Supporting People Experiencing Mental ILL Health

Knowing about factors related to Mental ill health as well as Physical health, can contribute to promoting the wellbeing of individuals. Experiencing mental ill health may involve having to face personal transitions, that are not necessarily shared or understood by members of the family or significant people in their support network. Such transitions include:

  • family illness or the death of a close relative;
  • divorce and family break-up;
  • issues related to sexuality;
  • adoption;
  • the process of asylum;
  • disability;
  • parental mental health;
  • losing their home,
  • loss of a job and the consequences of crime.

Like physical ill health, mental ill health may impact on the lives of individuals and those who play an important role in their lives. In addition, the impact of mental ill health on significant people in a person’s life may sometimes be unseen by supporting some public services.

Factors, such as discrimination, prejudice and stigma may also impact on perceptions and understanding of mental ill health and its consequences. However, early intervention and recognition of indicators of mental ill health can be useful in promoting mental health and wellbeing. Half of all mental health problems emerge before the age of 14 and three quarters by age 25. Inequality underlies many risk factors for mental health problems, and needs to be addressed through the wider determinants of health which are outlined inUnderstanding place’ and ‘Understanding people’, Public Health England (2017).

Some Mental Ill Heath Indicators (Pearson, BTEC Level 3 Diploma in Adult Care Unit 12: Understand Mental Ill Health)

  • Emotional, e.g. low mood, feeling sad or down, excessive fears or worries, or extreme feelings of guilt, extreme mood changes of highs and lows, inability to cope with daily problems or stress, trouble understanding and relating to situations and to people.
    Thinking, e.g. confused thinking or reduced ability to concentrate, suicidal thinking.
  • Behaviour, e.g. excessive anger, hostility or violence, Withdrawal from friends and activities, detachment from reality (delusions), paranoia or hallucinations.
  • Physical, e.g., significant tiredness, alcohol or drug abuse, major changes in eating habits, low energy or problems sleeping, headache, stomach pain or other unexplained aches and pains.

In addition, the following groups are identified at being of high risk of mental ill Health (Public Health England, 2017

  • black and minority ethnic groups (BAME)
  • people living with physical disabilities
  • people living with learning disabilities
  • Prison population and offenders
  • LGBT people
  • Carers
  • people with sensory impairment
  • homeless people
  • refugees, asylum seekers and stateless person

Thus, in addition to mental ill health indicators, specific groups of people ‘are at a higher risk of mental health problems because of greater exposure and vulnerability to unfavourable social, economic, and environmental circumstances’, Mental Health Foundation, facts about Mental Health (2016:56).

However, there are those who think that we all have the ability within us to improve aspects of our well-being. ‘No matter what challenges we face, everyone has the ability to take steps to look after and improve their mental health and wellbeing’ (NHS 2017).

Click here: Working With Mental ILL Health to download the EMPT Working With Mental ILL Health Sample Slides.

Click the following links for other useful information:

Oliver from rehap4addiction has provided the following information: My name is Oliver and I operate a national drug and alcohol addiction advice helpline called “Rehab 4 Addiction”. I started this free helpline back in 2011. You can find my website here: 
Rehab 4 Addiction offers a free hotline dedicated to assisting those suffering from drug, alcohol and mental health issues. Rehab 4 Addiction was established in 2011 by people who overcame addiction themselves. You can contact Rehab 4 Addiction on 0800 140 4690.




