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

受托儿童是社会上最弱势的儿童群体。本研究的目的是帮助我们了解受照料儿童的心理健康是如何随时间变化的，并探讨这些心理健康模式是如何受到照料经历、个人因素和学校相关因素的影响的。在英国，任何时候都有大约7万名儿童由国家照顾（也被称为“被照顾的儿童”）。这些儿童中有60%以上因遭受虐待或忽视等严重虐待而被送入国家照料。因此，接受照顾是对这一弱势儿童群体的一种“干预”，期望国家照顾能够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心理问题很高，在国家照料的儿童中，有50%被诊断出有心理健康问题，而在一般人群中，这一比例为10%。尽管有证据表明这群儿童有很高的心理健康需求，但对英格兰受照料儿童心理健康的纵向模式缺乏了解。该项目与欧洲经济和社会委员会的心理健康战略优先领域相关，旨在通过以下方式填补这一知识空白：(1)对受照顾儿童的纵向、国家一级行政数据进行二次分析，(2)对15个地方当局的受照顾儿童进行调查，该调查将提供补充数据，以便分析儿童的特点、学校和护理相关因素如何影响受照顾儿童的心理健康模式。除了使用二手数据外，该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使用先进的统计方法，最近的评论表明，目前只有很小一部分社会工作研究使用先进的定量方法。通过在项目开始时成立“利益相关者”咨询小组（包括政策制定者、从业员、学者、慈善机构和其他组织，如儿童事务专员）以及“受照顾儿童”参与小组，这项研究将受益于与一系列利益相关者的持续参与和合作。“受照顾儿童”参与小组将直接参与为受照顾儿童编制调查和设计反馈报告，这些报告将发送给参与的地方当局的所有受照顾儿童。此外，研究小组将直接与15个地方当局的管理人员和从业人员合作，反馈结果并组织同行学习活动，以促进改变与评估和为受照顾儿童提供心理健康服务有关的地方政策和做法。近年来，由于联合王国政府大力推动为有心理健康需求的儿童和青年提供更精简的支助，人们重新认识到儿童和青年的心理健康需求。从这项研究中获得的最新和及时的信息，是关于在国家护理机构中最容易患精神疾病的特定儿童群体，以及对心理健康结果产生积极/消极影响的因素，这将使支持儿童心理健康的决策者、从业人员和其他组织能够更好地为护理儿童制定政策、实施政策和有效分配资源提供信息，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.