Calls for Systemic Reforms in Scotland's Child Care Following Landmark Study

A comprehensive study led by the University of Glasgow, in collaboration with the NSPCC and other academic institutions, has shed light on significant issues within Scotland's child care system. The research focused on improving mental health outcomes for nearly 500 children aged 0–5 years placed in foster and kinship care. The findings emphasized the importance of authoritative and consistent oversight of a child's journey through the care system to ensure their well-being and mental health.

The study highlights that infants and preschool children thrive when provided with dedicated family care. Nevertheless, children entering foster care are at an elevated risk of developing mental health challenges. Early intervention, in particular, has demonstrated its effectiveness, suggesting the need for timely and targeted support.

A key recommendation from the researchers is the appointment of a dedicated Sheriff or expert chairperson to oversee each child's care proceedings in Scotland. Such leadership could facilitate quicker, more effective decision-making and enable children and families to access mental health services without unnecessary delays.

This investigation, which was the largest of its kind involving 488 children from Glasgow and London, compared the outcomes of the New Orleans Intervention Model (NIM) — a multidisciplinary approach involving psychologists, psychiatrists, and social workers — against traditional social work support. The NIM aims to foster strong relationships between children, their birth parents, and foster carers. Despite the promising results from the US, follow-up data showed no significant long-term differences between the two groups, largely due to systemic limitations in Scotland, such as lack of legally imposed decision-making timescales and administrative backlog.

In Scotland, where children’s hearings are overseen by lay panels instead of judges, delays in decision-making have led to slower placements and higher costs compared to England. The study found that the process of securing permanent placements was nearly five times faster in England, highlighting disparities in efficiency.

The researchers urge reforms to implement more authoritative supervision, enforce timely legal processes, and integrate infant mental health services seamlessly into social and legal settings. These adjustments could significantly improve outcomes for vulnerable children and reduce economic costs.

According to Helen Minnis, Professor of Child and Adolescent Psychiatry, systemic shortcomings hinder the delivery of effective mental health support to children in care. She emphasized the urgency of reforming the care system to better support infants and their families.

Matt Forde from NSPCC stressed the importance of early mental health interventions in fostering trusting relationships and breaking down barriers between children and caregivers. He called for these services to be a core part of social and family justice systems, with clear leadership guiding timely decision-making.

Sheriff David Mackie, who led a working group on reforms for Scotland’s Children's Hearings System, noted that current processes are inefficient and too costly, and advocated for a transformative approach to adoption and care procedures. The study's findings, published in Nature Medicine, underscore the need for significant policy shifts to ensure children receive timely and effective support.