Mental Health and Care Leavers

The research process by (Lopata, 2011) was divided into three stages. Stage one was the recruitment of research assistants involving Young Peoples Panel (YPP), designing of interview questionnaire material and training of YPP members in interviewing techniques. In stage two the research liaised with three local authorities in the UK and got approval to conduct the research. Interviews were conducted and audio interviews were recorded. The third stage involves transcription of audio interviews recorded, drafting of findings and result and development of recommendation base on research findings. In-depth interview was conducted with 14 youth care givers from 3 local authority areas between February and March 2011. Findings from the study revealed that negative life experiences among care leavers have always been compounded by lack of adequate knowledge of their needs, large service deficiencies experienced while in care and how such needs could be met. The study also found that majority of care leavers move to independent living between age 16 and 18 compared to their non-care peers who lived with parents until their twenties. The factors make young care leavers more likely than their peer to recur for public services at any age which they need it during their transition to adulthood. Care leavers possess adequate knowledge about some public services such as Jobcentre plus, NHS and GP services; and financial support services but very poor knowledge of existence of emotional, behavioural and psychological problem support were identified among the interviewed care leavers. Also majority of the study sample possess little or no knowledge about the availability of services such as supported accommodation services/housing benefits, drug use advice and citizen advise bureau. Some that have the knowledge of existence of this services lack awareness of how and where to access them. The study concluded by recommending that care givers, local authorities as well as the general public have the responsibility to ensure that young care givers are properly oriented about the availability of these support services and how to access them to facilitate successful transition into independent living. It is only by having a proper availability of services related to advocacy as well as peer mentorship may led to provision of proper care.

While in the studies by Clayden and Stein, 2005; Care leavers in the study were from 13 projects comprising 181 mentoring relations between mentors and mentees, which included reports from their referral forms which was collated to facilitate mentoring connections. Their meeting times were recorded. These includes length of meeting, files on the sessions.  The mentees also completed own form.  There were some limitations in the research which could have affected compilation of data, since various organizations might need specific information and the study could only deal with the particular need in the research.  Missing data were not accurately recorded or accounted for.

Demographics of care leavers

An almost equal balance between male and female care leavers were selected in their study comprising the research which began in 1 march until 28 February 2002 (51 per cent, 91) males and (44 per cent, 88) females totalling 179. Their average age was 17 years (n=167) since their ages range from 15 years to 23 years when the process of mentoring them started. This follows policy procedures which stipulates that mentoring care leavers could only be applied between 16 and 21 years. The age was inclusive in my criteria of 16-17 year old. Although my exclusion criteria was 18 years and above. The reasons for the selection of the sample was methodical, ethical consideration was moderate. The impact of mentoring was reported to be low where the focus or target was anticipated, for instance in one of the mentoring samples where focus was emotional well-being, relationship with family and social network including psychological well-being, the impact of mentoring was high for the participant in terms of various skills such as improvement in relationships, well-being, resilience, ability to solve problems, completing task given and, taking responsibility and also ability to manage stressful situations, an also live independently. Although one of the female mentees in the research was not able to achieve educationally, gain employment nor secure adequate accommodation, she was able to improve on parenting skills and also support from Child Care Services.  She also achieved on how to interview though training in interview techniques and was able to be on the interview panel where mentors were assessed. She was able to take positive steps in her future plans.  She also improved on how she communicates with others.  In this research only  care leavers were successful in realising their plans. Majority 93% of participants had achieved positively at the end of mentoring session, this was known through the recordings in the mentor's file. Their mental health improved from their sessions with mentors. From the study it can be analysed that mentorship should be such that it should led to an overall improvement in the relationship, well being as well as managing the stressful situations in the best possible manner.

Mentors ensured that care leaver had nurses who worked together with them through flexible times fixed for the convenience of the youth in an easily connected manner so that they can access services in healthcare centres, their foster homes.

