Teenagers in care proceedings have more frequent health service use than their peers
A new report has found that young people entering care proceedings have a higher use of both primary and secondary health care than young people in the general population in Wales.
The study carried out by the Family Justice Data Partnership, a collaboration between Swansea and Lancaster University, used data from the Children and Family Court Advisory and Support Service in Wales (Cafcass Cymru) linked to health records held within the SAIL (Secure Anonymised Information Linkage) Databank. It aimed to uncover noticeable differences in health service use between young people in the general population and those entering care proceedings. The latter had higher use of both primary and secondary health care, including accident and emergency care.
Just over half of those in care proceedings also had a mental health disorder recorded by their GP, compared to a third of their peers not in care proceedings. Hospital admissions and A&E attendance for mental health disorders, injuries, and poisoning-related conditions were also markedly higher. For example, 6.6% had a hospital admission for injury or poisoning, and 1.7% for a mental health disorder, compared to 1.3% and 0.1%, respectively, for these conditions in the general population.
Dr Lucy Griffiths, Senior Lecturer at Swansea University’s Population Data Science and ADR Wales Co Investigator, said: “By linking population-level family justice and health data held within the SAIL Databank, this research evidences the heightened health vulnerabilities of older children and young people entering care proceedings.
“While further work is needed to understand the background to the high rates of mental health diagnoses we have found, and the severity and causes of injuries, this study does highlight the need for better provision of coordinated social and health care support for young people at risk of entering care proceedings.”
Working within the SAIL Databank with Cafcass Cymru data acquired for this project by ADR Wales, the study also revealed that the number of adolescents subject to care proceedings rose from 219 to 323 between 2011-12 and 2019-20 an increase of 47%. This is rising faster than for any other group of children.
The rise represents a significant shift in the age range of children coming before the family court and raises questions about how well equipped the system is to meet their needs. A decade ago, adolescents made up just 18% of all children in care proceedings in Wales; this had risen to 23% by 2019/2020.
The Cardiff and South East Wales area had the highest rates of young people in proceedings, followed by North Wales. Swansea and South West Wales had by far the lowest – at almost half that of Cardiff and South East Wales.
There is evidence of a particularly sharp increase in the number of adolescents subject to care proceedings in the two years between 2014-15 and 2016-17. This coincides with changes in the use of voluntary accommodation arrangements under Section 76 of the Social Services and Well-being Act (Wales) 2014 after concerns were raised about their use by the family court. The changes mean that parents can voluntarily agree that their child or children should be accommodated by the Local Authority – often in foster care – with no involvement by the court. The marked rise in young people in care proceedings from this point suggests an increase in cases coming before the court instead.
Lisa Harker, Director of Nuffield Family Justice Observatory, said: “Older children come into care proceedings with a unique set of vulnerabilities, often induced by long-term instability coupled with harm from outside the home. For the child protection and family justice systems – which have, until recently, focused on protecting younger children and on understanding risks from within the family home rather than outside it – this means a complete rethink about the options available to professionals to meet these young people’s needs.”
The team behind the analysis includes ADR Wales academics Dr Lucy Griffiths, Rhodri Johnson, Professor Ann John and Professor David Ford, with colleagues from Swansea University (Ian Farr, Carys Jones, Alex Lee), Lancaster University (Dr Bachar Alrouh and Professor Karen Broadhurst) and the Nuffield Family Justice Observatory (Alice Roe).