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5 The health needs of young people leaving, or who have recently left, care
Stein and others in several countries have shown how poorly equipped many young people leaving care are to cope with life after care - practically, emotionally and educationally - and have made connections with their subsequent experiences of loneliness, isolation, poor mental health, unemployment, poverty, drift and homelessness (Stein and Kufeldt, in Scott and Ward (2005)). Meltzer and colleagues (2003) noted that 47% of looked after and accommodated 16-year-olds were assessed as having a mental disorder.
From research in England, it is estimated that a quarter of young women leaving care are pregnant or have a child and that the numbers of young women who give birth increases within 18 to 24 months of leaving care (Biehal et al. 1995). This is of particular concern because a significant number of looked after young people of this age have the added pressure of moving to independent living and many experience heightened feelings of anxiety and isolation. This echoes the feedback from young people themselves (Scottish Health Feedback 2003).
Young people have criticised the timing and poor preparation for leaving care. The transition from care to independent living has been considered to be detrimental in terms of health and wellbeing with high levels of depressive moods, low self esteem and deliberate self harm (Ridley and McCluskey 2003; Scottish Health Feedback 2003).
Many of the factors, identified by Stein and others, are associated with the areas of risk identified for those likely to self-harm or attempt suicide (Choose Life 2002). Factors such as changes in family composition; poor social cohesion or integration including neighbourhood deprivation and poverty; isolation; feelings of fear; inadequate access to services; employment status; substance misuse and alcohol problems; low self esteem; lack of confidence; and experience of abuse are present in many of the lives of young people looked after and accommodated who, from 16 onwards, are expected to move towards independent living.
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