A major new initiative launched last week sets out 20 concrete, evidence-informed recommendations to improve professional mental health support for children and teenagers in care across England. 

Developed by a coalition of leading universities and expert organisations including UCL and National Institute for Health and Care Research Applied Research Collaborations (NIHR ARCs), the recommendations seek to address long-standing gaps in access to high-quality, trauma-informed mental health services for some of the country’s most vulnerable young people.

More than 80,000 children are currently in care in England - a number that continues to rise. Many have experienced significant early adversity, including abuse, neglect, poverty, domestic violence, and parental mental ill-health. 

These early experiences, coupled with the instability of multiple placement changes and separation from family networks, mean that children in care are at least four times more likely than their peers to experience diagnosable mental health conditions such as anxiety, depression, PTSD, or behavioural conditions.

Yet despite the clear need, access to appropriate mental health care remains inconsistent and inadequate. 

Project lead, Rachel Hiller, Professor in Child and Adolescent Mental Health at UCL and Co-Director, UK Trauma Council, said:

"Too often, children in care are left without the timely, compassionate, and effective mental health support they need to heal and thrive. Children in care are individuals. They do not all have the same mental health needs. They have a right to access and expect best-evidenced support for their mental health. 

“With the right commissioning, joined-up leadership, and a shared understanding of and buy-in to evidence-based practice, change is possible. There are already examples of excellent practice that we can learn from and scale, so all children in care, no matter where they are based, can access high-quality mental health care”  

The new national recommendations were collaboratively developed by researchers and clinicians from UCL, University of Cambridge, University of Sussex, Kingston University, University of Bristol, and King’s College London, in partnership with the UK Trauma Council and CoramBAAF. The effort also been supported by the National Children’s Bureau, Anna Freud, Become, the Care Leavers Association and four NIHR ARCs, including ARC West.

The recommendations span key areas including:

  • Commissioning practices that prioritise long-term, evidence-based approaches
  • Integrated service delivery that brings together health and social care
  • Workforce development, with a strong emphasis on evidence-based practice

The full list of recommendations is now available through the UK Trauma Council’s website.

Advocates hope the guidance will prompt urgent action from policymakers, commissioners, and service providers alike, recognising that improving mental health support for children in care is not just a moral imperative but a critical public health and economic priority.

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