Mental health in context: An exploration of individual, contextual and relational factors associated with the mental health of children and young people growing up in State care

Using self-reported survey data from 905 participants aged between 11-18 years, this paper explores the individual, contextual and relational factors associated with the mental health of children and young people growing up in State care in England. The online survey, designed using the bioecological model, collected data on children's characteristics, behaviours, wishes and feelings; attributes of their main developmental contexts (placement, school, social work support); their health, including mental health; and the quality of relationships across developmental contexts. The mental health of children and young people was measured using the Strengths and Difficulties Questionnaire (SDQ). A hierarchical regression analysis exploring the sequential impact of different developmental contexts and children's interaction within them showed that the following factors were significantly associated with lower SDQ total difficulties scores, indicative of better mental health: identifying as male; being of any other ethnicity than white; being an older adolescent; living with siblings; having positive feelings about school; not being excluded from school; being content with the level of contact with their social worker; having less screen time; and good relationships across their developmental contexts, with their main carer, friends and their social workers. These findings highlight the importance of continuous consideration of children's whole developmental context and relationships across these multiple contexts in assessing, addressing and improving the mental health of children and young people growing up in State care.