Potential value of the current mental health monitoring of children in state care in England

Cocker, Christine, Minnis, Helen and Sweeting, Helen - BJPsych Open

Abstract

Background: Routine screening to identify mental health problems in English looked-after children has been conducted since 2009 using the Strengths and Difficulties Questionnaire (SDQ). Aims: To investigate the degree to which data collection achieves screening aims (identifying scale of problem, impacting on mental health) and the potential analytic value of the dataset. Method: Department for Education data (2009-2017) were used to examine: aggregate, population-level trends in SDQ scores in 4/5-16/17 year olds; representativeness of the SDQ sample; attrition in this sample. Results: Mean SDQ scores (around 50% ‘abnormal’/‘borderline’) were stable over 9 years. Levels of missing data were high (25-30%), as was attrition (28% retained for four years). Cross-sectional SDQ samples were not representative and longitudinal samples were biased. Conclusions: Mental health screening appears justified and the dataset has research potential, but the English screening programme falls short because of missing data and inadequate referral routes for those with difficulties.