Biehal and Wade (1996) carried out a longitudinal primary study to investigate the transition experiences of a sample of young care leavers in three local authorities in England over the first 18-24 month of their transition to independence. The study drew from the findings of a four-year Department of Health funded research carried out at the University of Leeds England. The study also explored the patterns of informal support with both biological and substitute families for care leavers and how such families' supports can negate challenges of independent living. A survey design of descriptive analysis was used. A sample of 183 care leavers were drawn from these three local authorities and completed survey questionnaire within 3-9 months of leaving the care. Interview questions specifically focus on their experience of being looked after such as the quality of placement, they experience, patterns of movement, educational progress, early housing related issues, employment options, development of life skills and patterns of formal and informal network of social support. 74 semi-structured interviews were also conducted with care leavers shortly after leaving care. A total of 28 postal questionnaires were completed by social workers to draw useful information about different patterns of leaving care and outcomes in the crucial first few months of leaving care. The survey questions with social workers cover similar grounds like those completed by care leavers. This methodology used allowed the researchers to gather useful data on the experiences and opinions of those involved (carers and care givers) so as to arrive at informed conclusion about impact of professional intervention and care leavers experience in transition. Meanwhile, the reliability and validity of the research instrument used as well as the sample selection method were not clearly explained in the research report. Also the representativeness of the studied samples among care leavers cannot be ascertained in the three local authorities. Findings from the study shows that 56% had entered care as a teenager, more than half had been in care for over10 years. Majority of them had experienced several movements and disruptions in placement during the time they spent in care, one third had made four or more moves during their stay while only 16% had stable placement throughout. The study also revealed that generally effective transition into independence is associated with the quality of formal and informal support from both biological and substitute families of care leavers. Based on these findings the study recommends that priority should be given to continuing professional efforts by local authorities and care givers and carers to improve family connections as one useful strategy to negotiate challenges confronting care leavers in transition.

Mayock and Veckic, (2006) in another study used a longitudinal cohort design to study a sample of 40 care leavers between the age of 12 -22.   The study was aimed to determine youth and after care homelessness in Dublin Ireland. Out of the 40 cases, 16 (40%) were reported to have a range of varied public care histories. The first phase of the study also reported that extending hard drug use was a common experience encountered among the young people in the sample. Chronic homelessness, unemployment and low life skills were also identified among the studied population. The study also revealed that many leave the care in unplanned ways or what is called ‘crisis transition' because there exist a obvious lack of national policy of guaranteed continued and consistent after care provisions that will cushion the various challenges of adulthood for young care leavers.  In identifying such policy deficiencies, the study pointed out that Child Care Act 1991 which is a typical example of after care policy in Ireland for instance mandated the provision of aftercare supports for care leavers but unfortunately does not include their health needs. Therefore, the study concludes by suggesting that a less conservative national policy be put in place to guarantee consistent provision of necessary supports for care leavers. Also the study proposed the extension of formal care leaving age to 21 years from the current 18 years.  Provision of pre-service and in-service training for careers as social workers was also highlighted as a key factor that will equip the practitioners with the needed skills to provide adequate in-care and out-care support and mentoring for foster youth.

Biehal et al, (1995) studied a sample of 74 young people aged 16 -19 to investigate different living care schemes and approaches to leaving care in three local authorities (city county and district).  Methods used include participant observation, in-depth interview and analysis of policy documents. A wide range of diversity of experience was identified in the later lives of care leavers. The study argue that unplanned or ‘crisis' transition compounded with the fact that care leavers assume adult responsibilities too quickly at early age than their non-care peer have made certain negative life conditions such as loneliness, isolation, unemployment, poverty, homelessness, constant movement, mental health deficiencies in them. Outcome dimensions of leaving care were measured and grouped under such categories as accommodation, life skills, education, health, career path, and relationship and social network. These categories of outcome dimensions of care leaving shall be discussed more extensively under different headings this section.

Supporting Secondary Studies

Wade and Munro (2008) used exploratory study to develop knowledge on how care leavers fare in adulthood after transitions in the UK. Due to Data protection and Human Rights legislation which limits access to useful database, National Cohort Development Survey (NCDS) provided the secondary data for the study. Findings from the study revealed that high risk of further movement and disruption, high unemployment and homelessness, high risk of social exclusion are commonly found among care leavers in adulthood. Also, limited after care a service which consequently affects better transition, stability, better educational attainment, were also identified in the study as common experiences of care leavers. There is evidence from the study  that care leavers are faced with possibilities of assuming adult role and independent living at a  much younger age than their peers (Stein, 2005; Mayock and Vekic, 2006), which tends to result  in their inability to cope with the challenges of independent living. For instance, limited planning before transition and consultation with their foster homes after transition may hinder their ability to manage homes and parenting successfully (Lamont et al, 2009).  Also, the study revealed that certain negative experiences of young people's pre-care such as emotional and behavioural problems may have significantly adverse effects on their progress even after transition. The authors concluded by contending that although the conditions of care leavers after transition is not determined by their past experiences, however, practitioners and public institutional supports are inevitable in housing, financial support, life skills and in reducing risk of social isolation if care leavers must have successful transitions and fare well in adulthood compared to their non-looked after peers.

