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Purpose: Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018. Design/methodology/approach: Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children's home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people's journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements. Findings: Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood. Practical implications: Other practical implications of the study's findings, such as improvements in secure transport arrangements, are also discussed. Originality/value: While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children's residential accommodation and provide new insights into how best to support these children. [ABSTRACT FROM AUTHOR]

Purpose: Care leavers are identified as a vulnerable group within UK society and, unsurprisingly, are more susceptible to mental health problems. Research highlights inadequacies among UK Government provisions combined with poorer outcomes for care leavers. This paper aims to measure the effectiveness of provisions on mental health when transitioning from the care system to adulthood. Design/methodology/approach: A systematic review was conducted to identify and highlight the inadequacies of provisions in place to aid a care leaver's transition and the effects on their mental health. Of the 211 studies identified from the search, six studies met the eligibility criteria and were deemed eligible by the researcher for further exploration of themes. Findings: The findings identified feeling isolated, training given to care professionals and caregivers, collaboration, lack of preparation and support and access and gaps in provisions as the five key themes. The overarching theme of interconnectedness and interplay between subthemes, mental health and a care leaver's transition, is strongly presented throughout. Many participants within the individual studies reported negative findings illustrating the weaknesses of provisions and the negative effect on their mental health. Furthermore, the findings emphasise the unique nature of everyone's experience transitioning out of the care system. Research limitations/implications: A limitation of the review is the selection of key words, which may have restricted the results produced during the main search, subsequently affecting the amount of relevant data extracted and synthesised. Finally, less emphasis on grey literature and more on empirical studies reduces the probability of discovering null or negative findings, therefore increasing the chances of publication bias (Paez, 2017). A small number of eligible studies increase the risk of not making important comparisons, prompting a wider search to be conducted in the future. An unequal ratio between national and international research in the systematic review restricts fresh perspectives and strategies concerning the mental health of care leavers. Practical implications: Care leavers are identified as a vulnerable group within society and, unsurprisingly, are more susceptible to mental health problems. The UK Government enforces national and local policies to support young adults leaving the care system and transitioning to independence. However, previous research highlights inadequacies among provisions, combined with poorer mental health outcomes for care leavers. Social implications: Following on from gaps in the current findings, an investigation into regional disparities across provisions aimed at assisting care leavers transitioning to independence would produce useful information for the field and policymakers. Although current research addresses the essence of interplay between mental health and transitioning, further research is required to help build a supporting argument for adaptations and improvements in policies and practice. Originality/value: This study supports the argument for an increase in attention from the UK Government and policymakers to improve the quality and quantity of support for a population often underserved and marginalised, especially in terms of reducing poorer mental health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider the implications of the COVID-19 pandemic for the treatment of children in penal custody. Design/methodology/approach: This paper is a viewpoint piece that analyses the consequences of the COVID-19 pandemic for children in custody, drawing on published information where available. Findings: This paper argues that imprisoned children are an extremely vulnerable group, whose experience of incarceration exacerbates that vulnerability at the best of times. Responses to COVID-19 are particularly painful for children in those settings, and the consequences are manifestly unjust. Originality/value: This paper provides an early attempt to consider the impact of COVID-19 on children in prison. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report on the findings of a qualitative study that explored the views and experiences of young people leaving care during the first phase of the Covid-19 pandemic in Northern Ireland. Design/methodology/approach: A qualitative approach was adopted involving semi-structured interviews with 24 care leavers 18–25 years old from across the region. Interviews were conducted remotely online or by telephone and explored young people's lived experiences during the pandemic including their views on the formal support services and how best to provide ongoing for support care leavers during the pandemic. Findings: Study findings highlight how known adversities for care leavers are exacerbated during the pandemic, having a detrimental impact, particularly on their emotional well-being. The response of the state as a corporate parent in mitigating the impact of the pandemic was found to be inadequate; with a need for much clearer communication, transparent and prompt decision-making and targeted specialist mental health services. The account given by the young people also highlighted the importance of participation and relationship-based practice to build on the young people's resilience in the context of high levels of social isolation and limited access to informal support systems. Originality/value: This research, based on the views of care experienced young people themselves, is the first study in Northern Ireland to report on the impact of the Covid 19 pandemic on care leaving. As such it makes a contribution to this emerging international field of study and, given the persistence of the pandemic, provides empirical findings and a social