Online Safety

Online safety

  • In online environments and when using technology such as computers, mobile phones or games consoles – online safety  is an essential element of safeguarding children and young people as well as vulnerable adults.
  • Online safety is not about restricting children/young people and vulnerable adults use of technology or banning access as this may compound difficult to manage behaviour; online safety is about focusing on education and raising awareness of the risks and building resilience so that we can all be confident and safer online.
  • To view the NLAFC (North London Foster Carers Councils) online training course aims click the following link: Online safety within fostering households NLAFC Aims .
  • The internet offers exciting benefits and opportunities for everyone, but it can also expose children and vulnerable adults to inappropriate and criminal behaviour. It’s important that we are aware of the risks and know how to appropriately safeguard children and vulnerable adults who go on-line. 
  • Some recent NSPCC (2017:14) research shows that ‘technology-assisted harmful sexual behaviour’ only appear to have come from families characterised by significantly higher levels of stability, less trauma and more positive parental relationships than those with dual harmful sexual behaviour and offline harmful sexual behaviour only. Whilst the London Child Protection Procedures (2018: 8.6.2) states that ‘the distribution of child abuse images continues to grow (a recent UK police operation seized over 750,000 images). Research shows that in the UK, over eight million children have access to the internet and a high proportion of these children (1 in 12), have met someone offline who they initially encountered in an online environment’.
  • Thus, it’s also important that all users of the internet are aware of the legal consequences of their online actions, both the pros and cons!
  • Taking care, being safer and responsible online and offline are an important part of child development and it is essential that all adults are aware and able to discuss this with children and young people as soon as they are online.
  • Online safety is an essential component of fostering households family/safer caring policies.
  • Parents or carers who regularly expose a child to online content which may pose a risk of harm or  deliberately expose child to illegal content or content online which puts a child at immediate risk of harm would usually be investigated by the police and social services.



Supervised Child Contact

  • Supervised child contact usually takes place when a child has or is likely to suffer harm. Supervised contact should ensure the safety of a child or children having contact; it also assists in building and sustaining positive relationships between a child and members of their non-resident family.


  • Potentially, supervised child contact can be intrusive, but it can also play a therapeutic role that provides the environment for children to have contact with significant others to develop how they relate to each other. Thus, on the one hand, supervised contact can be viewed as indiscreet, as the child contact supervisor may be required to remain within reasonable proximity to the child or children involved in the contact to ensure their safety. The contact supervisor is also expected to intervene if they consider that a child or children are at risk.


  • The Coram, guide to Best Practice in Supervised Child Contact highlights risk indicators (Characteristics) of child contact suggesting that the contact is dangerous. On the other hand, good practice suggests that the child contact supervisor/s should establish positive working relationships with the children and adults involved in the contact process whilst focusing always on the children’s needs as paramount consideration. The child contact supervisor is also expected to work in an impartial way with significant people involved in child contact who maybe distressed or expressing behaviour associated with conflict.



  • The National Association of Child Contact Centres (NACCC) gives a broad range of information related to child contact.

Sponsored by:Telephone: 0330 335 1848 


Introduction to Attachment Theory

  • Attachment theory was devised by psychiatrist and psychoanalyst John Bowlby. Within attachment theory, infant behaviour associated with attachment is primarily the seeking of (Close) proximity to an attachment figure in stressful situations; the caregiver.


  • Attachment theory suggests that Infants become attached to adults who are sensitive and responsive in social interactions with them, and who remain as consistent caregivers for some months during the period from about six months to two years of age. Attachment theory indicates that during the latter part of this period, children begin to use attachment figures (familiar people) as a secure base to explore from and return to.


  • From an attachment theory perspective, attachment means an affectional bond or tie between an individual and an attachment figure (usually a female or male caregiver). Such bonds are based on the child’s need for safety, security and protection, paramount in infancy and childhood.


  • The theory proposes that children attach to carers instinctively, for survival. Meins et al., 2002 research developed the important concept of mind-mindedness to describe the ability of a parent to understand and respond not only to the infant’s feelings but also to their thinking.


  • Thus, attachment theory suggests Infants form attachments to consistent caregivers, who are sensitive and responsive in social relationships with them.


  • The promotion of secure attachments contributes to a good Ofsted gradings, for Independent fostering providers, under the Ofsted Social care common inspection framework (SCIFF) framework, if the care and help assist children and young people ‘to develop a positive self-view and to increase their ability to form and sustain attachments and build emotional resilience and a sense of their own identity’ and the care and help ‘also helps them to overcome any previous experiences of neglect and trauma’.


