Youth mental health services

The poster illustrates findings from an evaluation of a youth-specific mental health service that formed part of a broader project on youth mental health

What can the experiences of young adult carers tell us about what can make services more helpful for them and their families?

Young adults who provide unpaid care for older relatives have poorer outcomes than their peers in education, employment, health and wellbeing. Services that can potentially have a positive impact on their lives include services provided to the person they care for. However, survey research in England has indicated that receipt of such services is not necessarily linked to fewer negative consequences for young adult carers. We conducted in-depth interviews with fourteen young adult carers who had responded to the original survey. We explored their experiences with services for the care recipient and what factors limit or enhance the usefulness of those services. We found three interrelated themes. First, difficulties accessing services can add to stress, and make problems harder to address when services are implemented; second, lack of continuity of services, and practitioners, undermines relationships and future trust in services, whereas consistent relationships are beneficial. Third, young adult carers described the benefits that resulted from their being involved in discussions and decisions about services, and the problems when this does not happen. The wellbeing of the young adult carer and the person receiving care are shown to be inextricably interrelated; we draw out implications for efforts to improve services

Social care inequalities in England: evidence briefing

Adult social care in England is once again high on the political agenda. The government has announced the introduction of a lifetime cap on eligible care costs and a slightly less harsh means-test for publicly-funded care. These are important developments which bear on the inequity of the costs faced by people with modest (or greater) wealth who are unlucky enough to develop a condition with substantial long-term care requirements, such as dementia. But funding reform of this kind largely ignores major underlying inequalities: in care need and unmet need, in the receipt and experience of care, and in the burden of unpaid caring. This briefing focuses on these inequalities in adult social care. It arises from a workshop held with policymakers and practitioners on 'Joining up, avoiding silos: social policy and services organised around the person'. Both the workshop and this briefing form part of the Nuffield Foundation funded research programme, Social Policies and Distributional Outcomes in a Changing Britain (SPDO), which examines social policies and social inequalities between the General Election in May 2015 and early 2020, the eve of the COVID-19 pandemic

Understanding health trajectories among unpaid carers in the United Kingdom

Context: There is very little research on the impact of caring on physical health, and the evidence that exists is mixed. There is also lack of evidence on the role of other factors including both socio-economic factors and the role played by care services and unmet needs for such services. Aims: This study aims to understand the association between physical health outcomes among unpaid carers in the United Kingdom compared to individuals who have not provided unpaid care, and investigate what is the role that time, and unmet needs for care services play in this relationship. Methods: We used four waves of the UK Household Longitudinal Survey, a large representative sample, covering the period 2015 to 2020. We performed Propensity Score Matching to compare health outcomes of carers against non-carers and Latent Class Analysis to identify different typologies of unpaid carers. Results: We found that the relationship between care provision and physical health is complex, that effects on health may differ between the short and medium run, and that deprivation levels and unmet need for services play an important role. Conclusion: This research contributes original insights into our understanding of the impact of different care trajectories on the health of the carer taking into consideration the characteristics of care-recipients, the effect of unmet needs, and external factors. This is crucial both in relation to their ability to provide support and in terms of their own care needs and is therefore of direct relevance to policy and practice to support unpaid carers

Informing and improving policy and practice for carers through research and evaluation

Carers Week took place last week to raise awareness and improve the lives of carers and the people they care for. Much has been said about the need for a robust evidence base to support this aim. Last year a seminar series funded by the Economic and Social Care Research Council explored some of the evidence and next steps; and there is a growing body of studies exploring different aspects of carers’ lives. Here PSSRU at LSE colleagues Valentina Zigante, Nicola Brimblecombe, and Derek King reflect on a joint workshop by the Social Services Research Group and the NIHR School for Social Care Research on how research and evaluation could inform and improve policy and practice in relation to informal carers

Barriers to receipt of social care services for working carers and the people they care for in times of austerity

Reconciliation of unpaid care and employment is an increasingly important societal, economic and policy issue, both in the UK and internationally. Previous research shows the effectiveness of formal social care services in enabling carers to remain in employment. Using quantitative and qualitative data collected from carers and the person they care for in 2013 and 2015, during a period of cuts to adult social care in England, we explore barriers experienced to receipt of social care services. The main barriers to receipt of services identified in our study were availability, characteristics of services such as quality, and attitudes of carer and care-recipient to receiving services. These barriers have particular implications for carers' ability to reconcile care and employment

Early onset of care needs in the older population: the protective role of housing conditions

Most older people wish to live in their own homes as they age and to have a choice over their housing and care situation. Housing has the potential to play a key role in promoting independence, delaying and/or preventing the onset of care needs and in influencing the level and type of care provision required. However, many older people live in homes that are not suitable for their comfort and needs. Our study focuses on older people living in non-specialist housing in England and aims to i) explore how housing characteristics cluster; and ii) investigate their association with an early onset of care needs. We used four waves of a large representative longitudinal sample of people aged 50 or over, covering the period 2012 to 2020. We performed Latent Class Analysis and a Cox regression survival model to provide answers to our research questions. We found that people living in poor housing conditions or living in social rented housing are more likely to experience early onset of care needs, which may lead to a higher demand for, and utilisation of, long-term care services. We believe that gaining a better understanding of the relationship between housing-related conditions and care needs is paramount from the preventative and service provision point of view, and is of relevance to policymakers, practitioners, and current and future adult long-term care users

Numbers of working carers whose employment is 'at risk' in England

Recent evidence suggests that a key threshold at which carers in England are at risk of leaving employment occurs when unpaid care is provided for 10 or more hours a week, a lower threshold than previously thought. Previous studies had shown that providing care for 20 or more hours a week had a negative effect on employment. One implication is that there are more working carers whose employment is at risk than previously thought. This paper aims to estimate the numbers of working carers whose employment is at risk because they provide care for 10 or more hours a week. A subsidiary aim is to estimate the numbers of working carers providing care for 10 or more hours a week to someone in a private household. Using the 2011 Population Census, Understanding Society (2010/11) and the Survey of Carers in Households (2009/10), we find that there are approximately 790,000 working carers aged 16-64 whose employment is at risk because they provide care for 10 or more hours a week. Of these, approximately 735,000 provide care to someone in a private household. There are nearly a quarter of a million more carers whose employment is at risk than previously thought

Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for

Previous UK research has found expressed unmet need for services by unpaid working carers and among disabled and older people. There are, however, suggestions from research that views on unmet needs for services differ between carers and care-recipients. Working carers in the UK say that the care-recipient is sometimes reluctant to accept services and the few international comparative dyad studies that have been carried out find that carers perceive higher unmet need than care-recipients. Recent policy discussions in England have also recognised that there may be differences of opinion. We collected data in 2013 from working carer/care-recipient dyads in England about perceived need for services for the care-recipient, disability, unpaid care hour provision and individual and socio-demographic characteristics. We find that care-recipients as well as their carers perceive high unmet need for services, although carers perceive higher unmet need. For carers, unmet need is associated with the disability of the carer-recipient and being the daughter or son of the care-recipient; for care recipients it is associated with unpaid care hours, carers’ employment status and carers’ health. The majority of dyads agree on need for services, and agreement is higher when the working carer provides care for 10 hours or more hours a week. Services for care-recipients may enable working carers to remain in employment so agreement on needs for services supports the implementation of legislation, policy and practice that has a duty to, or aims to, support carer’s employment