Presentation given by Panos Vostanis, University of Leicester (UK) at the 2013 FEANTSA Conference "Investing in young people to prevent a lost generation: policy and practice in addressing youth homelessness" http://feantsa.org/spip.php?article1596&lang=en
Mental health interventions and services for homeless children and families
1. Meeting the mental health needs of homeless children and families
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
Panos Vostanis
Professor of Child Psychiatry
University of Leicester, UK
pv11@le.ac.uk
2. Protective factors for child mental health
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
Attachment to main carer
Family and social stability
Educational achievement
Friendships
Coping strategies
3. Vulnerability factors for child mental health
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
Violence
Abuse
Acute life events
Chronic adversities
Family conflict, mental illness, alcohol abuse
4. ‘ I dream about it. I get pictures in my mind when I go to bed. Usually dad grabbing mum by the neck. I feel frightened and wish I could have done more for mum.’ 8-year-old homeless girl
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
5. Characteristics of homeless families Mothers (N=113) Children (N=249)
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
•Domestic violence: 56%
•Violent neighbours: 29%
•Hx of sexual abuse: 45%
•Poor social supports
•Mental health need 49% (predicted by abuse)
•Mental health contact (previous year): 13%
•Mean age 7.1 years
•Reported abuse: 9.6%
•Delayed communication
•School/nursery: 35% (from 87%)
•Mental health needs: 28% (predicted by maternal mental health)
•Mental health contact (previous year): 0.8%
6. How trauma impacts on child mental health
Trauma
Maternal Mental Health
Social Adversitie
homelessness
Parenting
Child Mental Health
7. Impact of disrupted environment on child mental health
Acute and chronic
Direct impact
Indirect impact through adults
Secondary impairments
Increase of risk / loss of protective factors
Interaction between factors (chain of adverse events)
Inverse access to services
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
8. Homeless children’s pathways to therapeutic help
Family
Community
Services
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
9. Interventions for homeless children and parents
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
•Parenting skills
•Resilience-enhancing
•Trauma-focused
Issues: Applied, integrated, innovative, flexible, timing, by whom?
10. Leicester Family Support Service for homeless children and families
Family Support Team
Social Services
Health
visitors
Schools
Educ Welfare
DV
agencies
Children’s Centres
CAMHS
Adult CPNs
Tenancy Support
Housing
11. Leicester mental health service for vulnerable children
LEICESTER
YOUNG PEOPLE’S
TEAM
In care
Refugees
Young offenders
Adopted
Homeless
12. Homeless families: Practice and organisational issues
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
‘Nobody’s core business
Targets? Guidelines? Incentives?
Housing usually key/lead agency
Care pathways
Cross-agency boundaries
Clarity of roles
Consultation
Supervision
Training
13. How can you help break the cycle?
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
What is realistic and achievable within
your current remit?
What else do you need to develop?
14. Discussion
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
● Identify realistic ways related to practice and local services of improving mental health input to homeless families within existing resources
● Plans for service development
15. Opportunities for international collaboration
Investing in young people to prevent a lost generation in Europe: key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
•Policy
•Service guidelines
•Training
•Research