Understanding outcomes and experiences: What is the prevalence of mental health and neurodevelopmental conditions among children living cross-border in residential caring environments, compared with those living within their home jurisdiction?

Background

The Children’s Health in Care in Scotland (CHiCS) study (2021) demonstrated that population‑wide linkage of social care and health records is feasible at scale, linking cohorts of care‑experienced children and young people and their peers to administrative health datasets, to better understand service use including prescriptions and hospitalisations for mental health and neurodevelopmental disorders. The Promise Data and Evidence Group is working to establish routine monitoring of selected outcomes through the CHaMP (Children's Health and Monitoring The Promise) project, led by Public Health Scotland.

However, existing administrative datasets still cannot be used to understand the underlying level of need, the extent to which demand for support is being met, nor the effectiveness of different forms of help offered across the system. This includes early social and emotional development, particularly in infancy and early childhood, recognising the importance of attachment, relationships, and early experiences in shaping lifelong wellbeing. Data linkage is currently not possible for children under 5, as until recently a child’s Scottish Candidate Number (SCN) has been used to link social work and health records. Work is currently underway to address this gap, using additional identifiers to enable linkage and improve coverage for under 5s.

Within GIRFEC, wellbeing is understood in a holistic way, reflecting all aspects of a child or young person’s life and development. It is commonly considered through the eight wellbeing indicators—Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included (SHANARRI)—which together support a rights-based, strengths-based approach to understanding and improving wellbeing. Questions in this section focus specifically on mental health and wellbeing. This includes social and emotional development, particularly in infancy and early childhood, recognising the importance of relationships, attachment, and early experiences in shaping longer-term wellbeing outcomes.

A recent longitudinal evidence review published by The Promise Data and Evidence Group shows that care experienced children face markedly higher risks of poor mental health, but also highlights substantial gaps in data coverage, particularly around preventive care, early childhood, and variation across caring environments.

Strengthening the evidence base on what supports are needed, who needs them, and what works in practice will be essential for delivering timely, effective, and equitable mental health support in line with The Promise.

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