The mental health and wellbeing of youth in care and care-leavers: Development of a national collaborative research agenda

目前，据估计，英国目前有超过75，000名儿童和青少年接受国家护理（McGhee et al. 2017），其中更大比例的儿童人口在他们生命中的某个时候经历过某种形式的国家护理。儿童因各种原因并通过许多不同的法律的途径进入国家的照顾，但有一个共同的线索，即儿童经历了一系列逆境，包括虐待，损失和贫困，这塑造了他们的护理前和护理中的经历，并影响了他们的心理健康和福祉（鲍德温等人，2019）。在英国，大多数年轻人从学龄或更大的年龄开始接受护理，这意味着在许多情况下，这些不良经历特别长。青少年是目前进入英国护理系统的增长最快的年龄组。虽然人们越来越关注儿童和年轻人的心理健康和福祉（Frith 2016），但人们特别关注被照顾的儿童（Bazalgette et al. 2015）。一直以来，人们都发现接受照料的年轻人的心理健康问题发生率比一般年轻人高得多，几乎一半接受照料的儿童（以及四分之三生活在寄宿团体护理中的儿童）符合精神疾病的标准（福特等人，2007年; Meltzer等人，2003年）。在英国，接受护理的年轻人达到精神疾病标准的可能性是同龄人的五倍。造成这种情况的原因有很多，包括儿童在进入国家照料之前所经历的逆境，如虐待、忽视和剥削，以及沿着一些受照料儿童在受照料期间所经历的经历，这可能会增加和加剧他们所经历的困难。这个项目旨在解决我们在如何理解年轻人的心理健康需求和轨迹方面的知识不足。被照顾的人，以及我们如何以可能有帮助的方式做出回应。我们正在寻求通过这个项目将研究人员、在学校和护理机构与这群年轻人一起工作的个人、政策制定者和有被国家照顾的生活经历的个人聚集在一起。这个项目将涉及一些工作包，旨在：与有护理经验的年轻人合作，探索如何定义心理健康，以及我们应该探索的关键问题;探讨我们如何将接受照顾的青少年的精神健康需要概念化，以及我们可以和应该如何以可能有效和为青少年所接受的方式作出回应;讨论在进行高质素研究时可能有用和切合实际的研究方法;来自研究，实践和生活经验的专家之间达成一致意见，研究可以衡量和评估年轻人的心理健康以及新工作方式的影响;并制定培训和支持非精神卫生从业人员的方法，以更好地识别和支持年轻人及其精神健康。

At present it is estimated that over 75,000 children and young people are currently in state care in the UK (McGhee et al. 2017), with a larger proportion of the child population experiencing some form of state care at some point in their lives. Children come into the care of the state for a variety of reasons and through a number of different legal routes, but there is a common thread of children having experienced a range of adversities, including maltreatment, loss, and poverty, which shape both their pre- and in-care experiences and impact on their mental health and well-being (Baldwin et al, 2019). In the UK, most young people enter care from school age or older, meaning in many cases these adverse experiences have been particularly prolonged. Adolescence is the fastest growing age-group currently entering the care system in the UK.While there are increasing concerns about the mental health and well-being of children and young people in general (Frith 2016), there are particular concerns about looked after children in particular (Bazalgette et al. 2015). Young people who are looked after have consistently been found to have much higher rates of mental health difficulties than the general youth population, with almost half of looked after children (and three quarters of those living in residential group care) meeting the criteria for a psychiatric disorder (Ford et al 2007; Meltzer et al 2003). Young people in care in the UK are five times more likely to meet the criteria for a psychiatric disorder compared to their peers. There are many reasons for this, including the adversities experienced by children before coming into state care, such as abuse, neglect and exploitation, along with the experiences which some children in care experience during their time in care, which can both add to and exacerbate the difficulties they experience.This project seeks to address the deficit in our knowledge about how we understand the mental health needs and trajectories of young people who are looked after, and how we can respond in ways which are likely to be helpful. We are seeking to bring together through this project researchers, individuals who work with this group of young people in schools and care settings, policy makers and individuals with lived experience of being looked after by the state.The project will involve a number of workpackages aiming to: work with care experienced young people to explore how mental health is defined, and the key issues we should be exploring; explore how we conceptualise the mental health needs of young people who are looked after, and how we could and should respond in ways which are likely to be effective and acceptable to young people; discuss the range of research approaches which are likely to be useful and realistic in undertaking high quality research; agreeing amongst experts from research, practice and with lived experience, the ways that research studies can measure and assess the mental health of young people and the impact of new ways of working; and to develop an approach to training and supporting non-mental health practitioners to better identify and support young people and their mental health.