”Young people who ‘age-out’ of out-of-home care face increased risks of poor outcomes, including homelessness, unemployment and substance abuse”

Around 10,000 young people in England age out of the care system every year on their 18th birthday. With care leavers making up 25% of the homeless population. Almost 25% of the adult prison population have previously been in care, and nearly 50% of under 21 year olds in contact with the criminal justice system had spent time in care. 39% of care leavers aged 19-21 years were known not be in education, employment or training (NEET), compared to around 13% of all 19-21 year olds. (stats taken from homeforgood).

This is a stark picture and a challenge for those supporting young people to transition out of care.

A recent systematic review and meta-analysis by What Works for Children looked at 16 studies from across the United States, and one study from Australia that aimed to better support outcomes for young people leaving out-of-home care. Each study differed in the way they supported young people. They included: policies that extend the age at which young people can remain in care, programmes that develop independent living skills, provide wraparound support or transitional accommodation as well as interventions that provide coaching and peer support or health information/coaching.

The review found that for almost all of the studies the evidence base was of poor quality with no clear findings on the effectiveness of their impact on outcomes for young people. With one exception being that extended care policies did have some positive impact.

The key findings of the review were:

”Study quality
A review of the quality of included studies concluded that for all studies there were significant concerns over the ways in which they were carried out. Therefore, there is low certainty of evidence for the included studies in this review. This suggests caution should be used when interpreting findings.

Transition support programmes
Coaching and peer support programmes were found to have a medium sized (some positive) impact on educational attainment. However, there are some concerns about the risk of bias in both of the included studies in this analysis, and the certainty we have in this evidence is therefore very low.

Independent living services, on their own, are unlikely to improve outcomes for care leavers. It may be the case that they are beneficial when combined with other support services, but they appear to be insufficient on their own.

Extended care policies
There is limited but emerging evidence that extending care can improve outcomes across a number of domains. However, more research is required to increase certainty and to better describe which aspects of extending care and its implementation work for which young people. Therefore, it is too early to recommend a particular approach.

Cost effectiveness
One study of extended care policies included a cost-benefit analysis which suggested that the benefits significantly outweigh the costs of providing additional care.”

The review also found very little evidence that, on their own, standard independent living services achieve positive outcomes. The review suggests that they can be effective when combined with other strategies, however the evidence base was again limited.

There was emerging and clear evidence that extended care policies were impactful and can improve outcomes across all domains, however further research is needed to understand what types of extended care is most beneficial.

For the most part across the world, formal care arrangements for young people cease at 18 and this is the case in England where a young person does not meet adult social care criteria.

There are programmes available to support young people towards the end of their placement, with little extending beyond. The majority of these programmes encourage the skills required for continued engagement in education, obtaining employment, and maintaining housing and general life skills. As we discussed in last months’ news there is often an over emphasis on ‘independence skills’ and with all such programmes of support their is very little research as to their effectiveness.

This review looked at several different domains and the impact the programmes, policies and interventions had on each. The domains looked at were:

• Homelessness
• Health
• Education
• Economic and employment
• Exposure to violence from others or conduct of violence toward others outcomes
• Risky behaviour

The majority of the findings showed that none of these programmes had a great impact on any outcomes in the various domains. This is a stark picture and suggests that much more research into the effectiveness of any such programmes is needed.  The report highlighted that ”Stakeholders who participated in focus groups reported a common thread of feedback that support services for young people need to be ‘humanised’ and need to consider the needs and preferences of individuals.”

The review concludes with its recommendations for policy and practice:

”Unfortunately, the scope and strength of current evidence on the effectiveness of policies, programmes and interventions for young people leaving care remains insufficient to draw conclusions about the effectiveness of any particular approach. The findings suggest that certain policies and programmes have promise, particularly extended care, however it is too early to recommend a particular approach. Instead, the very small effects observed in included studies suggest that decision-makers in policy and practice need to work towards improving the quality of policies, programmes and interventions targeting young people leaving care and services as usual. This could be achieved through targeted local, regional or national policy initiatives or through systematic efforts by sector organisations and service agencies to change practice based on principles of continuous quality improvement. Such efforts would require policymakers to provide the means, the support and incentives to review and enhance current services. It would require decision-makers in the field to truly operationalise and apply important service principles such as continuity and flexibility, autonomy and choice, but also accountability and responsibility. The use of evidence-based practices in transition services will require dedicated leadership, supported by data-informed improvement cultures, however it has the potential to facilitate such an urgently needed system change”

The overarching message from the review is that more research is required and more evidence-based practice is needed if we are to better support the outcomes for our young people leaving care. You can access the full review here

Do you have any great practices that have helped improve outcomes for the young people leaving your care? What are your thoughts on the research? Why not start a conversation on our Linked in Page