The greatest opportunity to prevent mental illness and provide effective early intervention occurs during childhood. Early intervention should include the identification of children at higher risk of developing mental illness or severe behavioural and developmental disturbances, and the targeted promotion of mental health among these groups. This includes children in foster and kinship care.
Children in out-of-home care in Australia are up to four times more likely to experience problems with mental health than their mainstream peers.1 Carers have emerged as powerful agents of change for these children. The quality of day-to-day care that children receive from foster and kinship carers and the nature of the caring environment are major factors influencing their mental health and wellbeing.
Carers can:
- support increased social connectedness
- support the development of problem-solving skills
- provide nurturing and empathetic care
- lessen the impact of multiple risk factors.2
In fact, carers are likely to be key to effective mental health promotion among children in out-of-home care. When we better understand this aspect of the carer role, we can effectively support them in their efforts to provide caring environments conducive to positive personal development.
The carer experience
In a study undertaken as part of the Ripple project, a five-year National Health and Medical Research Council (NHMRC) funded study, we conducted semi-structured interviews and focus groups with foster and kinship carers across Victoria.
Participants self-selected into the study by responding to advertisements distributed by several foster care agencies, including the peak bodies for foster and kinship carers. They were informed that they would need to consider questions relating to the mental health of children and young people for whom they had provided care or were currently caring. Thirty-one participants were involved – 14 kinship carers and 17 foster carers. The interviews and focus groups incorporated eight topic areas, including the challenges participants faced in supporting children with their mental health needs, and what support carers could access themselves while fulfilling their role. We developed an understanding of the role of the carer in promoting the mental health of children through analysing the responses and identifying key themes.
An overwhelming sense of exasperation, and even despair, about the caring experience was conveyed by many foster and kinship carers. They unanimously conveyed their belief that the children in their care had more intensive mental health needs than their mainstream peers. Many spoke in detail about the need to destigmatise the care experience in order to help the children in their care feel as normal as possible, and self-identified as being vigilant for early signs of any mental health disturbance. However, they felt that what many described as ‘the system’ did not always support them in their efforts to head off problems early.
We found the level of support available to different carers with similar levels of need to be inconsistent. In many instances support was not offered at all, even when children were already clearly displaying signs of poor mental health. Where formal supports were in place, these had mostly been sought out and accessed by the carer with great difficulty. Many participants claimed that the mental health needs of children were disregarded by the statutory system.
Supporting foster and kinship carers to promote positive mental health
Children in out-of-home care are at significant risk of developing mental illness or severe behavioural and developmental disturbances. We believe that providing effective support to foster and kinship carers may significantly increase the likelihood of positive socio-emotional outcomes for children in their care.
We urgently need to address the lack of systemic support for carers, and to remove the range of barriers that may affect their ability to promote the mental health and wellbeing of the children in their care.
The research suggests the need to improve access to a broad variety of mental health services for these children, while better resourcing carers, and providing them with:
- flexible respite care
- timely and accurate information
- targeted training and advice.
These must be provided not just to some carers, but to all carers of vulnerable children in foster and kinship care.