This is a high-quality publication from the Focus project of the Royal College of Psychiatrists' Research Unit. Thirty-five contributors writing from a variety of perspectives and agency backgrounds provide a wealth of information relevant to the mental health needs of looked after children. Included are statistics, practice tips, information on services and insights from the experience of the young people themselves. I was particularly interested to read that 23% of adult prisoners and 38% of young prisoners have been in care. Also, that a study examining the prevalence of psychiatric disorders in adolescents in the care system in Oxfordshire found 23% to be suffering from a major depressive disorder.
The bulk of the material is organised around case vignettes. An example is that of a 7-year-old of mixed parentage, who is currently in a children's home awaiting news of his 8th placement. This vignette is used to raise issues of attachment, number of placements, ethnicity and parental mental illness. Organising the material in this way, although slightly confusing to this crusty psychiatrist, is truer to the way problems attach themselves to people in the real world, and may well be more reader friendly for those at whom the book is aimed. I liked the way that each section ends with further reading, details of relevant current projects and initiatives and where to go for help and more information. The back cover states that the book is aimed primarily at foster carers and social workers and I imagine that it will be most helpful to them. However, I also feel that it contains information that should be available to those commissioning, planning and managing services, and to those in education, mental health and youth justice, whose work brings them into contact with these troubled and troubling young people.