Wellbeing Of Children In Care

Supporting the wellbeing of children in care: Piloting a mentalising approach in North Tyneside

Published: 25/03/2021

Author: Andrea King

Since June 2018, the Anna Freud Centre, supported by Research in Practice, Action for Children and the Child Outcomes Research Consortium (CORC), have been leading Department for Education funded work across nine pilot sites to develop a child-centred approach to understanding and supporting the mental health and wellbeing of children in care.

This includes the introduction of a mentalising approach to wellbeing and mental health assessments, and a new Virtual Mental Health Lead role which coordinates support and ensures the voices of children in care are heard in care planning processes. As the project draws to a close, these blogs share learning from some of the pilot sites that have been our partners on this journey.

In our first blog, we take the opportunity to highlight the Minister for Children and Families Vicky Ford’s recent visit to North Tyneside, where she meets with children in care and the multi-agency professionals who have been taking part in the pilot. Minister Ford said of the visit:

‘I was so pleased to hear about the brilliant work going on in North Tyneside to support the mental health of children in care. North Tyneside’s collaborative approach across health, education and social care is inspiring, and their commitment to intervene early and really listen to what the children in their care think and feel is making such a positive difference to young people’s wellbeing.’

At the start of the visit we meet Joe, who describes his own experiences in foster care and reflects that until very recently, support felt very ‘reactive’, with a distinctive ‘lag’ before it was made available. In Joe’s words, the mentalising approach made a difference by allowing his ‘voice’ to be understood and shared in reviews – meetings which had previously felt ‘intimidating’ to attend. Joe describes that the mentalising process allowed his ‘worries’ to be clearly stated, ‘spurring’ his social worker on to find solutions to his accommodation situation. In the discussion, it also becomes clear that Joe’s school was pivotal – they recognised his vast potential despite what was happening in his life, and invested time in him. Joe has just been accepted to read Law at Oxford University, with a dream of becoming a Barrister to advocate for others in need.

In the visit, Jacqui, Director of Children’s Services at North Tyneside, describes how close listening to children and families and meaningful leadership partnering across health, education, and social care, have been central to enabling North Tyneside’s innovation and Outstanding Ofsted status. The reality of this is evident – Jane, Virtual Head, describes how mental health, social care, educational psychology, occupational therapists, and education leaders meet regularly together as a team to understand the needs, experiences, and talents of each child in care.

Holly, a social worker, describes how the mentalising approach has supported the whole child to be seen – not just the needs and challenges, but also the opportunities and strengths – and how far the child’s ownership of the Journal document (which results from the assessment and is written in the child’s own words), has supported care planning. In light of this value, Holly wants to see mentalising assessments and Journals extended beyond children in care, to include all children in need and in child protection. Karen, an Independent Reviewing Officer (IRO), echoes this, describing how the mentalising approach has enabled the key thoughts and feelings of children to be better understood and acted upon in statutory care planning and review.

Perhaps the most powerful insight of all was from Alex, Head of Year in a local school, who describes how crucial the mentalising approach has been in supporting his understanding of the everyday thoughts, feelings, and challenges of children in care. Alex talks powerfully about the ‘greater insight’ that has emerged, which has fundamentally changed the perspective of all teaching staff working with the child in question – he describes the emergence of empathy. In Alex’s words, this empathy becomes the lens through which he responds to this young person’s difficulties getting to school, staying in school, and managing every day – it’s the foundation to ‘giving this child every bit of support she can get’.

It’s no surprise that Minister Ford concluded by saying how ‘moved’ she was, and asking how this mentalising approach could be expanded elsewhere. As North Tyneside extends their pilot implementation, we finish by understanding how local authority, NHS and education leaders are cooperating in local integrated care systems to make good use of investment - both from the NHS and more broadly – to meet the needs of the most vulnerable children.

The last word goes to Joe:

‘If things were noticed earlier, I would have been where I am now much sooner’.

Andrea King

Andrea King is an Associate for Research in Practice, supporting the strategic leadership of the innovative, Department for Education funded Children in Care Mental Health Assessments Pilot. Andrea works part-time as Assistant Director for NHSE/I, overseeing children and young people's mental health in the South East region, having previously worked in Children’s Services for twenty years. She is passionate about improving outcomes for those with little voice or power, who experience adversity, inequality or harm; and specialises in innovation and building sustainable improvement.