looked-after children

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after Children and young people (LACYP) living in public care are known to be a highly vulnerable group, who have often experienced several pre-care poor socio-economic and family circumstances with subsequent placement instability, as well as inadequate compensatory care within the social care system. We aimed to evaluate the relationship between the adverse socio-emotional risk factors experienced by a cohort of LACYP and their emotional, behavioural and physical health needs within a South-West England Local Authority between Jan and Dec 2018. Methods: We carried out a retrospective review of the medical records of all looked-after children and young people (LACYP) within one year (Jan to Dec 2018) at the North Somerset Local Authority (NSLA). This was an audit project of the LAC Health team completed as part of the Clinical Governance strategies of the NSLA. Results: 93% (89/96) of the LACYP experienced at least one or more socio-emotional adverse risk factors. The commonest socio-emotional risk factors recorded were parent-related including poor mental health (67%), neglectful parenting (59%), drugs/alcohol abuse (45%) and domestic violence (47%). Forty-six (48%) of the LACYP had at least one or more emotional problems, 48 (50%) had neurodevelopmental conditions, while 63 (66%) had at least one or more physical problems. The most common emotional needs were behavioural problems (35%), anxiety/ depression (17%), nicotine/substance misuse (10%) and self-harm (6%). Conclusion: High levels of physical, emotional, behavioral, developmental and neurodisability disorders are prevalent among LACYP due to their high vulnerabilities to adverse life experiences and trauma while living within their biological families. Present and future clinical implications of the socio-emotional risk factors and the need for more integrated multi-agency services for addressing the diverse health needs of the LACYP were discussed. What is known? • There is increasing awareness of the relationship between childhood exposure to adverse events and long-term adult mental and physical health • Looked after children and young people (LACYP) are highly vulnerable to early traumatic and poor socio-economic circumstances exposure What this study adds: • Over 90% of LACYP experienced at least one ACE which disproportionately affected the youngest age-group • Parental factors such as childhood abuse, alcohol/substance abuse and mental health problems were the most common adverse factors experienced by the LACYP