  • Therefore, the quality of the social relationship, between the child and caregiver is more influential than the amount of time spent they spend together. The theory indicates that the biological mother is the usual principal attachment figure, but the role can be taken by anyone who consistently promotes nurturing over a significant period. Such nurturing involves behaviours that involves engaging in social interaction with the infant and appropriately responding readily to behavioural signals shown by the child.



  • See below for some useful attachment theory information hyperlinks:

Diploma in Residential Child Care – A5_FLYER_DIGITAL. secure pdf secure base





Levels of qualifications attained makes a difference

The lower a young adult’s qualifications, the more likely they are to not be in employment but wanting paid work. For example, around a 25% of all people aged 25 to 29 with no GCSEs at grade C or above were not in employment but wanted paid work in 2010. This compares to around 7% of those with degrees or equivalent.

In terms of life chances strategy – the Child Poverty Action Group adopts the view  of promoting labour market policies that create opportunities for progression from entry-level jobs.  Over 55% of young people with GCSE’s below grade C or no qualification are low paid compared to around 12% of those with a degree or equivalent. www
The levels of qualifications gained may also impact on the life chances of the children of the low paid – as the recent loss of student grants may well have a financial impact on young people who go on to undertake degrees. The recent House of Commons briefing paper (June 2017:9) highlights that the ‘biggest impact of the loss of grants will be on students from the lowest income households’ Thus. the higher the level of qualification gained by young people correlates to a higher level of achieved pay. Therefore, all the different levels of qualifications appear to make a noticeable difference to the amount of paid income individuals achieve.

The qualification levels in England, Wales and Northern Ireland are as follows

Entry level
Each entry level qualification is available at three sub-levels – 1, 2 and 3. Entry level 3 is the most difficult.

Level 1
Some level 1 qualifications are:
• first certificate
• GCSE – grade D, E, F or G   Visit for a full details of what qualifications levels means

Level 2
Some level 2 qualifications are:
• CSE – grade 1
• GCSE – grade A*, A, B or C

Level 3

Some level 3 qualifications are:
• A level – grade A, B, C, D or E
• access to higher education diploma
• advanced apprenticeship

Level 4

Some level 4 qualifications are:
• certificate of higher education (CertHE)
• higher apprenticeship
• higher national certificate (HNC)

Level 5

Some level 5 qualifications are:
• diploma of higher education (DipHE)
• foundation degree
• higher national diploma (HND)

Level 6

Some level 6 qualifications are:
• degree apprenticeship
• degree with honours – for example bachelor of the arts (BA) hons, bachelor of science (BSc) hons
• ordinary degree without honours

Level 7

Some level 7 qualifications are:
• integrated master’s degree, for example master of engineering (MEng)
• master’s degree, for example master of arts (MA), master of science (MSc)
• postgraduate certificate in education (PGCE)
• postgraduate diploma

Level 8

Some level 8 qualifications are:
• doctorate, for example doctor of philosophy (PhD or DPhil)
• level 8 award

Go to for full information on the level of qualifications:


Children in Care Need Male Care workers Too!

Male care workers can often be the first positive male role models that children have met, and play a vital role. But male care workers can face their own challenges in roles traditionally considered to be mainly carried out by women. Children in Care invariably bring a history of their relationships with males to fostering and adoption placements. Thus, The Fostering Network and CoramBAFF have produced information around how fostering and adoption can be more ‘men friendly’.

In addition, the following research indicates some benefits related to involved fathers:

  • The father’s education level is important (Yeung, 2004) and is of course linked to his income: better educated fathers tend to earn more. One study found that it wasn’t simply the father’s income but his permanent income that was most significant. Fathers’ education level tends to contribute substantially to permanent income (Chevalier et al, 2013). Also see the EMPT® promoting positive outcomes for children workbook (2014) Promoting positive outcomes workbook.doc Updated 2017.
  • Fathers with more education are able to provide more resources and learning opportunities for their children, and are also more likely to engage in positive interactions, such as reading, with them (Tamis-LeMonda et al, 2013).
  • Fathers’ sensitivity in interacting with their children is enormously important and sensitive fathers are not only found among better educated or wealthier fathers: the is enormous variation across social class. Sensitivity/supportiveness by fathers in interactions with their children, their engagement in literacy activities together, fathers’ use of wide vocabularies and strategies such as expanding on what children say, referring to objects and events, eliciting actions, directing attention, prompting play etc. have substantial positive impacts on child outcomes (Tamis-LeMonda et al, 2012).
  • The experience of becoming a father can provide a catalyst for making the transition to a more responsible masculine identity. Young mens masculine identities are strongly defined by locality. Young men at risk tend to be embedded in local cultures of hypermasculinity, often with problematic consequences. Many aspire to a saferand more responsible masculinity, with their aspirations again being largely shaped by local expectations ( ).


