The health and well‐being of children and young people who are looked after: Findings from a face‐to‐face survey in Glasgow

Abstract

Evidence suggests children and young people who are looked after (LACYP) may have poorer health outcomes than children and young people in the general population, particularly in relation to mental health. This paper discusses findings from a survey of the health and well-being of LACYP in Glasgow. A structured questionnaire used in the 2010 Glasgow Schools Survey (GSS) was adapted and administered in face-to-face interviews with 130 young people aged 11-18 in 2014-2015 to investigate various aspects of health and well-being including physical activity, diet and sleep, smoking, alcohol and drugs, health feelings and worries, behaviours, attitudes and expectations. LACYP were more likely to report that they had tried drugs, slightly more likely to have scores indicating a high level of difficulties on the Strengths and Difficulties Questionnaire (SDQ) and less likely to report that they ate fruit and vegetables, used active transport methods to get to school and expected to go on to further or higher education; however, reported rates of physical activity, smoking and drinking were similar. LACYP were less likely to report that they had engaged in antisocial behaviour, truancy or bullying or been exposed to environmental tobacco smoke, less likely to worry or have low self-esteem, and more likely to rate their health positively. There were some variations according to placement type. The findings of this study present a more positive picture of the health and well-being of LACYP in Glasgow than might have been expected but should be treated with caution due to small sample size. Further research is needed to identify differences in relation to placement type and to determine whether being looked after might be associated with improved health and well-being outcomes for some children and young people.

Do adolescents in care systematically under-report their mental health difficulties in population studies? A narrative review

“…In the aforementioned study by Rees (2013), the mean self-report SDQ total difficulties score (14.8) was slightly lower than the mean carer-report score (16.3), though not substantially so. In a recent survey of Glasgow children in OOHC (N ¼ 130, 78% family-based), the mean self-report SDQ total difficulties score (11.9) was comparable to the mean self-report score for adolescents in the general community (11.2), obtained in a 2010 Glasgow Schools Survey (Vincent & Jopling, 2018), which indicates that those adolescents in care reported a normative distribution of difficulties. Unless otherwise stated, refers to CBCL/YSR total problems, externalizing problems, and internalizing problems.…”

“…Mean T-scores and "T score equivalents" of mean raw scores Family-based care. Seven of the reviewed studies contrasted mean carer-report and self-report mental health checklist scores for adolescents solely or predominantly residing in family-based (i.e., foster and/or kinship) care, and one study contrasted SDQ scores reported by children in OOHC and a local community sample (Vincent & Jopling, 2018). Two were the NSCAW CW and LTFC cohorts and another was the Australian foster care survey, described in the previous section.…”

“…Three studies estimated the prevalence of mental disorders from structured psychiatric interviews with adolescents; thirteen studies obtained self- and carer-report scores on cross-informant checklists (some studies also employed additional self-report measures); and three studies only obtained self-report checklist scores. The studies had 100% OOHC samples, with two exceptions: 11% of a U.K. survey sample were young people who had been restored to their birth parents’ care (Goodman, Ford, Corbin, & Meltzer, 2004) and 8.5% of another U.K. survey sample resided with their parents while in statutory care (Vincent & Jopling, 2018). The studies are summarized in Table 2.…”

Physical activity engagement among young people living in the care system: A narrative review of the literature

“…Physical activity (PA) is an important health behaviour that is associated with a multitude of physical and psychological health benefits (Ahn & Fedewa, 2011;Kirkcaldy et al, 2002;Motta, McWilliams, Schwartz, & Cavera, 2012;Pate et al, 2013) and -due to the social interaction that often occurs as part of PA participation -is associated with benefits for young people's social development (Eime et al, 2013). While there is limited evidence regarding the PA levels of young people in care, the evidence that is available demonstrates that this population do not meet PA recommendations (i.e., 60 minutes of moderate to vigorous activity on a daily basis, Dowda et al, 2009;Vincent & Jopling, 2018;World Health Organisation, 2010). Indeed, one study in the United States found that young people in foster care or residential care were less likely to achieve PA recommendations when compared to their peers in the general population, who lived at home with their parents (i.e., single parent, two parents, and step-parents) (Ornelas, Perreira, & Ayala, 2007).…”

The experiences of carers in using shared activities to communicate with looked‐after young people about alcohol, tobacco, and drug use

“…They are also at increased risk of early initiation of alcohol, tobacco, and drugs and tend to use these substances more frequently and heavily than do their peers and are more likely to develop problematic use (Braciszewski & Stout, ; Kepper, van den Eijnden, Monshouwer, & Vollebergh, ; Thompson & Auslander, ; von Borczyskowski, Vinnerljung, & Hjern, ). The findings from a recent study, however, suggest that some looked‐after young people may have rates of tobacco and alcohol use similar to those of their peers, although drug use rate was higher (Vincent & Jopling, ).…”