Search

Objective: The purpose of this paper is to report on enablers and barriers during the first 2 years of the health systems integration project that included the implementation of a health navigator role. The project aims to improve health outcomes for children and young people residing in out of home care in rural Australia with a health navigator co‐located between child protection practitioners and community health services clinicians. Setting: Rural Northwest Victoria. Participants: Sunraysia Community Health Services and the Department of Health and Human Services. Design: The qualitative design of the project evaluation involved semi‐structured interviews and documentary evidence analysis. Analyses of interviews and documentary data demonstrate the challenging nature of siloed service delivery in rural Australia, particularly during a time that comprised multiple interruptions due to COVID‐19. Results: A limited synergy between organisational priorities and reporting systems hindered project progress. The lack of a shared definition of 'health' challenged the effective collaboration between health clinicians and child protection practitioners and the role of the health navigator. The health navigator raising health awareness through project involvement, training and sector‐wide stakeholder engagement resulted in a slow but steady process of increased prioritisation of health care, increased health literacy among the child protection workforce, and broadening participation of area‐based stakeholders, but did not translate to increased access to health plans for children. Conclusion: Integrating health systems across multiple sites with support of a health navigator revealed difficulties, particularly during COVID‐19. The first phase of the project demonstrated the value of shared governance and partnerships as an imperative foundation for fundamental change. Relationships strengthened throughout the project, leading to a better understanding of area‐based strengths, which in turn supports improved pathways to health care for children and young people in OOHC within rural communities and driving the subsequent phases of the 10‐year project. [ABSTRACT FROM AUTHOR]

Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care. [ABSTRACT FROM AUTHOR]

Foster carers' knowledge of caring for abused and neglected children is a largely under-researched area. We know very little about the nature of carers' knowledge in relation to caring for children who have been abused or neglected. This paper reports on an exploratory study which examined the knowledge of caring. Qualitative data were analysed based on in-depth interviews with 10 foster carers in Queensland, Australia. A range of knowledge was identified showing an interaction of both personalized and formal understandings in the caring response. Given the breadth of knowledge recognized from the analysis, this paper presents one dimension of their knowing: theory and abuse-indicated understandings. Participants' responses in these areas were at times sound, but many struggled to provide convincing and well-formed explanations of topics, such as attachment, harm and child development which may suggest that their understandings are not what they could be. Although further research is needed on a larger scale, this study does highlight the necessity to re-examine processes and strategies for carer knowledge support, so as to strengthen their understanding of these issues. [ABSTRACT FROM AUTHOR]

Sexual abuse and dating violence are chronic problems for children and young people in out‐of‐home care. This study explored the impact of a prevention and response programme Power to Kids, which targets harmful sexual behaviour (HSB), child sexual exploitation (CSE) and dating violence (DV) for children and young people in home‐based (foster) care. Twenty‐eight case managers, 25 foster carers and 13 children and young people participated in a mixed methods study in Victoria, Australia informed by the research question: How does the Power to Kids programme impact the sexual health and safety of children and young people in home‐based (foster) care? The data analysis revealed a SAFETY approach whereby the sexual health and safety knowledge of carers and case managers was enhanced, and carers were given permission to have Brave Conversations with children and young people, who could then apply the new knowledge to their lives. Case managers were upskilled in identifying indicators of sexual abuse and empowered to escalate stalled therapeutic and disruption practice when children and young people were identified as experiencing HSB, CSE or DV. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about how prepared the aged care system is to meet the specific needs of Care Leavers and Forgotten Australians. We explored service provider and advocate perspectives about the barriers and facilitators for appropriate and safe care for this group. Methods: Three focus groups with sixteen professional stakeholders examined the ways aged care support is accessible and inaccessible for Forgotten Australians. Results: Participants noted structural and organisational features that act as barriers to best practice aged care. It was perceived that funding models and processes provide insufficient opportunity to develop trust with professionals and access tailored care. Once engaged with aged care services, the sector lacks the psychological literacy required to tailor care to manage the complex needs and preferences of Forgotten Australians. Conclusions: Systemic and organisational change that promotes increased flexibility, trauma‐informed care and non‐residential housing options will improve the safety and accessibility of aged care for Forgotten Australians. [ABSTRACT FROM AUTHOR]

Young kinship carers tend to be overlooked in kinship care policy and practice. This Australian research project explored the prevalence of kinship care households in Australia, with a particular focus on households headed by young kinship carers. Census data were utilized to explore the number of kinship care households across the carer age spectrum and some of their characteristics, including households with Indigenous carers and carers with a culturally and linguistically diverse (CALD) identity. Characteristics of households headed by carers aged 16–30 years were explored in some detail, and comparisons made with young parents. The data pointed to particular challenges for young kinship carers in relation to post‐secondary education, employment and income security. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine sex differences in self‐reported psychological distress, behavioural and emotional problems, and substance use in young people living in out‐of‐home care (OoHC). One hundred seventy‐six young people aged 12–17 years (females 53.4%) in OoHC in metropolitan Melbourne, Australia, were interviewed. Participants completed self‐report measures: Kessler Psychological Distress Scale, Strengths and Difficulties Questionnaire, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test—Youth Version. Girls had more OoHC placement instability over the past year compared with boys (p =.019). Compared with boys, the girls had significantly higher levels of distress (p <.001) (p =.007), were more likely to have self‐reported emotional symptoms (p <.001) and peer relationship problems (p =.043) and were more likely to use sedatives (p =.004). Girls had more psychological distress, behavioural disturbance, and sedative abuse; placement instability might contribute to these problems. Greater integration across OoHC, mental health, and substance use sectors is required. Girls in OoHC may benefit from interventions targeting problems with peer relationship and substance use and supporting prosocial behaviour; such targets may reduce distress and emotional symptoms and possibly prevent longer term problems. [ABSTRACT FROM AUTHOR]

