Putting Children's Mental Health First

Most foster carers have little, if any, specialist training in dealing with mental health issues. We rely heavily on our own life experience, particularly the experience of bringing up our own families, and we look to our social work teams for support and advice.

This Children's Mental Health Week please give thought to children and young people in care and to those who look after them.

Few foster carers would consider themselves 'mental health experts'. Yet they are responsible for the wellbeing of thousands of the UK's most vulnerable children. Some 60,000 children live with foster families, and about three quarters of these children will suffer from emotional or behavioral problems.

Most foster carers have little, if any, specialist training in dealing with mental health issues. We rely heavily on our own life experience, particularly the experience of bringing up our own families, and we look to our social work teams for support and advice.

Responding to the physical burden of abuse and neglect is challenging enough for foster carers. But managing emotional trauma in a child who is a stranger to you, and whose family circumstances often remain unclear is a real test of resilience and determination. It is a voyage of discovery, for child and carer, and along the way you both will be forced to confront issues and events that will test your faith in humanity. Bad things have happened, the sort of things that make you rage when you see them depicted on TV. But this is real life, and it is being revealed in your living room, or your kitchen or, as is so often the case, in your car; usually when you least expect it, and when your guard is down.

The children are conflicted: they crave affection but they fear rejection and they push you away. They want to trust you but expect you to let them down. They want to unburden themselves of the pain and heartache, but do not want to betray their loved ones. They don't want to live with you, or anyone else, but they don't want to go home. Our fostering work is mostly with siblings, and we are struck time and again by the different experiences that children from the same family, who lived under the same roof, bring with them. Their accounts often contradict each other, not because they are wrong or made up, but because that is how it happens.

How to unpick truth from fiction, lies from genuine, heartfelt revelations? How to interpret what is said in the middle of the night, after another harrowing nightmare, but denied the following morning, in the cold light of day? Children who live under siege instinctively develop survival strategies, and quickly learn what it is that you want to hear. Others simply do not yet have the language to tell you what they fear

Yes, it is important to agree a long-term plan for children who come into care as quickly as possible. Nobody wants a vulnerable child to live with uncertainty for a day longer than is necessary. But how to agree placement decisions that will set a life course that will be difficult to change, until we understand the emotional damage caused by an extended period of neglect or abuse? So much of it comes down to the skill of the foster carer in managing a process of healing and attachment, and mostly down to gut instinct about what makes good parenting, rather than evidence-based academic learning or training.

It is an uncertain course, made no easier by the difficulty in gaining access to professional help when it is needed. Waiting lists for counselling and therapy are unfeasibly long, with lengthy gaps between appointments, causing deep frustration. A child or young person often sees a foster carer as part of a system that is failing them, even when that same foster carer has made a significant emotional investment in trying to secure the support they need. It is an uncomfortable position to be in.

In our role as foster carers we witness the transformational nature of love and stability in a child's life. Clean clothes, a hot bath or shower, a warm comfortable bed, regular meals, which should all be taken granted by children, are just the beginning. Learning to live without the threat of violence, and trusting adults to care and protect, are the bigger prizes. We understand that however much progress children make when they are in our care, they will always live with the burden of those difficult, early years. How well they cope may be determined by the way in which we respond to their emotional needs in those first few weeks they share our home. It is no small responsibility.

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