Abstract
Background
There are over 5,500 children and young people in the custody of the State in New Zealand. Their complex experiences and life stories have important implications for health services. Research has shown that children and young people in State care are a very vulnerable group with relatively high levels of unrecognised or unmet health needs (1,2).
Methods
A rapid literature review of the health needs of children and young people in State care and of best practice for health services in responding to those needs. Te waka hourua (the two-hulled canoe) (3) was used as a framework to understand health needs of children in State care, as well as to consider how health services can best respond to those needs.
Results
Children and young people in State care have needs across all health domains, including secure whānau and family attachment as well as timely assessment and effective management of physical, spiritual, and mental health needs. Many of these children experience co-occurrence of physical and mental health conditions which means there needs to be excellent co-ordination between paediatric and youth health services and mental health services within and between DHBs. Key infrastructure elements to achieve positive outcomes will include gathering and use of good data, development of staff knowledge, skills and understanding, and effective community programmes to improve child safety.
Conclusion
An effective child-centred approach that will enable health services to better identify and address health issues for all children, including the most vulnerable. It is also essential to remember that the journey toward health and wellbeing is also impacted by wider societal and historical influences (3).
References
1. Health needs audit for looked after children and young people in the care of the London Borough of Hillingdon. Adoption & Fostering [Internet]. 2016 July 1, 2016; 40(2):[188-97 pp.]. Available from: http://aaf.sagepub.com/content/40/2/188.short
2. Szilagyi MA, Rosen DS, Rubin D, Zlotnik S, Szilagyi MA, Harmon D, et al. Health care issues for children and adolescents in foster care and kinship care. Pediatrics. 2015;136(4):e1142-e66.doi http://dx.doi.org/10.1542/peds.2015-2656
3. Pitama S, Huria T, Lacey C. Improving Māori health through clinical assessment: Waikare o te waka o meihana. The New Zealand Medical Journal. 2014;127(1393):107-19.