Protecting the wellbeing of children in care
A simple questionnaire developed by our researchers is now used by local authorities across the UK to monitor the mental health of children in care and ensure they get the support they need.
There are an estimated 89,000 looked-after children and young people in the UK. An easy-to-use, reliable, short questionnaire developed and validated by Professor Robert Goodman, helps make sure their mental wellbeing is regularly monitored by the local authorities responsible for their care – and that they get any support they need.
The Strengths and Difficulties Questionnaire (SDQ) can identify children who may need specialist help because they have mental health problems or emotional difficulties. ‘It can be completed in five minutes by the carers, teachers or parents of children and young people,’ says Professor Goodman from our Department of Child and Adolescent Psychiatry.
It has been used by local authorities since 2008 to screen every child aged four to 16 who has been in their care for longer than a year: the information collected is sent to Government as part of an annual statistical return about looked-after children, called the SSDA903 return.
The use of the SDQ as part of the regular return was first recommended following four Government-commissioned landmark surveys that identified the large number of children in care who potentially needed support from mental health services.
The surveys were carried out between 1999 and 2003 and commissioned by the Department of Health, the Welsh Assembly and the Scottish Parliament and led by Professor Goodman with the Office for National Statistics. The surveys used the SDQ and demonstrated that looked-after children are nearly five times more likely to have mental health and/or emotional problems than children being brought up by their own families. The results helped put the mental wellbeing of looked-after children firmly on policy-makers’ agendas.
The survey results informed the recommendations of Care Matters: Time for Change, a 2007 white paper from the then Department for Education and Skills, which highlighted the need to improve the mental health of young people and children in care. Since then, annual SDQ scores have helped local authorities monitor the effectiveness of the services they offer to support the mental welfare of children and young people in their care. The scores also help professionals decide whether an individual child or young person needs a referral to specialist mental health services.
Professor Goodman has made the SDQ available to researchers and health and social care professionals to download free of charge, in many different languages. He also created ‘Youth in Mind’, a website aimed at parents and carers so they can access SDQ and a range of books and websites about mental health problems.
Professor Goodman and colleagues also developed and validated the Development and Well-Being Assessment (DAWBA), another measure used in the large nationwide surveys of the late 1990s/early 2000s. DAWBA is a more complicated diagnostic tool, specifically for health professionals and researchers.
Research led by Professor Robert Goodman
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• R Goodman. Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). Journal of the American Academy of Child and Adolescent Psychiatry, 2001; 40(11): 1337-1345
• Goodman R, Ford, T et al. Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. European Child and Adolescent Psychiatry, 2004; 13 (Supplement 2): 25-31
• Ford T et al. Psychiatric disorder among British children looked after by local authorities: a comparison with children living in private households. British Journal of Psychiatry, 2007; 190: 319-325
• Goodman A, Goodman R. Population mean scores predict child mental disorder rates: validating SDQ prevalence estimators in Britain. Journal of Child Psychology and Psychiatry, 2011; 52: 100-108
• Howard Meltzer, Rebecca Gatward, Robert Goodman, Tamsin Ford. The mental health of children and adolescents in Great Britain (2000). The report of a survey carried out in 1999 by the Social Survey Division of the Office for National Statistics on behalf of the Department of Health, the Scottish Health Executive and the National Assembly for Wales.
• Goodman R, Ford T et al. The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 2000; 41: 645-655
• Goodman A, Goodman R. Strengths and Difficulties Questionnaire scores and mental health in looked after children. British Journal of Psychiatry, 2012; 2000: 426-427. DOI: 10.1192/bjp.bp.11.104380