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

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, having an impact on mental health) and the potential analytic value of the data set. Method: Department for Education data (2009–2017) were used to examine: aggregate, population-level trends in SDQ scores in 4/5- to 16/17-year-olds; representativeness of the SDQ sample; attrition in this sample. Results: Mean SDQ scores (around 50% ‘abnormal’ or ‘borderline’) were stable over 9 years. Levels of missing data were high (25–30%), as was attrition (28% retained for 4 years). Cross-sectional SDQ samples were not representative and longitudinal samples were biased. Conclusions: Mental health screening appears justified and the data set has research potential, but the English screening programme falls short because of missing data and inadequate referral routes for those with difficulties

Rights through alliances: findings from a European project tackling homophobic and transphobic bullying in schools through the engagement of families and young people

This paper draws on findings from a European project, ‘Rights through Alliances: Innovating and Networking Both Within Homes And Schools’ (RAINBOW-HAS), conducted in 2013–15. It built collaboration between six EU countries to analyse and improve the rights of children and youth regarding sexual orientation and gender identity in educational settings. The main focus of discussion derives from a secondary discourse analysis following thematic analyses of the qualitative interviews undertaken with a range of different families, schools and community associations across these European countries, which provide a snapshot of contemporary practice. We discuss the relative silence of social work in challenging homophobic and transphobic bullying, given their potential in promoting family and young people’s engagement

Biblio-sitography of the UK context rights through alliances: innovating and networking both within homes and schools

This background context paper provides an overview and highlights from the UK in relation to homophobic bullying in schools. The paper was prepared for Workstream 1 of the Rainbow Has European Funded Project involving 6 European countries and which looked at the Rights Through Alliances: Innovating and Networking Both Within Homes And Schools between 2012-15. This paper describes the UK context and other participating countries prepared a similar background paper to inform a comparative approach and to benchmark activity across Europe. The full project report and other outputs from the programme can be viewed on the project website http://rainbowhas.eu

Having children outside a heterosexual relationship: options for persons living with HIV

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This article presents information about the social, legal and medical issues that medical and non-medical practitioners in the UK should consider in order to signpost options for people living with HIV (PLWH) who are not in a heterosexual relationship and want to become parents. Despite significant medical advances, increased medical awareness amongst HIV practitioners, and the ability to live a full life with HIV, stigma still exists around PLWH wanting to have children. There is a lack of awareness amongst the general public and the non-specialist medical community, about the realities of living with HIV, and the options available to become a parent. Vertical transmission rates in the UK are very low (<0.5%) [1]. Despite this, even amongst PLWH it is evident that stigma surrounding parenting with HIV is real, with almost 50% of HIV-positive respondents in a European study saying that having HIV would be a barrier to them deciding to have a family [2]. Irrespective of their sexual orientation, HIV-positive parents and prospective parents may bear not only the brunt of an historical HIV stigma, but also the negative discourses that surround lesbian, gay, bisexual or transgendered/gender diverse (LGBT) parenting, despite the legal advances over the past decade. First steps to breaking down this stigma are to increase public awareness around the realities of living with HIV, and awareness among PLWH that being a parent is an option for them. In 2016 in London, the UNAIDS 90-90-90 target was achieved for the first time. England came close to meeting that target, with 88% of those living with HIV being diagnosed, 96% of those on HIV treatment and 97% of them having an undetectable viral load [3]. Most PLWH taking antiretroviral medication therefore have undetectable levels of HIV in blood, meaning they cannot transmit HIV via sexual fluids [4]. Despite this, parenting is not always routinely discussed with PLWH. A recent study in London HIV clinics found that very few clinicians spoke with HIV-positive gay men about the possibility of having children [5]. Misconceptions about HIV transmission risk and medico-legal issues concerning reproduction may, thus, be rarely addressed. Education is also key to challenging stigma, and supporting the medical profession to better advise HIV-positive patients is critical, as a medical appointment is often the first opportunity that people who are newly diagnosed have to think about future options

Social workers views on the use of the Strengths and Difficulties Questionnaire (SDQ) with looked after children

