ABSTRACT
Much of what is written in this book points to the need for a clinical workforce that has much greater knowledge and skills for working with children with a history of alternate care, including those who are subsequently adopted. Standard child clinical conceptualisation, assessment methods and formulations miss the mark for these vulnerable populations in a number of critical ways. This final chapter proposes ten principles to guide the design of mental health services for children in care, and those adopted from care. Effective specialisation in child welfare work by clinical child psychologists, psychotherapists and psychiatrists, requires: (i) specialised knowledge and skills; (ii) a shift from traditional clinical practice to a clinical/psychosocial- developmental scope of practice; and (iii) a strong advocacy role. To support such specialised practice, service design should be guided by: (iv) a primary – specialist care nexus, that includes universal, comprehensive assessments; (v) a shift from acute care to preventative, long-term engagement and monitoring; (vi) integration within the social care milieu; (vii) a shift from exclusion to active ownership of these client groups; (viii) normalisation strategies; and (ix) alignment of services for these client groups. Finally, it is argued that mental health service provision for these vulnerable groups is strengthened by policy that promotes (x) ‘whole of government’ accountability for their mental health needs.
