Improving well-being for looked after children

PictureL-R: Dr. Paul Rees, Dr. Heather Payne, Alistair Davey, Dr. Liz Andrew, Dr. Sarah Morgan-Trimmer (seminar organiser), Dr. Sally Holland, Prof. Simon Murphy (DECIPHer Co-Director).

By Sarah Morgan-Trimmer

The twenty first Health Challenge Wales: Evidence for Policy seminar took place at the end of January, with over 80 delegates from policy, practice and research coming together to discuss the emotional well-being and mental health of looked after children and care leavers in Wales.

Looked after children receive very little attention in public health research, despite the fact that health and social outcomes are relatively poor for this group. Looked after children experience mental illness at levels around five times higher than average; they are also more likely to become teenage parents and to misuse substances. Adults who were looked after as children experience worse mental health, physical health and social outcomes than comparable groups. Looked after children and care leavers may also experience problems in psychological functioning that do not meet criteria for clinical diagnoses but nevertheless have a significant impact on their well-being and overall health status.

This Health Challenge Wales seminar was organised to discuss current research in the emotional well-being and mental health of looked after children and care leavers, and generate new ideas for research that might help improve outcomes for this group. Alistair Davey, Deputy Director for Delivering Policy for Children and Adults (Social Services and Integration Directorate, Welsh Government) spoke first, outlining the policy context for looked after children’s services in Wales, including the new Social Services and Well-Being Bill. Paul Rees, Associate Professor at Swansea University, presented recent findings from an analysis of administrative data in one local authority, which examined factors affecting positive outcomes for looked after children. Liz Andrew discussed the ‘Skills for Living’ service run by Action for Children, which has had high rates of engagement and good outcomes for care leavers. Sally Holland, Reader at the School of Social Sciences at Cardiff University, presented findings from a Big Lottery-funded study into effective non-statutory services for looked after children.

Delegates also spent some time networking and discussing issues in small groups, looking at the gaps in current evidence and ideas for new research. Some of the key research questions and ideas that emerged were:

  •  How to organise services so that they are less variable across geographical areas, better coordinated and more stable;
  • Knowing when and how to assess psychological functioning in young people, and the need for good assessment tools to accurately assess a child’s needs in this area;
  • Provision of longer-term support for care leavers, and what best services might look like;
  • Understanding what kinds of services work best for young people, such as the exploration and development of approaches based on ‘attachment’ and ‘resilience’ theories;
  • Improving our understanding of mental and emotional well-being in looked after children and care leavers by identifying the pathways through care experiences that contribute to good or poor psychological outcomes;
  • Understanding how to develop foster care practice and support foster carers in order to improve outcomes for the young people in their care;
  • Developing good practice for contact with birth families (including siblings in care), as this has a significant impact on well-being;
  • The need to include young people’s voices in developing services and research agendas.


These ideas and presentations, covered in just an afternoon, generated much discussion and many ideas for potential research. Slides and notes from the presentations are available on the Health Challenge Wales website.

If you would like to collaborate with DECIPHer or PHIRN in a research project on the health and well-being of looked after children or care leavers, please take a look at our research pages, which describe the type of research that we do, and get in touch: Morgan-TrimmerSA@cardiff.ac.uk.



Sarah Morgan-Trimmer is a research associate at PHIRN (Public Health Improvement Research Network) and DECIPHer (the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement), based at Cardiff University. She tweets at @SarahMTrimmer

The Health Challenge Wales seminars are run by PHIRN, supported by the National Institute of Social Care and Health Research, Wales.

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