Some other useful male care worker resources:

CoramBAFF practice note 49 highlights the role of male carers in meeting the needs of fostered and adopted children. It includes discussion about gender in the family placement environment, the developmental needs of children, the experiences and perspectives of male carers, and the impact of allegations and abuse. Issues for agencies to consider and pointers for good practice are identified.



The Fostering Network the State of the Nation’s foster care survey (2016)

The Fostering Network the State of the Nation’s foster care survey (2016) – What foster carers think and feel about fostering is now available.

The Fostering Network research involved in total 2,530 foster carers from across the UK completed the survey online: 1,942 of these fostered in England, 359 in Scotland, 122 in Wales and 107 in Northern Ireland. These numbers represent four per cent, eight per cent, three per cent, and five per cent of the total foster carer populations respectively.

 Aspects of the Fostering Network reports findings are:

  •  32 per cent of foster carers felt that children’s social workers do not treat them as an equal member of the team around the child
  • 31 per cent of foster carers reported that they were rarely or never given all of the information about a fostered child prior to placement
  • 46 per cent of foster carers said their fostered children were unlikely to receive information about independent visitors
  • Almost a third of foster carers had been referred children from outside their defined approval range
  • 52 per cent of those who had taken children from outside their approval range had felt pressured into it
  • Three-quarters of those who had taken a child from outside their approval range said they received no additional training and support from their fostering service
  • Just under half of all foster carers (49 per cent) did not have an agreed training plan for the next 12 months and the same proportion of carers felt there were training courses they would have liked to attend but did not.

  Ofsted (2015) published an earlier report about foster care that amongst other findings showed:

  • There were fewer fostering households overall, but more family and friends households: there were 36,890 fostering households, a decrease of 1% from the same date in 2014. In the same period, the number of family and friends households increased by 6% to 4,145
  • More children were recorded as missing from placements and going missing more often: there were 5,055 children recorded as missing in 2014-15, an increase of 19% from the previous year. The number of times that children were recorded as going missing increased by 29%

 Whilst Ofsted (2012) highlighted the following:

  • 67,340 foster carers were approved on 31 March 2012. Of these, a large majority of carers were White (84%). The next largest number was Black (8%), followed by Asian (4%), Chinese and ‘Other’ (2%) and Mixed (1%). This was very similar to the ethnicity profile of foster carers for 2010-11
  • There were a total of 40,842 fostering households on 31 March 2012. This is an increase of around 7% from the previous year. Of these, 67% were registered with local authorities and 33% were registered with IFS
  • Overall, there were 7,427 new fostering households approved during the year. This is an increase of 9% from the same period in 2010-11. Local authorities approved 63% (4,648) of new households and 37% (2,779) were approved by IFS. This compares with 60% of new households approved in 2010-11 by local authority and 40% by IFS

There are some similar findings in both the Fostering Network’s stateofthenationsfostercare2016 and their 2014 state of the nation’s foster care report findings. In the Fostering Network 2014 report foster carers also felt  foster carers should be respected and treated as a skilled co-professional, and to be recognised as part of the team working with the child; often, in fact, they are the person who knows the child best.

The Fostering Network 2014 report showed that foster carers felt that not only should their experience and expertise be valued and listened to about day-to-day care, but also in long-term planning for children. This report also highlighted that foster carers wanted to be recognised and treated as professionals by teachers, health care workers, police and others involved in children’s lives. These working in partnership issues are consistent – The Fostering Network National conference way back in 2002 (Working Across Boundaries) raised similar issues concerning working together.


