Support a child in care with mental health concerns

Research indicates that children in care experience significantly poorer mental health than other children who have not been in care.

Talk to the child, their family and key people to find out what may have contributed to the child’s experience of mental health issues. It could be one or a combination of the following:

• a lack of permanency for the child
• the child’s experience of abuse or neglect
• the child’s disruption of attachment and relationships
• the child’s loss of identity, especially if they identify with a particular culture.

Think broadly and holistically about how to support a child in care to heal and recover from their experiences. Connect the child to supportive and safe people, if possible, within their family. If a family member cannot provide a home for the child, ask them how else they can stay connected and supportive.

Support a young person in youth detention

A young person in detention can feel isolated and vulnerable, especially at holiday and celebration times such as birthdays, Easter and Christmas. This can initiate, increase or revive their risk of self-harm. Additionally, many staff members with whom a young person has valuable interactions with during the year, are often absent at these times. A young person at risk of self-harm should be especially monitored at these times and contingency plans put in place as required.

The impending release of a young person into the community following a period in detention is also a trigger for feelings of anxiety and stress. A young person’s risk should be assessed and monitored as part of their transition plan.

Psychotropic medication for children in care

Psychotropic medication is any prescribed medication which affects cognition (such as perception and thinking), mood, level of cognitive arousal (alertness) and behaviour. Psychotropic medication includes antidepressants, antipsychotics and stimulants. Medication, used in conjunction with other therapeutic approaches such as individual or group therapy, can be beneficial for some people. It will be important to liaise with the health professional and the child to work out the best treatment option. 

If a child is being assessed for psychotropic medication:

• consider going with the child, parent and/or carer to the medical appointment — or seeking feedback from the doctor
• share information with the health professional about the child’s history of abuse and neglect — the more information the doctor has about the child’s history, the better they will be able to make a decision about diagnosis and treatment
• discuss the possibility that the child might be responding to or resisting experiences of violence - provide trauma informed reference to behaviours and emotional wellbeing
• ask questions about the doctor’s recommendations
• ask advice about the side effects of this medication — make sure the child, carer and other key people are aware of this
• in the first weeks that the child is taking medication, ask the carer to monitor the child’s behaviour, emotions, concentration, sleep and appetite — discuss any changes with the medical practitioner.

Refer to the procedure Support a child in care, Meet a child's health and wellbeing needs for more information.