Time to Tackle Care Leavers 'Inverse Care Law'

The support that our country's most vulnerable children and young people get has been established with the best intentions, and is delivered by the huge, often selfless, efforts of professionals and carers. But when the whole system seems to miss the point, it's time for change. It's time for a care system designed to recognise the importance of emotional and mental health to the children and young people it is there for, all the way into adulthood.

Being a young person can be tough. We all know that the journey to adulthood throws up all sorts of challenges, emotionally and developmentally. And the journey is always longer and more complex than we could ever imagine as a child. It is of little surprise that a significant proportion of adolescents feel sad or low several times a week and that the incidence of diagnosable mental illness increases greatly in the mid to late teens.

This week is National Care Leavers Week, and the challenge is even greater for these young people. Not only must they make the difficult transition into adulthood but also move on from the trauma that led them to be taken into care, and the subsequent difficulties maintaining a stable life and relationships. Children in care are around four times more likely than their peers to have mental health problems and these issues do not dissolve on a 16th, 18th, or 21st birthday.

The state has a special duty towards such young people - but to what extent are health and social care services designed around their needs?

Short answer: Not as much as they need to be

Firstly, as soon as they turn 18, many young people are forced to leave the home that has been arranged for them as a child in care, presenting a huge step into the big wide world and a significant reduction in everyday personal and emotional support. This stride into adulthood is often earlier than many of their peers, and while right for some, is disastrous for others.

At the same time, most child and adolescent mental health services will close their doors to these young people, denying them access to specialist support that may be able to help them move on from their pre- (and in) care experience.

It seems that there must be a better way, and children and young people themselves have told parliamentarians that practical and specialist support should continue to be available to call on when needed later in life.

It would be unfair to deny that improvements have been made over the years, and that many care leavers have a more positive experience. Last year saw the start of increased support for 'staying put' arrangements; where a young person stays on with their former foster carer for up to three extra years. All care leavers get some support from a personal advisor in their first few years of adulthood, and some benefit from additional one-to-one support.

However, there is an 'inverse care law' at play in the support offered to care leavers, where some of those who need it the most, miss out. There is to date no equivalent to 'staying put' on offer to those who have been in a children's home rather than with a foster carer, even though these young people typically have more complex needs. Similarly, while care leavers who are in education or training have guidance from a personal advisor until they are 25, those who are not, lose this support at 21.

The support that our country's most vulnerable children and young people get has been established with the best intentions, and is delivered by the huge, often selfless, efforts of professionals and carers. But when the whole system seems to miss the point, it's time for change. It's time for a care system designed to recognise the importance of emotional and mental health to the children and young people it is there for, all the way into adulthood.

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