justice perspective of ongoing relevance to policy and practice with young people leaving care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to determine the attachment strategies of prospective adoptive parents and any correlation between attachment and the defensive strategies they used when talking about loss of fertility. The study also examined whether attachment strategy of the applicants had a bearing on the decision by the local authority to place a child. Design/methodology/approach: The sample was comprised of 48 respondents (21 couples) representing 84 per cent of all people who applied to one UK Social Services Department in a 12-month period. Placement of a child was reviewed two years following the assessment. The study used the dynamic maturational model version of the adult attachment interview (DMM-AAI), together with added questions on loss of fertility to assess the applicants' attachment strategies together with unresolved loss and trauma and the DMM modifiers. Findings: Unlike adoption studies using the Main and Goldwyn system, this study rated very few of the applicants' AAIs as secure (13 per cent), 48 per cent were in the normative low-risk range and 52 per cent of the AAIs were coded in the more complex DMM insecure strategies. There was a significant bias towards marriages where the partners deployed opposite low-risk/DMM strategies (13 (62 per cent) of couples). Compared with data on non-clinical populations the AAIs showed a high level of unresolved loss or trauma (58 per cent). Using a six-way distribution (A1-2, C1-2, B, A3-4, C3-6 and A/C) there was an 87 per cent correspondence between discourse about loss of fertility and that about attachment, thereby supporting the established proposition that reproduction is part of the attachment system. Twenty one per cent of the AAIs were coded as "disorientated" and this is discussed in terms of conflict for adoptive of parents concerning the raising of a child who carries their own genes or those of strangers. A case is made to conceptualise negative impact of infertility in terms of unresolved trauma rather than loss. Research - limitations/implications: This study adds to research showing that the DMM approach is more finely calibrated than the ABC+disorganised model with the latter likely over coding for security. The results emphasise that fertility and reproduction are legitimate subjects for attachment studies and that AAI discourse analysis is a valid methodology for future research. However coder agreement as to whether or not loss of fertility was resolved was only fair (64 per cent) κ. 0.25 (po0.33). More work is required in order to determine what constitutes unresolved loss of fertility and what impact, if any, this has on parenting an adopted child. Practical implications: The practice implications are considered in a separate paper. Social implications: The findings are contentious in that they suggest a significant number (48 per cent) of adoptive parents have needs not dissimilar to other clients of psychological services. Originality/value: This is the first DMM-AAI study with prospective adoptive parents and the findings show significant differences when compared with previous studies using the Main and Goldwyn AAI. It is also the first study to establish fertility as a legitimate area for attachment studies by using AAI discourse analysis. [ABSTRACT FROM AUTHOR]

Purpose: This study aims at a better understanding of parents' identity work when their parenting skills are questioned, in an organizational setting. The parents in this study were assessed as at risk of unsatisfactory parental functioning because of problems related to drugs, mental health and/or psychosocial functioning, and they were observed and offered guidance at an extended health centre in Norway. The study explores how individual self-presentations are interwoven with and dependent on organizational narratives of identity. Design/methodology/approach: Based on an analysis of 16 qualitative interviews, three exemplary cases are analyzed in detail. Narrative identity and professional gaze constitute the theoretical framework. Findings: Parents and service providers negotiate which organizational narratives of identity are available, and the narratives are integrated in parents' self-presentations in different ways. The most common strategy is to accept the organizational narratives offered, but they are also transformed and rejected. The experience of being seen by an empathic professional gaze contributes to the creation of an acceptable self-narrative. Practical implications: Tending to parents' identity needs should be an integral part of services provided. If parents are to cooperate with state services and engage in interventions, their needs for preserving an acceptable and coherent self-narrative must be considered. Originality/value: This paper adds to the understanding of how identity work is a central feature of service provision. It also adds to the literature on relationships between identity narratives at different levels of society. [ABSTRACT FROM AUTHOR]

Purpose Well-documented ethnic disparities exist in the identification and provision of quality services among children receiving community-based mental health services. These disparities extend to parent treatment engagement, an important component of effective mental health services. Currently, little is known about differences in how providers support parents’ participation in treatment and the degree to which parents actively participate in it. The purpose of this paper is to examine potential differences in both provider and parent in-session participation behaviours.Design/methodology/approach Participants included 17 providers providing standard community-based mental health treatment for 18 parent-child dyads, with 44 per cent of the dyads self-identifying as Hispanic/Latino. In-session participation was measured with the parent participation engagement in child psychotherapy and therapist alliance, collaboration, and empowerment strategies observational coding systems.Findings Overall, results indicate significantly lower levels of parent participation behaviours among Hispanic/Latino families compared to their Non-Hispanic/Non-Latino counterparts. No significant differences were seen in providers’ in-session behaviours to support parent participation across Hispanic/Latino and Non-Hispanic/Non-Latino families.Research limitations/implications These findings contribute to the literature on ethnic differences in parent treatment engagement by utilising measures of in-session provider and parent behaviours and suggest that further investigation is warranted to documenting and understanding ethnic disparities in parents’ participation in community-based child mental health treatment.Originality/value This paper contributes to the evaluation of differences in parent treatment engagement through demonstrating the utility of an in-session observational coding system as a measure of treatment engagement. