Westlake, Meryl Ffion; (2024) Exploring the Mental Health Among Children Living in Residential Care in England: A Mixed Methods Approach. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Statutory guidance indicates that local authorities are responsible for safeguarding and promoting the welfare of children living in their care. However, despite a consensus that the children placed in residential care have greater difficulties than those in family-based settings, there is a scarcity of research investigating the mental health of children in residential care, to inform evidence-based practice. Children’s mental health difficulties and risk-taking behaviours are closely related, with research suggesting heightened vulnerability in residential care. Screening tools are used to understand these difficulties; however, researchers and practitioners have identified limits to the current tools, leading them to develop new assessment methods. This thesis used a mixed methods approach to advance understanding of children’s psychological difficulties and experiences in residential care. As part of this, a meta-analysis of the prevalence of mental health disorders and symptoms among these children was conducted. Quantitative methods were subsequently used to analyse data collected using the BERRI questionnaire, a carer-report, multi-dimensional tool developed to assess mental health difficulties, including risk-taking behaviour, among children living in care. Qualitative methods were then used to investigate young adult’s experiences of what is helpful and harmful in children’s homes. The findings indicate a consistent pattern that children in residential care have a high prevalence of mental health difficulties. Specifically, children who have experienced a greater number of recent life events have heightened mental health difficulties. There were also specific age and gender patterns of difficulty and patterns of risk-taking behaviour in relation to children’s residential placement. The qualitative findings showed that for residential care to promote children’s welfare, the existence and experience of safety was paramount. This was achieved through genuine care from staff, positive and stable peer relationships, and a child-centred approach to decision making. Implications for children’s social care policy and practice in England will be discussed.

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