Carer perceptions of a specialist mental health service for children and young people in care

Abstract

Introduction: Children and young people in care are a key client group for child and youth mental health services. A collaborative approach to addressing the complex and long-term needs of children or young people in care is essential and carers who support these children or young people are vital team members of this collaboration. Method: This research surveyed carers over a 4-year period to gather feedback about a specialist mental health service. 277 carers responded to the Carer Perceptions Survey. Participants were mainly foster (65%) and kinship (17%) carers. However, residential workers (13%) and biological parents (5%) also responded to the survey. A thematic analysis was undertaken with responses to open-ended questions about most liked aspects of the service and ideas for service improvement. Results: Themes included support for carers, communication between carers and staff, personal attributes of staff, working in collaboration, accessibility to the service, and carer training. Carers expressed their appreciation of staff who provided support in collaborative and respectful ways and valued staff who listened to their experiences and ideas. In addition, carers expressed interest in receiving more information and training about how best to support the mental health of children and young people in their care. Conclusion: Effective mental health services for children and young people in care require clinical staff that foster respectful engagement and facilitate collaboration with carers in all aspects of care.

Keywords

children and young people mental health care experience carer perspectives multidisciplinary care teams

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References

Alston

Bowles

(2018). Research for social workers: An introduction to methods (4 ed.). Sydney: Allen & Unwin.

Australian Institute of Health and Wellbeing (2019). Child protection Australia 2017–18. Retrieved from https://www.aihw.gov.au/reports/child-protection/child-protection-australia-2017-18/contents/table-of-contents

Bath

(2008). The three pillars of trauma-informed care. Reclaiming Children and Youth, 17(3), 17–21

Blythe

Halcomb

Wilkes

Jackson

(2013). Caring for vulnerable children: Challenges of mothering in the Australian foster care system. Contemporary Nurse, 44(1), 87–98. https://doi.org/10.5172/conu.2013.44.1.87

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braun

Clarke

(2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806

Braun

Clarke

(2021). Thematic analysis: A practical guide to understanding and doing. SAGE.

Callaghan

Young

Richards

Vostanis

(2003). Developing new mental health services for looked after children: A focus group study. Adoption & Fostering, 27(4), 51–63. https://doi.org/10.1177/030857590302700408

Ciarrochi

Randle

Miller

Dolnicar

(2012). Hope for the future: Identifying the individual difference characteristics of people who are interested in and intend to foster-care. European Journal of Social Work, 42(1), 7–25. https://doi.org/10.1093/bjsw/bcr052

10.

Cohen

J.A.

Mannarino

A.P.

Deblinger

(2016). Treating trauma and traumatic grief in children and adolescents. New York: Guilford Press.

11.

Cormack

(2018). Analyzing qualitative minigroup data using thematic analysis. London: SAGE Publications Ltd.

12.

Eadie

(2017). Evolve therapeutic services: Outcomes for children and young people in out-of-home care with complex behavioural and mental health problems. Children Australia, 42(04), 277–284. https://doi.org/10.1017/cha.2017.37

13.

Farmer

(2005). Foster carer strain and its impact on parenting and placement outcomes for adolescents. The British Journal of Social Work, 35(2), 237–253. https://doi.org/10.1093/bjsw/bch181

14.

Fernandez

(2008). Unravelling emotional, behavioural and educational outcomes in a longitudinal study of children in Foster Care. British Journal of Social Work, 38(7), 1283–1301. https://doi.org/10.1093/bjsw/bcm028

15.

Forrester

Kershaw

Moss

Hughes

(2008). Communication skills in child protection: How do social workers talk to parents? Child & Family Social Work, 13(1), 41–51. https://doi.org/10.1111/j.1365-2206.2007.00513.x

16.

Golding

K. S.

(2010). Multi-agency and specialist working to meet the mental health needs of children in care and adopted. Clinical Child Psychology and Psychiatry, 15(4), 573–587. https://doi.org/10.1177/1359104510375933

17.

Guest

MacQueen

Namey

(2012). Applied thematic analysis. Retrieved from https://methods.sagepub.com/book/applied-thematic-analysis

18.

Harding

Murray

Shakespeare-Finch

Frey

(2018). High stress experienced in the foster and kin carer role: Understanding the complexities of the carer and child in context. Children and Youth Services Review, 95, 316–326. https://doi.org/10.1016/j.childyouth.2018.11.004.

19.

Henderson

Scannapieco

(2006). Ecological correlates of effective foster care. Journal of Family Social Work, 10(1), 43–60. https://doi.org/10.1300/J039v10n01_03

20.

