Extending the THRIVE Framework for system change to age 25 could bring stability for care leavers when they need it the most

28 October 2021

Monday 25 – Sunday 31 October 2021 marks National Care Leavers’ Week in the UK: an opportunity for all of us to look at how we can better support care leavers and ensure they have the best possible start to adult life. 

In the Fostering, Adoption and Kinship Care Team at the Tavistock and Portman NHS Foundation Trust, we can’t stress enough how vital it is that care leavers receive both the emotional and practical support they need. As a mental health trust that specialises in psychotherapy, and the social and relational aspects of emotional health, we view care leavers as a particularly vulnerable group. Family breakdown can be hugely distressing for children and young people, and can lead to long-term attachment difficulties and post-traumatic symptoms that require intensive mental health help and support. 

A safe, stable environment is crucial for care leavers during the transition from their teenage years to their early 20s, and we know that care leavers face many practical challenges during this time around housing, education, employment and social isolation. During this period of transition, it is vital that care leavers receive the emotional support they need. 

NCLW depressed girl in tunnel

Too frequently, however, care leavers do not meet the often high thresholds for specialist child and adolescent mental health services (CAMHS). This can lead to a gap in provision where a care leaver who has experienced significant trauma, yet does not meet the criteria for a psychiatric diagnosis, can be left without the emotional support they need. The THRIVE Framework for system change aims to close this gap, and ensure that every young person receives the right emotional support. To do this, mental health services must be truly responsive to the unique needs of the young person. 

While the THRIVE Framework was initially designed to support children and young people up to age 18, at the Tavistock and Portman we believe that needs-led emotional health and wellbeing support should be available for young people up to the age of 25. This is particularly important for vulnerable populations, such as care leavers. The right mental health support, at the right time, can provide care leavers with the tools they need to manage the often difficult transition into adulthood. Without this support, too many care leavers will struggle to manage adult life and may face issues with relationships, employment and education. Mental health services must do everything they can to support care leavers and empower them to build fulfilling lives. Extending the application of the THRIVE Framework to age 25 is an important step in this direction. 

Dr. Emilios Lemoniatis is a Consultant Child and Adolescent Psychiatrist in the Fostering, Adoption and Kinship Care Team at the Tavistock and Portman NHS Foundation Trust

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