Managing Quality Outcomes in Health and Social Care Settings

Managing quality outcomes is an essential element of management competence. Measuring and assessing service quality in the social care sector presents some distinct challenges. However, indicators of service quality, including those of service impact on outcomes for children. Monitoring can mean ‘continuous or regularly repeated observations of important parts of service structure, process, output or outcome. In promoting the managing quality outcomes – monitoring performance against standards identifying non-conformance, eliminating non-conformance is another appropriate way of monitoring standards.  It’s also useful if audits are based on scientific evidence.  Therefore, appropriate practice research support making sense of monitoring care services outcomes.  Click the following hyperlink for a free copy of the EMPT® Monitor and manage the quality of the provision of care services presentation PDF.

Some Leadership and Management Care criteria related to monitoring quality:

1.1 Analyse how legislative and regulatory frameworks inform quality standards that apply to the work setting

1.2 Analyse how quality standards influence positive outcomes for individuals

1.3 Evaluate a range of methods that can be used to measure the achievement of quality standards

2.1 Work with team members and others to

  • Agree quality standards for the service
  • Select indicators to measure agreed standards
  • Identify controls to support the achievement of agreed standards

2.2 Develop systems and processes to measure achievement of quality standards

2.3 Support team members to carry out their roles in implementing quality controls

2.4 Explain how quality assurance standards relate to performance management

3.1 Support team members to carry out their roles in monitoring quality indicators

3.2 Use selected indicators to evaluate the achievement of quality standards

3.3 Work with others to identify:

  • Areas of best practice
  • Areas for improvement

The Ofsted Social care common inspection framework (SCCIF) 2017: independent fostering agencies highlights areas of good leadership

5.3 The effectiveness of leaders and managers

Some of the areas of required evidence are:

  • Whether leaders and managers show an ambitious vision, have high expectations for what all children can achieve and ensure high standards of care
  • How well leaders and managers prioritise the needs of children and young people
  • The extent to which carers are supported to ensure that children and young people continually make progress from their starting points across all aspects of their development, because leaders and managers have a clear understanding of the progress that children and young people are making in respect of the plan for them
  • Whether leaders and managers provide the right supportive environment for staff through effective supervision and appraisal and high quality induction and training programmes, tailored to the specific needs of the children and young people
  • How well leaders and managers know and understand the setting’s strengths and weaknesses, prevent shortfalls, identify weaknesses and take decisive and effective action
  • Whether the agency is achieving its stated aims and objectives
  • the quality of professional relationships to ensure the best possible all-round support to children and young people in all areas of their development
  • Whether leaders and managers actively challenge when the responses from other services are not effective
  • The extent to which leaders and managers actively promote equality and diversity


Training Support & Development Standards for foster care and the Social Model of Disability (5.8 a)

Diploma in Residential Child Care – A5_FLYER_DIGITAL. secure pdf




Giving advice and information, to young people, about substance misuse risk taking

Make sure you understand enough about drugs and substance misuse, including why children might experiment with them, so you can talk to children and young people in an informed way. For foster carers understanding the facts about drugs may also help you to:

  • promote the care plan needs of Children in Care
  • contribute to children’s risk assessments
  • inform you around what you could do in a crisis.

To understand substance misuse aim to improve your knowledge around the range of different substances and the range of different indications of substance misuse related behaviours. Also improve your knowledge around:

  • Substance misuse jargon
  • Strategies around engaging/involving children and young people in the assessment of their needs, including assessing an their understanding of services available
  • Assessing the risk to individuals and to others, and the importance of reviewing substance misuse risk assessments
  • Sources of information about, and the range of, substance misuse services available locally

For those who work with children and young people, its also useful for you to be aware of the:

  • importance of gathering full and accurate information, and how to do so
  • any legal requirements
  • the organisation’s policies and procedures in dealing with risk of danger to individuals
  • how to report accurately
  • the importance of stating any gaps in information or assumptions made

Listen as well as talk

Talking to teenagers can be sometimes be challenging. When you’re discussing drugs and substance misuse, don’t preach or give a speech and don’t make assumptions about what they know or do. Let the child or young person tell you their experiences. It’s often easier not to talk face-to-face, but to have a conversation side-by-side, such as when you’re driving in the car, washing up together, watching television or preparing food.