Hoffman

Marvin

Cooper

Powell

(2006). Changing toddlers’ and preschoolers’ attachment classifications: The Circle of Security intervention. Journal of Consulting and Clinical Psychology, 74(6), 1017–1026. https://doi.org/10.1037/0022-006X.74.6.1017.

21.

Kinniburgh

Blaustein

Spinazzola

van der Kolk

(2005). Attachment, self-regulation and competency: A comprehensive intervention framework for children with complex trauma. Psychiatric Annals, 35(5), 424–430. https://doi.org/10.3928/00485713-20050501-08

22.

Klag

Fox

Martin

Eadie

Bergh

Keegan

Turner

Raeburn

(2016). Evolve therapeutic services: A 5-year outcome study of children and young people in out-of-home care with complex and extreme behavioural and mental health problems. Children and Youth Services Review, 69, 268–274. https://doi.org/10.1016/j.childyouth.2016.08.017.

23.

Kruzich

J.M.

Jivanjee

Robinson

Friesen

B.J.

(2003). Family caregivers' perceptions of barriers to and supports of participation in their children's out-of-home treatment. Psychiatric Services (Washington, D.C.), 54(11), 1513–1518. https://doi.org/10.1176/appi.ps.54.11.1513

24.

Liamputtong

(2019). Qualitative research MethodsDocklands (5th ed.). VIC: Oxford University Press.

25.

Lynch

Newlands

Forrester

(2018). What does empathy sound like in social work communication? A mixed-methods study of empathy in child protection social work practice. Child and Family Social Work, 24(1), 139–147. https://doi.org/10.1111/cfs.12591

26.

Munford

Sanders

(2016). Finding meaningful support: Young people's experiences of “risky” environments. Australian Social Work, 69(2), 229–240. https://doi.org/10.1080/0312407X.2015.1133682

27.

Murray

Tarren-Sweeney

France

(2011). Foster carer perceptions of support and training in the context of high burden of care. Child & Family Social Work, 16(2), 149–158. https://doi.org/10.1111/j.1365-2206.2010.00722.x

28.

Octoman

McLean

(2014). Challenging behaviour in foster care: What supports do foster carers want? Adoption & Fostering, 38(2), 149–158. https://doi.org/10.1177/0308575914532404

29.

Onions

(2018). Retaining foster carers during challenging times: The benefits of embedding reflective practice into the foster care role. Adoption & Fostering, 42(3), 249–265. https://doi.org/10.1177/0308575918790433

30.

Raviv

Taussig

H. N.

Culhane

S. E.

Garrido

E. F.

(2010). Cumulative risk exposure and mental health symptoms among maltreated youth placed in out-of-home care. Child Abuse & Neglect, 34(10), 742–751. https://doi.org/10.1016/j.chiabu.2010.02.011

31.

Sawyer

Carbone

Searle

Robinson

(2007). The mental health and wellbeing of children and adolescents in home-based foster care. Medical Journal of Australia, 186(4), 181–184. https://doi.org/10.5694/j.1326-5377.2007.tb00857.x

32.

Schneider

Grilli

Schneider

(2013). Evidence-based treatments for traumatized children and adolescents. Current Psychiatry Reports, 15(1), 1–9. https://doi.org/10.1007/s11920-012-0332-5

33.

Schofield

Beek

(2005). British Journal of Social Work, 35(8), 1283–1301. https://doi.org/10.1093/bjsw/bch213.

34.

Stanley

(2007). Young people’s and carers’ perspectives of the mental health needs of looked-after adolescents. Child and Family Social Work, 12(3), 258–267. https://doi.org/10.1111/j.1365-2206.2007.00491.x.

35.

Tarren-Sweeney

(2010). It’s time to re-think mental health services for children in care, and those adopted from care. Clinical Child Psychology and Psychiatry, 15(4), 613–626. https://doi.org/10.1177/1359104510377702

36.

Tarren-Sweeney

(2017). Rates of meaningful change in the mental health of children in long-term out-of-home care: A seven- to nine-year prospective study. Child Abuse & Neglect, 72, 1–9. https://doi.org/10.1016/j.chiabu.2017.07.002.

37.

Withington

Duplock

Burton

Eivers

Lonne

(2017). Exploring children’s perspectives of engagement with their carers using factor analysis. Child Abuse & Neglect, 63, 41–50. https://doi.org/10.1016/j.chiabu.2016.11.022.