as likely as looked after children with no disorder to have marked difficulties with each of the three abilities: reading (37% compared with 19%) mathematics (35%compared with 20%) spelling (41%compared with 24%). The mental health of young people looked after by local authorities in England Meltzer et al ONS 2003

Unrecognised health difficulties I remember a young person saying to me that she couldn’t see the blackboard very well and I said, ‘well have you asked to be moved to the front of the class?’ ‘No.’ ‘Why not?’ ‘Oh, well I don’t like to say.’ Learning support worker

Care leavers Transition to independence may coincide with transfer to adult health services The stress of leaving care may trigger mental health problems Greater access to alcohol and drugs Social isolation affects emotional wellbeing Poverty and poor housing has adverse effects on health

Young people’s health needs should be built into the preparation, leaving care and after care planning and review cycle. These needs should be viewed from the young person’s perspective and link material circumstances (housing, employment, income) and social relationships to a young person’s physical and mental health Helping Care Leavers: Problems and Strategic Responses Stein M. & Wade J