Fauth,Hart and Payne (2012) in a sponsored research, titled ‘supporting care leavers' successful transition to independent living' reported summary highlight of the first stage of a five-year primary study that was aimed to examine strategies that work in supporting young care leavers successful transition into adulthood. Among the objectives, the study aimed to examine the best model of mentoring and one-on-one after-care support to assist care leavers into better education, life skills training, employment and positive transition outcomes. The study shows that a successful transition into adulthood is positively relative of the quality of care experience in general and the specific mentoring directed at the transition process.
In the breakdown of overview of support received by young care leavers Ofsted, 2012 cited in Fauth, Hart and Payne (2012), noted that 75% of young people who were soon leaving the care are getting in-care support to prepare them for life as independent adults, 56% were getting support to prepare them for higher education after transition and 52% were receiving help in getting a job upon transition while 13% were getting no support at all.  For care leavers 60% had solid pathway plans, 12% had no such plan while others were not certain. 85% had a personal mentor/ social worker assigned to them. As at the time of this report, 64% were in education, 6% in paid job, 6% were receiving in-work-training while 29% were neither in education or work training. In terms of their housing commission 21% rated their accommodation as very good or good, 18% rated theirs as okay while only 11% expressed that their accommodation was bad or very bad. Among the care leaver, 59% were getting support to prepare for life of independence as an adult, 40% were being prepared for higher education and 32% were receiving help in getting a job.  While 23% reported that they were not receiving support at all compared to 17% found in 2010. 24% reported cases of bullying and social exclusion because they had been in care.

From the above report, it is evident that many in-care and care leavers are receiving some sort of mentoring preparing them for adult life, while only a few reported not getting help at all. One major issue that remains a subject of debate is the effectiveness of such monitoring and how relevant it is to the young care leavers. A report from the Children's Rights Director for England (2012) examined a perception of care leavers on public services and relevance of supports received from care workers. The result of the study revealed that care leavers had some negative perceptions about such services; some even reported that support services given were not relevant to their situations. Others went on to express lack of trust in the service providers to treat them with respect and respond to their specific needs, perceiving that support services were complex and bureaucratic (Fauth, Hart and Payne, 2012).

Discussion of Findings

Efforts have been made in this major research to review published studies on how young care leavers fare in adulthood, challenges they encounter in independent living and the roles of mentoring in achieving successful transitions. One challenge that was recurrently lamented in almost all the studies reviewed in this major is the limited access to secondary data sets which is needed to adequately develop informed knowledge of how care leavers fare in adulthood in the UK (Wade and Munro, 2008 pp 214; Hannon et al, 2010; Lamont et al, 2009; Clayden and Stein, 2005).  Meanwhile after systematic and rigorous review of these studies, it became evidently clear that a consensus exist in the findings of these studies that care leavers experienced disadvantage in a number of ways. Common among these negative transition outcomes in the later lives of care leavers, which shall be discussed under separate themes in this section, are housing problems, higher unemployment rates and mental health problems, involvement in criminal activities, poor educational experiences, out-of- wedlock parenting, and limited or no after care services (Munro, 2008 pp 214; Hannon et al 2010; Clayden and Stein, 2005; Lopata, 2011).  At the end, workable recommendations shall be made for policies and practice on effective strategies that will aid successful transitions for care leavers and improve their quality of life in adulthood.

Some of the studies reviewed explored directly various dimensions of outcomes in later life of care leavers after transition into independence living ( Mayock and Veckick, 2006) while others compare these dimensions of outcomes with that of non-looked after children. Very differing sources of data were utilised in different studies.  Studies based on primary data as well as those that rely on secondary sources were utilised in this review. Different methodologies were as well used and their result presented from different perspectives, the importance of mentoring and continuous support service is however one interesting consistency that runs through most of these studies.  It is apparently obvious that successful transition into adulthood cannot be divorced from the flexibility and responsive nature of the care system and the birth families of the looked after children.  When the care system is flexible and responsive to the individual needs of the looked after children, It can effectively aid successful transition into adulthood and improve the quality of life of this vulnerable group.

