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Who are "children with complex needs"?

Children who have been through adversity, abuse or neglect (including most Looked After Children) often have a variety of complex needs including a mixture of trauma, attachment, mental health, neurodevelopment, educational and social needs. Research shows that over half have a diagnosable mental health condition, and half of the remainder have mental health needs that are below diagnostic thresholds or don't fit neatly into a diagnostic category. Children who have experienced trauma and/or poor early care are often a challenge to multiple agencies, and are often viewed as a "troubled family", a "child in need" or are on a child protection plan, in or on the edge of Care. Yet the needs of these children are often very poorly understood. This could be because they are often not easy to engage in traditional services, or because professionals tend to see them either through the lens of their behaviour, or their trauma, and don’t often get a holistic picture.

Despite this level of complexity, when children are placed into Care, their needs are not prioritised. The system is very under resourced, crisis-driven and influenced by supply and demand. The most complex children are the hardest to place and often end up placed far from their home and originating authority. There are then additional barriers towards recognising their psychological needs:

  • Variety of placement types, with little clinical governance
  • Multi-agency context, often out of area
  • Carers doing most of day to day work are often unqualified, disconnected from evidence-based interventions
  • Limited CAMHS resources (perceived as inaccessible)

There is very little access to psychological assessments, and demand exceeds supply. So we have designed BERRI to be a tool that can help identify needs in a pragmatic way, and give advice about strategies that might help these children to make progress. The BERRI can also help to identify and quantify need, allowing professionals to prioritise those that require services, and to measure whether children make progress when provided with specialist services.