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to test whether incorporating a 20-week Kundalini yoga programme into a residential home for children improves well-being outcomes.Design/methodology/approach This is a mixed methods feasibility study. Feasibility was assessed through recruitment and retention rates as well as participants’ self-report perceptions on social inclusion, mental health and well-being and through semi-structured interviews on the benefits of the study. Mutual recovery entailed that children in care (CIC), youth practitioners and management participated together in the Kundalini yoga sessions.Findings The study initially enrolled 100 per cent of CIC and 97 per cent (29/30) of eligible staff. Attendance was low with an average rate of four sessions per participant (SD=3.7, range 0-13). All the participants reported that the study was personally meaningful and experienced both individual (e.g. feeling more relaxed) and social benefits (e.g. feeling more open and positive). Pre- and post-yoga questionnaires did not show any significant effects. Low attendance was associated with the challenges faced by the children’s workforce (e.g. high levels of stress, low status, profile and pay) and insufficient consultation and early involvement of stakeholders on the study implementation process.Research limitations/implications Because of the chosen research approach (i.e. feasibility study) and low attendance rate, the research results may lack generalisability. Therefore, further research with larger samples including a control or comparison group to pilot similar research questions is mandatory.Practical implications This study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for CIC and staff working in children’s homes.Social implications The concept of togetherness and mutuality within residential spaces is discussed in the paper.Originality/value The effects of Kundalini yoga have not been reported before in any peer-review publications. This paper fulfils an identified need (i.e. poor outcomes among CIC and residential staff) and shows how movement and creative practices can support the concept of mutual recovery. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe the development process of building an assessment model to assess the emotional and behavioural needs of “looked after children”. Design/methodology/approach – The paper is a technical paper developing and evaluating a process for comprehensively assessing children ' s needs using a combination of three existing tools. Findings – The paper identifies a model to assess “looked after” children and highlights some of the early benefits and challenges which have been encountered using this model. Practical implications – This paper suggests a model and timeframe to ensure that detailed assessments of the mental health of “looked after” children are effectively carried out. Social implications – There is a potential for an improvement in assessment of looked after children that will lead to the identification of appropriate interventions and services. Originality/value – The paper is new in identifying a combination of assessment measures and a timeline to complete these. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children. Design/methodology/approach – Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence. Findings – Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established. Research limitations/implications – The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care. Practical implications – Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour. Originality/value – Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explore the growing field of the teaching of mindfulness to young people, looking at its social and policy context, its applications, and other areas of work that it might support and within which it might fit. It focuses particularly on the state of the current evidence for such teaching and the conclusions that can be drawn from it. Design/methodology/approach – The paper is a literature review, drawing mainly on the 20 or so significant and good quality studies (i.e. those with significant numbers of participants, published in peer-reviewed journals) that make up the evidence base for mindfulness and the young, along with some comments on the policy context into which mindfulness can and might fit. Findings – Work on mindfulness with young people is popular with both staff and students, has a developing presence and can be effective in promoting a very wide range of outcomes. When well taught and when practised regularly, it has been shown to be capable of improving mental health and well-being, mood, self-esteem, self-regulation, positive behaviour and academic learning. There are many possible promising locations for mindfulness within mainstream education and the health services, including work to improve on mental health and well-being for staff and students, social and emotional learning, special education and mainstream subject based work. Originality/value – Mindfulness is a new and growth area. Work with adults is well developed with a convincing evidence base, but work with the young, although developing rapidly, is much younger and this review is one of only a handful attempting to bring it to wider professional awareness. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the association between children who are at risk of being or who have been excluded from school between the ages of 4 and 12 years and the role of psychopathology, development and attainment. Design/methodology/approach – A case-control approach was conducted. Cases were children who had been excluded from school compared to those who had no reported exclusions and normative data where possible. A range of measures were used to collect information from the parent, child and teacher on areas covering the child’s mental health and well-being. Findings – The findings showed the number of difficulties faced by children who are at risk of being or who have been excluded from school compared to gender- and age-matched controls and normative data increased. Behavioural difficulties were apparent in the majority of the cases and an alarming number of children reported self-harm. Interestingly nearly all the cases had recognised needs, but not all of them were accessing appropriate services. Practical implications – There have been a number of changes regarding the identification and support of children’s mental health and well-being. This study highlights gaps in resources and provision, particularly around behavioural difficulties for children who are presenting as not coping in school. Originality/value – The findings from the SKIP study indicate the complexities and compounded difficulties faced by children who are experiencing exclusion from school. By implementing a systematic group of assessments the study was able to identify these complexities of need across a vulnerable group of children. [ABSTRACT FROM AUTHOR]