This thesis investigates the views of English social workers and child and adolescent mental health service (CAMHS) clinicians about how social workers use the Strengths and Difficulties Questionnaire (SDQ) with looked after children. Focus groups and semi structured interviews (conducted 2011 - 2013) examined social workers’ (n = 58, from nine local authorities) understandings of the mental health needs of looked after children and their use of the SDQ in assessing this, as well as how CAMHS clinicians (n = 24, from 11 Health Trusts) viewed the role of social workers in appropriately assessing mental health problems. Normalisation Process Theory was used to appraise how the SDQ had been routinely operationalised in everyday social work practice. A case study of one local authority explored the working practices of looked after children’s social workers and specialist CAMHS clinicians working in a co-located (high integration) service which had achieved consistently high annual SDQ returns over a number of years. The study found most social workers were not aware of the SDQ scores of the children or young people they were allocated and did not know how to interpret it in terms of looked after children’s mental health. Routinely collected SDQ data on looked after children who had been in care for a year or longer was not utilised by most of the social workers or the local authorities which collected it. Specialist CAMHS used the SDQ alongside social workers in only two local authorities. Level of integration (based on degree of co-location of social workers and CAMHS) did not appear to be associated with social workers’ SDQ use. Detailed examination of one local authority showed that although it contained a highly integrated service and was the best in the country at getting completed SDQ forms returned from foster carers, having a robust process for data collection was not enough to ensure the SDQ was integrated within social work practice in the organisation. Given challenges to local authority budgets and services, any recommendations to improve current practice must be mindful of resource implications. Better utilisation could therefore be made of existing local authority processes and resources to embed the SDQ into routine practice. A multi-agency approach remains critical to establish the routinised usage of the SDQ. This has the potential to benefit all agencies and most importantly, looked after children

Positioning discourse on homophobia in schools: What have lesbian and gay families got to say?

This paper reports findings from a study in England, which investigated the experiences of lesbian and gay parents in relation to homophobia in primary and secondary schools. The study was part of a larger European Union project investigating the impact of family and school alliances against homophobic and transphobic bullying in schools across six nation states. Qualitative in-depth semi-structured interviews with seven lesbian and gay parents from five families were conducted to explore their unique experience and perspectives on these issues. Discourse analysis was used to facilitate understanding of how lesbian and gay families negotiated the outsider/insider and public/private spheres of the school and communities of which they were a part. Parents identified a number of strategies to address their experiences of homophobia within schools. The findings have implications for how social work recognises and promotes diversity and equality when working with lesbian, gay, bisexual and transgender families, as social workers have a powerful role in supporting families. This involves recognising the strengths of lesbian, gay, bisexual and transgender families in their assessments

Positioning discourse on homophobia in schools: what have lesbian and gay families got to say?

This paper reports findings from a study in England, which investigated the experiences of lesbian and gay parents in relation to homophobia in primary and secondary schools. The study was part of a larger European Union project investigating the impact of family and school alliances against homophobic and transphobic bullying in schools across six nation states. Qualitative in-depth semi-structured interviews with seven lesbian and gay parents from five families were conducted to explore their unique experience and perspectives on these issues. Discourse analysis was used to facilitate understanding of how lesbian and gay families negotiated the outsider/insider and public/private spheres of the school and communities of which they were a part. Parents identified a number of strategies to address their experiences of homophobia within schools. The findings have implications for how social work recognises and promotes diversity and equality when working with lesbian, gay, bisexual and transgender families, as social workers have a powerful role in supporting families. This involves recognising the strengths of lesbian, gay, bisexual and transgender families in their assessments

What can we do to support families with parents from trans and gender-diverse communities

There have been radical changes in the social and political context for gender diverse people in the last decade, both positive and negative. Debates about gender identities are played out in the public arena with either fierce (sometimes unsubstantiated and discriminatory) exchanges or a silence from those who could potentially advocate and be an active ally for individuals and communities who are adversely impacted. Here we share some of our own research knowledge and experience of working in trans care by focusing on trans parenting, a marginalised group within family research, policy, and practice. Achieving a better understanding and gaining insights into the lives and experiences of parents who are gender diverse helps to focus on the specific issues they might face, and the nuanced support and advocacy needed, not least for the benefit of their children and other family members. We firstly summarise some external influences impacting on trans parenting before sharing some key themes from the research evidence on trans and non-binary parenting (Hafford-Letchfield et al, 2019). We then draw on our empirical research with professionals collaborating with trans parents (Hafford-Letchfield et al, 2021) to illustrate the opportunities and challenges for inclusive practice with trans and gender diverse individuals who wish to become parents through adoption and fostering. We leave you with some pointers developing affirming professional practice and care for families with trans parents

Transitional safeguarding: Transforming how adolescents and young adults are safeguarded

This article argues for a transformation in the protection and safeguarding needs of young people during their transition between childhood and adulthood. In order to explore with local authorities how they would address some of these challenges, the authors facilitated four national workshops with principal social workers, senior and middle managers (n ¼ 88) from approximately one-third of Local Authorities in England (n ¼ 52) from both Children and Adult social services. Participants discussed enablers and barriers to local and regional approaches to transitional safeguarding at practice, managerial, strategic and multi-agency levels. Findings from the workshops showed many examples of commitment to improvement and change, despite funding constraints and system barriers. No single local authority had a coherent and comprehensive approach to Transitional Safeguarding. Although some partnerships had started to lead innovation, it was still too early to demonstrate any effective impact throughout all systems, including whether outcomes for young people had improved. Participants also emphasised that young people should be involved as key stakeholders in developing appropriate responses. The system changes required to improve Transitional Safeguarding practices are complex and involve a re-configuration of the ‘risk’ versus ‘rights’ paradigms that permeate societal responses to the protection of young people