Educational Attainment

There has been a growing concern among researches and policy makers about the education attainment of care leavers. Although, some are of the view that care leavers' educational attainment, which subsequently determine their employment opportunities and career paths, are influenced by past events that had occurred in their lives before they came into care (Hannon et al, 2010), others argued that factors such as placement stability, school place stability, and assistance with school work are responsible for educational attainment (Biehal et al, 1995). From whichever perspectives one looks at it, the disheartening fact common to several studies on care leavers transition outcome is that a significant gap exist between the educational attainment of care leavers and that of their non-care peer, for instance, the Department for Education, 2013 reported that care leavers are less likely to have achieved 5 A*-C GCSEs. Compared to 80% non- looked after children, only 36% of looked after children achieved this grade in 2012.  It is repeatedly common in research findings that care leavers are less likely (6%)  to go into higher education, compared to their peers(23%) at age 18 (Department of Education, 2013; Wade and Munro, 2008). Vast majority of care leavers are not in education at all, while few enrolled in school left without recognised certificate (Stein and Carey, 1986).   In the Hannon et al, 2010 and Clayden and Stein, 2005 reported the importance of personal mentor. This was expressed by a care leaver  “if it wasn't for my personal adviser I  would never have got to University.  I didn't think I could do it, but he thought I could and he encouraged me a lot and helped me apply…Now I am there and loved it”. This thought emphasises the role of mentors in assisting care leavers to attain better educational attainment and positive employment outcomes in adulthood.  Also given the consistency of research findings on the gap between looked after children and non-looked after peer, there is the need for government and care giver to ensure children in care and care leavers are provided with the necessary support needed to achieve better educational attainment and employment prospects.  Care workers should also ensure that support given ameliorates educational problems of care children rather than compounding it.

Strong evidence exist in relevant studies that very wide gap exist between the educational attainment of looked after children and their non-care counterparts.  The study found out that poor educational experiences is common among former foster youth than it is found in non- foster youth.  Similar to this finding, Wade and Munro, 2008 in an exploratory study utilised National Cohort Development Survey (NCDS) to develop knowledge on how care leavers fare in adulthood and found that fostered youth children are two times less likely to compare favourably with the educational attainment of the non-care counterpart without mentors or advocates.  This study also identified strong relationship between care system and other life outcomes of former fostered youth such as higher unemployment and homelessness, high rate of social exclusion and others.  Contrarily, Hannon 2010 argued that there is little evidence of care system having completely negative effect on children's welfare.  In fact, a comprehensive report of a primary study by Hannon et al, (2010) suggest the opposite, in this study it was found out that majority of care leavers have benefitted positively from care systems, individually tailored mentoring support as well as proper peer advocacy, this had been found to have progressive impact on their educational attainment, career placement and general well-being (Hannon, 2010; Clayden and Stein, 2005).  This finding disagrees with Wade and Munro, 2008 that found negative correlation between care experiences and educational attainment of former foster youth.  To support Hannon's view and Ofsted, 2012 report described that 64% of care leavers were in Education (colleges and universities. 6% in work, another 6% in in-work training while only 29% were not in education.   Rather than blaming the care system, Hannon, 2010 emphasised the importance of mentoring and stable placement.  The authors found strong association between educational achievements of looked after children, and role of personal mentor and their placement stability.  Biehal et al, 1995 found that the looked after children who had experienced instability in their placement among their studied sample were performing worse in their educational participation than those who had stable placement.  Other factors including truanting behaviour, social exclusion and abuse were also found common among looked after children that experienced unstable placement.  These negative experiences will no doubt hinder educational progress because the children will not be able to stay at the same school for long.  Also evidence from the number of studies revealed that moving children into independent living at 18th birthday or less before the GCSEs has immense negative influence on their educational attainment (Hannon et al, 2010).  Strong association between educational attainment and placement stability was also identified by Clayden and Stein, 2005. The study found that care leavers who attain university education had stable placement experience while in care, properly mentored by their social workers, regularly encouraged by their parents and had received support from foster carers with their education (pp 109). Contrary to the declining educational progress identified by Wade and Munro (2008), Hannon et al (2010) found that around the time of their 19th birthday, the percentage of care leaves in education had increased from 58.4% in 2005 to 64.9% in 2008.

