Longitudinal mental health trajectories of children growing up in State care in England: An exploration of patterns and influencing factors

托管所儿童是社会上最脆弱的儿童群体。本研究的目的是帮助我们理解托儿所儿童的心理健康是如何随着时间的推移而变化的，并探索这些心理健康模式是如何随着时间的推移而受到照料经历、个体因素和学校相关因素的影响的。在英格兰，任何时候都有大约7万名儿童由国家照顾(也被称为“托儿所儿童”)。这些儿童中有60%以上是由于遭受虐待或忽视等严重虐待而被送入国家托管所的。因此，被照顾是对这一弱势儿童群体的一种“干预”，期望国家照顾将改善或至少稳定他们的心理健康。尽管如此，许多研究表明，这一弱势儿童群体的精神问题很严重，50%的国家托儿所儿童患有可诊断的精神健康问题，而一般儿童的这一比例为10%。尽管有证据表明这类儿童的心理健康需求非常普遍，但关于英国托管所儿童心理健康的纵向模式的知识缺乏。该项目着眼于ESRC的精神健康战略优先领域，旨在通过以下方式填补这一知识空白：(1)对托管所儿童的纵向、国家级管理数据进行二级分析；(2)对15个地方当局的托管所儿童进行调查，这将提供补充数据，以便能够分析儿童的特征、学校和与托管所相关的因素如何影响托管所儿童的心理健康模式。除了使用次级数据，这项研究的主要创新将是使用被称为潜在轨迹模型的统计建模技术。ESRC社会工作和社会关怀研究战略顾问指出，在社会工作研究中缺乏这样的先进统计方法，最近的审查表明，目前只有很小一部分社会工作研究使用先进的量化方法。这项研究将受益于一系列利益攸关方的持续参与和合作，方法是在项目开始时建立一个“利益攸关方”咨询小组(政策制定者、实践者、学者、慈善机构和其他组织，如儿童事务专员)和一个“托儿所儿童”参与小组。“托管所儿童”参与小组将直接参与为托管所儿童创建调查并设计反馈报告，这些报告将发送给参与的地方当局的所有托管所儿童。此外，研究小组将直接与15个地方当局的管理层和从业人员合作，反馈结果并组织同行学习活动，以促进当地政策和做法的改变，这些政策和做法涉及评估和提供关爱儿童的精神健康服务。近年来，由于英国政府大力推动为有精神健康需求的儿童和年轻人提供更精简的支持，人们重新认识到儿童和年轻人的精神健康需求。这项研究提供了新的、及时的信息，说明国家照料儿童中最有可能罹患精神疾病的特定群体，以及对心理健康结果产生积极/消极影响的因素，这将使倡导儿童心理健康的政策制定者、从业人员和其他组织能够更好地为照料儿童提供政策制定、政策执行和有效资源分配的信息，他们将是这项研究的最终受益者。

Children in care constitute a most vulnerable group of children in the society. The aim of this study is to contribute to our understanding of how mental health of children in care varies over time and to explore how these patterns of mental health are influenced by care experiences, individual factors and school related factors over time. At any given time in England, there are around 70,000 children being looked after by the State (also referred to as 'children in care'). More than 60% of these children are taken into State care due to experiences of severe maltreatment such as abuse or neglect. Consequently, being taken into care is an 'intervention' for this vulnerable group of children, with the expectation that State care will then ameliorate or at least stabilise their mental health. Despite this, numerous research studies indicate that mental concerns in this vulnerable child population is high, with 50% of children in State care having a diagnosable mental health concern, when compared to 10% of children in the general population. Despite the evidence of high prevalence of mental health need shown by this group of children, there is a dearth of knowledge on the longitudinal patterns of mental health of children in care in England.This project, which maps on to the ESRC strategic priority area of mental health, aims to fill this gap in knowledge through: (1) secondary analyses of longitudinal, national-level administrative data on children in care and (2) a survey of children in care in 15 local authorities, which will provide supplementary data to enable analyses of how children's characteristics, school and care related factors influence the mental health patterns of children in care. Apart from the use of secondary data, the study's main innovation will be to use statistical modelling techniques known as latent trajectory models. Use of advanced statistical methods such as these have been signposted as lacking in social work research by the ESRC Strategic Adviser for Social Work and Social Care Research, with recent reviews indicating that only a very small proportion of social work research studies currently use advanced quantitative methodologies. The study will benefit from the continuous involvement of and collaboration with a range of stakeholders through the establishment of both a 'stakeholder' advisory group (policy makers, practitioners, academics, charities and other organisations such as the Children's Commissioner) as well as a 'children in care' participation group at the outset of the project. The 'children in care' participation group will be directly involved in creating the survey for children in care and in designing feedback reports that will be sent to all children in care in the participating local authorities. Additionally, the research team will work directly with the management and practitioners of the 15 local authorities to feedback the results and organise peer-learning activities to facilitate changes to local policy and practices pertaining to the assessment of and provision for mental health services for children in care.In recent years, there has been renewed recognition of the mental health needs of children and young people, aided by a significant push by the UK Government to provide more streamlined support for children and young people with mental health needs. New and timely information from this study on the specific groups of children in State care who are most at risk for mental illness and the factors that positively/negatively influence mental health outcomes would enable policy makers, practitioners and other organisations who champion children's mental health to better inform policy formation, policy implementation and effective resource allocation for children in care, who will be the ultimate beneficiaries of this research.