The mental health of children looked after before and during the Covid-19 pandemic: A cross-sectional study using propensity score matching

Abstract

Introduction

Evidence indicates that for some children and young people, levels of mental health difficulties increased over the initial years of the Covid-19 pandemic.

Aim

We examined whether levels of carer-reported mental health difficulties and wellbeing were different between 2019 (pre-pandemic) and 2020 and between 2019 and 2021 for children looked after.

Method

We conducted a repeated cross-sectional secondary analysis using propensity score matching. Mental health difficulties and wellbeing were measured using the 87-item BERRI assessment tool. Overall, N = 593 young people (7–26 years) were included from 23 settings.

Results

Between 2019 and 2020, carers reported lower levels of behavioural (coefficient=-9.85, 95% CI = -15.84, -3.85), emotional (coefficient=-10.27, 95% CI -17.38, -3.16), relationship (coefficient=-12.31, 95% CI = -21.45, -3.17) and overall (coefficient=-46.43, 95% CI = -76.77, -16.09) difficulties for young people. Between 2019 and 2021, carers reported only lower levels of behavioural difficulties for young people (coefficient=-8.25, 95% CI = -14.14, -2.35).

Discussion

Although levels of mental health difficulties decreased over the first year of the pandemic, by the second year they had for the most part returned to pre-pandemic levels.

Implications for practice

The present research on the mental health and wellbeing of children looked after during the early stages of the Covid-19 pandemic remains relevant to help understand and contextualise the longer-term psychosocial impacts we are seeing today.

Plain language summary

Research shows that mental health difficulties got worse for some children and young people over the first few years of the Covid-19 pandemic. Research also shows that children looked after, who are under state care, are likely to experience more challenging life events and to have higher levels of mental health difficulties than children and young people in the general population. But we do not know much about how mental health difficulties changed for children looked after over the first few years of the pandemic. This study found that the carers of children looked after reported lower levels of behavioural, emotional, relationship and overall difficulties for young people in 2020 than in 2019. The carers of children looked after reported lower levels of behavioural (but not emotional, relationships and overall) difficulties for young people in 2021 than in 2019. The article highlights two implications for practice: (1) the carers of children looked after should be supported to understand the mental health experience of young people; and (2) it is important to continue to monitor the mental health of vulnerable groups of young people, including children looked after, to determine how to best support this vulnerable population in light of the longer-term psychosocial impacts of the Covid-19 pandemic we are seeing today.