Housing

Almost all the studies directed towards measuring the housing situation of former fostered children.  The selected studies measured transition outcomes in terms of suitability and safety of care leavers' accommodation. The general consensus that runs through almost all the studies was on how former fostered youths fare in adulthood and challenges they encountered in transition.  Homelessness and housing instability was the most common issues for care leavers (Clayden and Stein, 2005;; Hannon et al, 2010).  In the same line of thought, Kelleher and Kelleher (1998) studied a sample of 56 young people leaving the care. And found out that out that only one in ten were housed in hotels or supported accommodation. 36% of the studied samples were on constant movement, 32% returned home after leaving care while almost one third were homeless. Clayden and Stein (2005) have however suggested that if positive outcomes must be achieved in accommodation dimension of transition, young people must be allowed to participate in planning and decision making concerning their housing needs, in the style and location favoured by care leavers. Inability to pay house rent, social exclusion and difficulties in finding accommodation may be responsible for care leavers' homelessness. Dixon et al, (2004) found out that a least 35% of their sampled fostered youth had been homeless at some point during the nine months of the duration of their studies, 43% of those who had experienced such homelessness had made four or more moves since leaving the care compared with 5% who had not made constant moves.  Safety and suitability of accommodation of former foster youth have been an issue of considerably increased interest among researchers, social workers and policy makers. This is because housing has been agreed upon as a crucial dimension to successful transition for the care leavers and his had influences on how peer advocates and mentors proffer solutions through negotiating or bidding for suitable and comfortable accommodation. The placement  stability experienced by care leaver when they first left care has significant impact on almost all their subsequent outcomes such as ability to ability to attend and remain in college, to hold a job for a reasonably long time; and successful parenting. Hannon et al (2010) found that stable placement and good supported accommodation was the factor most significantly associated with good mental health, successful career path, adequate life skill training, successful parenting, in care leaver.  Hannon et al, 2010 further posits that given the importance of stable placement in achieving positive outcomes in adulthood, care leavers must be involved in planning and decision making regarding their housing needs.  Clayden and Stein (2005) and Hannon et al (2010) identified certain crucial factors that would promote suitable accommodation for care leavers these include; properly assessing their helping young people prepare for moves, avoiding moving people who are settled, offering a choice in style and location of accommodation, having contingency plans in place for supported accommodation and setting up a package of support to go with the support”. In a longitudinal cohort study, Mayock and Vekic (2006) used a sample of 40 care leavers in the age range of 12-22 Years to measure youth homelessness in Dublin, the study found that 16 (40%) of the sample reported varied cases of placement instability. Chronic homelessness was encountered in the study as a critical challenge for more than half of the sample. Similar cases of homelessness were however not found or reported by Hannon et al, 2010 and Clayden and Stein, 2005.  For instance Hannon, (2010) reported that 89.6% of former care leavers with whom the local authorities were in touch during 2009, were considered to be in suitable accommodation around the time of their 19th birthday.  This is an Increase from 3.9% found in 2009 and 88.4% found in 2008 (Hannon et al, 2010.pp111). Biehal et al, 1995 also found out that most young people Interviewed in their sample moved to their independent accommodation at the age of 16 to 17 while 61% had done so before the age of 18.

Mental Health

Completed Studies on care leavers after leaving Children Services revealed that this group are more vulnerable and at greater risk of mental problems than their peers (Wade and Munro, 2008; Hannon et al, 2010; Lamont et al, 2009). Mental health problems are possible negative outcomes of drug abuse, isolation, depression and social exclusion. All the research studies observed that not including the health needs of care leavers in the Children Leaving  Care Act 2000 exposes them to greater health risk, it is also unfortunate that most health services do not recognise the health needs of care leavers who left care above age 18 as a group in need of urgent health services. Therefore there is need to identify personal health needs of this group and proffer both social, professional support in assessing these services.

A body of research had identified very wide gap in the health outcome of children leaving the care system and their non-looked after peer. Lamont et al, (2009) explored the diversity of experiences encountered by care leavers in transition and found that mental health problems is an inevitable outcome of social exclusion, drug abuse ,emotional as well as behavioural problems that are common among former foster youth. Lamont et al, 2009 posit that although fostered children experienced similar health risk and problems as their non- fostered peer, but at a greater rate, this was also found to be true in (Dixon et al 2004).