Purpose – Home visiting is a strategy widely implemented to support families following the birth of a baby. There is a broad consensus that home visiting programmes are successful. But there is little understanding of factors moderating this success. The purpose of this paper is to examine the relationship between maternal involvement in a nurse home visiting programme, maternal depression, and adjustment to the parenting role. Design/methodology/approach – A retrospective design was employed in which the medical records of 40 mothers who had been enroled in a nurse home visiting programme were examined. The number of nurse home visits from birth to six months, maternal depressive symptoms, Home Observation for Measurement of the Environment (HOME) and responsivity scores were examined. Mothers had been selected for the programme if they had a history of mental illness, were in a violent relationship, or reported drug or alcohol problems. Findings – A significant, positive relationship was found between maternal involvement, positive HOME environment and maternal responsivity scores. Furthermore, the mothers with the highest scores for HOME environment and responsivity to their infant ' s cues at six months were mothers experiencing deteriorating symptoms of depression. These mothers had the highest levels of involvement with the programme. Despite their mothers’ deteriorating mental health, infants whose mothers received the greatest number of visits from a nurse received the greatest benefit ameliorating their risk for developing poor attachment and impaired behavioural, emotional and cognitive development. Originality/value – This is the first study to examine the relationship between changes in maternal depression and programme outcomes in a home visiting programme. It is one of the first explorations of the relationship between maternal involvement and programme outcomes in a targeted nurse home visiting programme to prevent child maltreatment. The findings from this study are critical to future home visiting programme development and evaluation. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to describe the development and application of the KIPP-list of care activities. The acronym KIPP stands for Knowledge and Insight into Primary Processes. The instrument is intended as a tool for family coaches to systematically report care activities conducted in the Dutch family support programme Ten for the Future (in Dutch: Tien voor Toekomst). Design/methodology/approach -- The design of the instrument was based on the components of the programme and a literature search for similar instruments used in the Netherlands, complemented by a staff survey. A series of three studies was carried out to test the instrument's validity and user-friendliness, and to assess its potential for programme evaluation. Findings -- The majority of care activities were performed in cooperation with one or both parents alone, and less frequently with children or external professionals. Although the main focus of the work of the family coaches fell into the categories of "collecting information" and "working towards (behavioural) change" with families, the relatively high frequency of all the types of care contacts emphasises the intensity of this family support programme with a complex target group. Originality/value -- Data gathered with the instrument provided meaningful information by descriptive analysis. KIPP thereby proved its general feasibility in increasing insight into service provision. The instrument can be useful in several stages and on several levels of quality assurance and service optimisation, including reflective practice, supervision, team management and research. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to determine whether multi-type child maltreatment is associated with health-risk behaviours and mental ill-health in adolescence. Design/methodology/approach – In total, 406 15-16-year-old students from Maltese schools answered the “Child maltreatment physical and mental health” questionnaire (Nguyen et al., 2010). This assessed demographics, health risk behaviour, mental health and child maltreatment. Findings – Of the four categories of maltreatment measured (physical, sexual, emotional and neglect), 27.4 per cent of the young people experienced one type, 16.6 per cent two types, 11.1 per cent three and 6.5 per cent four. For health-risk behaviours, there were positive relationships between multi-type maltreatment and school fights (r=0.27, p<0.01), breaking school rules (r=0.19, p<0.01), illicit drug use (r=0.14, p<0.05) and alcohol use (r=0.10, p<0.05). As regards mental health, multi-type maltreatment was positively associated with depression (r=0.38, p<0.01) and anxiety (r=0.23, p<0.01), and negatively associated with self-esteem (r=-0.26, p<0.01). Practical implications – Early recognition of multi-type maltreatment and its consequences enables providers of children’s services to offer the required diverse range of services. Additionally, policy makers should ensure the adoption of multi-sectoral and collaborative inter-agency approaches so as to effectively and holistically manage child maltreatment, not only during the acute childhood phase but also during adolescence and adulthood, when consequences are expected to emerge. Originality/value – This study raises awareness about the prevalence of multi-type child maltreatment in Malta. It also highlights the negative association between cumulative exposure to multi-type child maltreatment and mental health outcomes and risky behaviours. [ABSTRACT FROM AUTHOR]