Aim: Children in statutory out-of-home care (OOHC) are known to have poorer physical, developmental and mental health outcomes compared with their peers. The number of children in OOHC is increasing in Australia, with Aboriginal and Torres Strait Islander children disproportionately represented. To document the health needs of Aboriginal and Torres Strait Islander children and adolescents in OOHC attending the paediatric service at the Victorian Aboriginal Health Service (VAHS) between February 2014 and February 2016.Methods: The electronic medical records of all patients in OOHC seen by a paediatrician at VAHS between February 2014 and February 2016 were audited. Demographic data, including age and type of OOHC placement, were recorded, as were their health needs.Results: Of the 200 children seen by a paediatrician over this 2-year period, 103 were identified as being in OOHC for all or some of this same period: 43 in foster care, 8 in residential care and 52 in kinship care. Of the 103 children, 35 were <6 years of age, 51 between 6 and 13 years and 17 between 13 and 18 years; 66% were identified as having mental health problems, 37% hearing problems, 34% vision problems, 40% dental caries and 46% developmental delay including 36% with speech delay.Conclusions: Aboriginal and Torres Strait Islander children in OOHC seen by the paediatric service at VAHS have high rates of physical, developmental and psychological health needs. These data have significant potential to inform government policy and investment in effective models of care to better meet the needs of Aboriginal and Torres Strait Islander children in OOHC. [ABSTRACT FROM AUTHOR]

Abstract: Stable, long‐term foster care homes are critical to ensuring a safe and nurturing childhood for many children worldwide. Greater foster carer satisfaction is associated with increased carer retention and is therefore critical in securing such stable homes for children. The purpose of this study is to determine which factors associated with foster care agencies contribute to higher levels of foster carer satisfaction. Results from a longitudinal study of 137 foster carers indicate that perceived adequacy of agency support, preplacement training, money to cover placement expenses, and a good match between the carer and the child are predictive of higher foster carer satisfaction. A mediation model further points to the provision of preplacement training as key to ensuring higher levels of satisfaction. Results offer new insights into factors related to foster carer retention and provide guidance to foster care agencies about actions that they can take to maximize the retention of foster carers. [ABSTRACT FROM AUTHOR]

This article examines the evidence on maltreatment in foster care, drawing on a critical review of research published in the USA, the UK and Australia. Few studies have reported on the extent of maltreatment in this setting and the evidence that does exist is inconclusive. The limited available evidence suggests that maltreatment may be reported for up to two per cent of children in foster care in any one year, but much depends on the definitions used and on local variation in thresholds for investigation. The article discusses the perpetrators and nature of this maltreatment and problems with substantiation, and highlights important gaps in the existing research. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages: It is important to distinguish allegations of maltreatment from those concerning poor standards of care. However, the boundary between the two may sometimes be unclear., Poor assessment and supervision of foster carers may increase the risk of maltreatment., Precipitate responses to allegations of poor standards of care, without a proper assessment of the balance of risks, may themselves be harmful to children's emotional wellbeing. [ABSTRACT FROM AUTHOR]

ABSTRACT Inter-agency collaboration is seen as an effective way to support children and families with multiple and complex needs. Children in out-of-home care, especially those exhibiting challenging and disruptive behaviour, often require the services of multiple agencies. Ninety-two South Australian stakeholders experienced in supporting children in out-of-home care were interviewed about their experience of collaborative practice, using the specific example of supporting children with extremely challenging behaviour. Participants were teachers, foster parents, child welfare workers, child mental health professionals and residential care workers. Thematic analysis revealed several tensions inherent in such collaboration. Results are discussed in terms of their unique implications for managing challenging behaviour, and suggestions are made for improving collaborative approaches to behaviour and multi-agency practice. [ABSTRACT FROM AUTHOR]

Objectives: To report baseline mental health measures from the Children in Care study, a prospective epidemiological study of children in court-ordered foster and kinship care in New South Wales, Australia. Methods: Mental health, socialization and self-esteem were assessed in 347 children in a statewide mail survey, using two carer-report checklists, the Child Behavior Checklist (CBCL) and the Assessment Checklist for Children (ACC). Results: Children in the study had exceptionally poor mental health and socialization, both in absolute terms, and relative to normative and in-care samples. Levels and rates of disturbance for children in foster care exceeded all prior estimates. Rates of disturbance for children in kinship care were high, but within the range of prior estimates. Boys presented with higher scope and severity of mental health problems than girls on the CBCL, while gender-specific patterns of disturbance were shown on the ACC. A moderate age effect was accounted for by children's age at entry into care. Conclusions: Children in care are at high risk of mental health problems. Psychological support for the children and their carers is an essential secondary prevention strategy. Implications for service delivery are discussed. [ABSTRACT FROM AUTHOR]