The following learning material provide useful information around the harm reduction substance misuse method:

  1. The Low Down Substance Misuse Training Powerpoint A.Evans (2009) Updated 2019 www.emptlondon): Paul Hira (2008)

Readers can also get information from other credible sources such as the drugs website: FRANK

Rehab 4 Alcoholism is a free and impartial helpline for people troubled with drug and alcohol issues. Rehab 4 Alcoholism aims to save lives by stopping addiction before it becomes too late. Tel: 0800 111 4108 Web:  

Oliver from rehap4addiction has provided the following information: My name is Oliver and I operate a national drug and alcohol addiction advice helpline called “Rehab 4 Addiction”. I started this free helpline back in 2011. You can find my website here:

Rehab 4 Addiction offers a free hotline dedicated to assisting those suffering from drug, alcohol and mental health issues. Rehab 4 Addiction was established in 2011 by people who overcame addiction themselves. You can contact Rehab 4 Addiction on 0800 140 4690.

SFC_2_PAGE_LEAFLET_V1_DIGITAL (1) White Final 13.03.19 Secure

What are the UK drug laws?


TSD 2.3 (a & b) Promoting Child Contact

Importance of child contact when promoting relationships with parents and others 

Blue and white 3D illustration of the word contact connected to a computer mouse

  • Child contact refers to all relationship links between a child and their families of origin and friends, regardless of the form and frequency of these links. This may include overnight stays, telephone calls, exchange of letters or photographs or indirect links through third parties.
  • These will range from frequent face to face contact to occasional exchanges of information. In some cases, contact will be supervised. Whatever the type of contact a child or young person receives – it can help them maintain important emotional and psychological bonds with significant people.
  • The majority of children’s interests will best be served by efforts to maintain or develop relationship links with their birth families. Face to face meetings will generally be the most common and satisfactory way of maintaining such relationships.
  • Even when there is no obvious contact, social workers and carers need to address the need to keep a child connected with their family background and to help them develop a sense of identity.
  • Research related to child contact shows that the earliest weeks of a Child In Care episode are crucial to the success of a placement, the relationship between the parents, carers and social workers, the level of future contact and the prognosis for an early return home.
  • Corporate parents therefore should ensure that contact arrangements are in place before or at the point a child moves to a foster placement and that arrangements for contact are recorded on the Placement Agreement/Plan.
  • See our promoting-contact-course-pptx-sample-extracts-pdf-signed

Some useful practice guidance:

  1. For children separated from one or both birth parents through divorce or care proceedings, continuing contact with family members is usually important to their emotional and psychological development and well-being, Alan Slade, Coram (2002:7), A Guide to Best Practice in Supervised Child Contact. The EMPT® Managing Director, Astell Evans contributed to this guide and is acknowledged on page 5 of this book.
  2. Foster carers ‘are able to form and maintain contact and positive working relationships with parents and other significant adults for the child or young person’, Ofsted Framework for Independent Fostering Agencies (2014: 16).
  3. Children have, where appropriate, constructive contact with their parents, grandparents, siblings, half-siblings, wider family, friends and other people who play a significant role in their lives (NMS 9). Ofsted Framework for Independent Fostering Agencies (2014: 20).
  4. Foster carers play a crucial role in supporting children’s relationships. They need to offer a consistent, reliable base from which children can connect with their families safely. Their approach to the tasks involved in contact has implications for the welfare of their fostered children at the time and in the longer term, Fostering Network (2016).
  5. If the child has been abused, contact can allow abuse to continue if there is unsupervised direct contact or ineffective scrutiny of letters and cards.  Foster carers are generally positive about contact but some report problems associated with it. In some cases these are serious, SCIE (2004).

Giving advice and information, to young people, about substance misuse risk taking