Meanwhile, the importance of advocacy and placement stability had been identified as useful factors that can effectively negotiate poor mental health and emotional and behaviours problems in care leavers.  Hannon et al, (2010), however argued that though there is a link between emotional problems and placement instability, the real influence that placement ability can itself present on care leaver's mental health is more difficult to judge than can be imagined.  The authors posit further that given the repeated cases of mental health problems among children in care and care leavers, individual-based emotional and mental health support, and timely on- the- job training for social workers to provide care leavers with targeted emotional preparation support before leaving.  Such services should also be of obvious priority for care leavers even after transition into independent living.  To support this reasoning, Lamont et al, 2009 report pointed out certain factors that can effectively mitigate the detrimental effects of poor health and mental problems among care leavers is to include the need for care leavers health workers having an informal and flexible approach to providing advice and meetings for care lavers, ensuring that care leavers enjoy uninterrupted access to health services.   Several studies had also lamented the fact that health services do not include health needs of care leavers past 18 years.  Care workers and nurses are not required to provide services to fostered youths once they have left care, also their health needs and age may fall below the requirements of intervention to benefit from adult mental health services.  These factors have exposed them to grater health risks.  Apart from policy deficiencies, Hannon et al, (2010) argued that lack of consistency in mental health support, have impinged both as a cause and consequence of lack of personal mentor and unstable placement.

Life Skills

Preparing youth adequately for the challenges of independent living has been the focus of my studies. The argument is that if successful transition into adulthood will be achieved, it is inevitable to ensure that youths are adequately prepared and equipped with necessary practical skills. Biehal et al (1995) argued that such preparations for independent should be clearly defined by the young people's needs and not their age. Planning and preparing youths for independence must begin early, involving care leaver's participation, be flexible includes contingency plans in case previous arrangements break down and avoid bureaucracy. Lamont et al (2009) studies had revealed that government policies and care system have more often than not neglected the importance of mentoring as well as emotional  and psychological preparations for youths who are about to leave care. Majority of studies that focus on youth preparedness for transition and care system at large have altogether misunderstood the concept of life skills (Hannon et al 2010) to focus only on less important skills like cooking, cleaning, healthy eating, physical exercise and so forth. Whereas,  Hannon et al (2010) , Lamont et al (2009) and Clayden and Philips, 2005 agreed that ‘life skills' includes emotional and psychological preparation, practical skills, relationships and budgeting skills all of which are crucial to successful transition to adult living. Studies have suggested that when well incorporated into leaving care support services and adequately delivered, personal development programs (such as communications, and decision-making skills) and practical skills (such as budgeting, house hold tasks, shopping, anger-management) have positive influence on care leavers educational achievement, employment success, housing, successful parenting, mental health and building positive relationships  and other positive outcomes of care leavers were achieved through positive mentoring and good relations with their peer advocates. (Lamont et al, 2009; Clayden and Philips, 2005). Dixon et al (2004) completed a study of 106 care leavers and found that the concept of ‘life skills' had not been captured holistically.  The authors also found that in preparing youth for transition, certain aspects of ‘life skill' were not well delivered and assessed while some were almost completely neglected. While some did not have positive relations with their mentors.

Preparing Care Leavers for Transition

Moving out of care into independent living is one major issue of concern to foster youth, researchers, carers and policy makers. This is because transition into adulthood can be a difficult time for many young people than might be imagined because during this time care leavers are expected to assume adult status. Lamont et al 2009, Clayden and Stein, 2005 posit that transition from substitute home or foster home to their first independent accommodation may as well overlap with other changes such as transition from school to work in the lives of care leavers.  However, it has been argued that successful transition into independent living is a function of how well or not they are prepared for this stage of their lives. Compared to non-care peers, fostered youths often do not have the emotional, financial support and personal support of parents or even care workers. Hannon et al, 2010 in their research emphasised the importance of providing positive ‘looked-after' experiences for care leavers, supporting young people to plan, and prepare towards successful transition to adulthood. This last insight highlights that greater efforts needed to be placed on the role of mentoring in successful transition. The needs and aspiration of fostered children should define the type of support services they get not their age. Preparing youth for transition into independent is expected early enough, elaborative and involve participation from the youth in terms of planning and implementation of much needed support.

