Scottish Journal of Residential Child Care Current Issue

With mental health and wellbeing in mind, Allyson McCollam

This paper is based on work undertaken on behalf of the Scottish Development Centre for Mental Health and it explores key challenges in addressing the mental health needs of children and young people who are looked after away from home. It considers some models of working that show promise in building bridges between activities to promote good mental health for all such children, as well as highlighting activities that focus on assessment, care and treatment for those who require such intervention.

Arts in health: Promoting the health and wellbeing of young care leavers, Sheena McGregor and Clare Macaulay

Research demonstrates that young people who have been in care have a greater likelihood of becoming parents themselves at a young age, and that their children are more likely to be taken into care (Chambers et al., 2002). In addition to this, becoming parents themselves is likely to re-awaken the abuses and deprivations of their own childhood. This group of vulnerable young people may be helped by art therapy. The British Association of Art Therapists (BAAT) defines art therapy as a form of psychotherapy that uses art media primary mode of communication (BAAT, 2009).Young people who take part in art therapy need not have any skill in art. The creative arts process helps the young person to effect change and growth on a personal level through the use of art materials in a safe and facilitating environment. Art therapists are also aware of how body language and the manner of relating to the therapist and other group members express the state of mind. For example, anxiety can be expressed through finding it difficult to take off a jacket or turn off a mobile phone.

Mindful Care: The pilot of a new mental health service for young people who are looked after away from home in Moray. Jenny Makinson, Christopher Wiles, Debbie Jones and Sheila Erskine.

It is well documented that children and young people who are looked after away from home have significantly high rates of mental health problems coupled with poor psychological adjustment and general levels of emotional wellbeing (McCann et al., 1996; Minnis & Devine, 2001; Minnis et al., 2001; Hill & Watkins, 2003; Meltzer et al., 2004; Rodrigues, 2004; Ford et al., 2007). A range of conduct, emotional and hyperkinetic disorders appear most common in this population, and co-morbidity rates are noticeably high (Meltzer et al., 2004). Furthermore, only a small proportion of this at-risk population is likely to be accessing Child and Adolescent Mental Health Services (CAMHS) (Dimigen et al., 1999). Barriers to successful CAMHS input occur at several stages within the process, from identification and referral of mental health problems through to the engagement of the young person and effective interventions for their specific constellation of behaviours and symptoms (Blower et al., 2004; Mount, Lister & Bennun, 2004).

Using information technology to communicate about health andwellbeing, assessment and review: Audio computer-assisted selfinterviewing (A-CASI) Murray Davies

The development and growth of information technology in the past decade has changed the face of communication at both a personal and an organisational level. As young people and practitioners become more familiar with its applications, it seems pertinent to think about how it can be applied more widely in relation to health and wellbeing in residential child care settings. An increasing number of local authorities are introducing audio computer assisted self-interviewing (A-CASI) as a method for improving communication with young people in their care. Self-completion methods in general are viewed as advantageous, in comparison to other approaches, in terms of being cheaper and quicker to administer and also in terms of minimizing the under-reporting of issues that could be sensitive (De Vaus, 1996). A-CASI approaches have been identified as being of particular benefit in conducting research with particular groups, such as children and young people and have also been associated with aiding literacy difficulties, with an enhanced sense of privacy and with increased disclosure of sensitive information (De Leeuw et al., 1997; Borgers et al., 2000; Borgers et al., 2004). In addition, its use is thought to decrease respondent error or fatigue and allows the relatively easy use of more complicated question aires, providing richer data than other self-completion approaches (Tourangeau and Smith, 1996).

This paper will look at A-CASI as a method for helping young people to communicate about issues of health and wellbeing. It will describe the use of Viewpoint Interactive A-CASI, which is the most frequently used software system in Britain, being used by over 130 local authorities in the UK. Finally, it will raise some of the challenges facing practitioners who wish to implement such systems.

Helping looked-after children and young people cope when they are ill Ann Wilson

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity (World Health Organisation, 1948).

While everyone would wish that all children should be in a state of physical, mental and social wellbeing, this should apply even more to children and young people who are looked after away from home. Unfortunately, research shows that they are among our most disadvantaged young people in terms of their health and wellbeing (Scott and Hill, 2006). There are problems with longer-term preventive care in the form of health surveillance and routine immunisations (Residential Care Health Project, 2004). It should also be recognised that they may face difficulties in the shorter term, when they are ill.

Corporate parenting is one way that should ensure that looked-after children who become ill are helped. This paper seeks to explore the views of some of those involved in corporate parenting when a child is ill. It will outline some of the findings of a project by Action for Sick Children (Scotland). This project looked at the healthcare needs and priorities at times of illness for children and young people who are looked after away from home. As part of that work we surveyed a range of health professionals who may be involved in corporate parenting at times of illness. We also obtained the views of young people regarding their treatment.

The contribution of Music Therapy to the emotional wellbeing of children in residential care Aby Vulliamy

I was recently surprised to discover that there is only a small handful of music therapists employed within Scottish residential child care. There also appears to be a significant gap in the international literature with regard to music therapy in residential child care. I believe that the use of music therapy in residential child care can enhance wellbeing. This paper will review seven issues that I find particularly pertinent to music therapy for children who are looked after away from home. I will use case study examples from two young people with whom I have worked, reinforced with theoretical references, in order to show how these issues influence music therapy in residential child care.

The contribution of Music Therapy to the emotional wellbeing of children in residential care: Practitioner review Moyra Hawthorn

Children’s stories: A GP perspective Lesley Morrison

The actor Samantha Morton has just directed her first film about a girl growing up in a children’s home, which Samantha Morton did herself. She has just spoken publicly about her criminal conviction, while in the home, for the attempted murder of someone who harassed and provoked her consistently. She spoke out because she has been so affected by the recent Commons Select Committee report (2009) which warned that the state is failing to adequately protect children in care from sexual exploitation, homelessness and falling into crime, and concluded that there had to be greater investment in children in care. There also needs to be greater investment in the processes by which children are identified as being at risk and needing to be taken into care. In some families, the warning lights flash pretty brightly. When a young male patient starts the consultation by saying, as one did the other day ‘I’ve got a bairn and a habit’, your child protection antennae quickly become active. The medical student with whom I was working was fairly unsympathetic towards him until I explained that he had suffered a very emotionally deprived upbringing with an alcoholic mother. At least he was acknowledging his problem and asking for help. Whether his child continues to live with him and his partner remains to be seen.

Nutritional guidelines for residential care settings for young people John Brown