Recommendations

Based on the findings from included articles, the following recommendations will be suggested.

It is important for mentors and peer advocates to understand different ethnic backgrounds of young people that needed mental health services, multi-cultural perspectives such as race, religious differences and connect with them by ensuring that medical practitioners also defend the vulnerable children by also acting on their behalf to protect their rights and give them equal services and attention during consultations with them. (Brabeck, 1999; D'Andrea, 2004a; Ponterotto, Casas, Suzuki and Alexander, 2001; Sue and Sue, 2003):

When young people are unprepared for independence and adulthood, especially when the transition is unexpected this can increase their anxiety.  It is important that a proper assessment  should be conducted so that every area of the child's future needs will be looked into  and a good plan put in place though both professional and informal supports for young people before transiting from Children Services and during independent living after transition.

Efforts should be made to ensure that activities such as leisure periods are included in their Care Plan to aid care leavers towards satisfactory educational attainment through positive relationships with peers, family and friends through the introduction of more prospects through pre-education and career training.

Increased efforts should be directed towards equipping young people with important practical life skills that will give them the necessary capacity for successful adult living through the support of mentors to access to training facilities followed by getting a proper employment for the same.

Public institutions should complement government efforts where policy gaps exists to provide housing to young care leavers by involving them in decisions and suggestions on the most suitable lodgings, a likelihood plan in place in case there is change in arrangements.

To ensure successful transition, young people should be assessed and merged with an experienced mentor who is well trained to approach the transition problems of care leavers individually and according to their specific needs specially and for policy makers to input what works with the young person into the policy guidelines so that monitoring to ensure compliance is in place.

To promote their outcome and improve their living standard in transition, state supported employment and work placement programmes are essential in order to pursue their career goals and favourably access the labour market.

Suggested areas of further studies

Calls for more research have been made because there is much we do not yet know on the role of peer advocacy and mentoring in promoting care leavers' successful transition into adulthood. There is the need for more systematic analysis of services to understand what forms of support appear most helpful to this vulnerable groups of young people. Finally, involving young care leavers in research shifts the focus onto care-leaving children's rights and emphasises the role of advocacy in care services. This is consistent with empowerment models of practice (Luckock et al., 2006, p.18) and anti-oppressive and anti-discriminatory approaches (Dominelli, 2003).

Conclusion

From the entire report, conclusion can be drawn that both peer advocacy and mentoring are practiced in UK to the full extent and this is playing a significant role in supporting refugee and looked after children in the country. The services that are provided through peer advocacy and support are different from that of social support as peers have somewhat similar experience to that of unprivileged children who are suffering from pain from being isolated and left all alone. Looked after children are left alone by their parents because of certain reasons and so they suffer from lack of necessary warmth and care at such a tender age. Similarly, refugee children have to leave their place and even parents and come to a new one because of which they suffer from a number of mental problems and traumatic disorders.

In this respect, peer advocacy and mentoring play a quite a significant role. This is so as peer mentors and advocates provide them the love and care, make arrangements for their schooling and safeguard their well-being and health, secure good accommodation for them as well as employment. This help in developing their skills and building confidence so that they can utilize the best of their potential and achieve success. It is the peer advocacy and mentoring that support the unprivileged children in such manner that they learn to trust others and relationships further in life which in turn is required in their adulthood and transition it in proper manner. However, it was also found that there are certain issues while implementing of peer advocacy and mentoring services like high costs and funding, long term time commitment, lack of availability of expertise and skills required being peer mentors and advocates. With this, it can be concluded that with adequate planning and providing necessary resources government and various organizations in UK can successfully adopt these services for such unprivileged children.

Limitations

This major project was a very thorough research which was confronted with some limitations such as the use of only the qualitative studies, although combining quantitative studies will have been more in-depth but still this did not in any way affect the quality of the study. It is still a limitation since it limits the statistics and the wider study which would have been included. The time limit was a factor in which more generic studies would have been included if more time were allocated and available. Only 15 articles were included in the project, out of which 4 were primary articles although enough evidence was shown in the project, but more studies will have done more justice to the research topic. Money was another constraint in which more printing and transportation to key informants will have been beneficial. Still a wider study on the same topic will add more knowledge to practice and research, fill existing gaps and correct the challenges faced by young people transitioning from children's services into independence.

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