INTRODUCTION
Many children and young people in the UK care for another person. In March 2011, the national census in England and Wales found that over 22 000 children aged 0–9 years, nearly 100 000 aged 10–15 years, and around 125 000 young people aged 16–19 years provided unpaid care for another person.1 They may participate in household tasks, provide emotional support, or help with nursing care. They are more likely to care for a parent than a sibling.
WHAT IS THE HEALTH IMPACT OF BEING A YOUNG CARER?
Young carers report lower life satisfaction and more worries and problems in relation to their wellbeing.2,3 They are at increased risk of missing school, falling asleep at school, and being bullied. The 2017 film I Kill Giants focused on the emotional and social impact of having an ill parent. Although the long-term effect on their mental health as they move into adulthood is unclear, in one study 11 young people who had cared for a single parent with disabling multiple sclerosis reported feeling silent, invisible, unsupported, and missing out on childhood while providing intimate physical and emotional care.4 The 2011 national census suggested a direct correlation between higher hours of care and poorer health in young carers. It also indicated that the youngest carers are most severely affected.
WHAT LEGAL RESPONSIBILITY DOES THE LOCAL AUTHORITY HAVE FOR YOUNG CARERS?
In England, the Children and Families Act 2014 requires local authorities to ‘… take reasonable steps to identify the extent to which there are young carers within their area who have needs for support’.5 A young carer’s needs assessment usually takes the form of a single assessment from social care or an Early Help assessment, which can be completed by any professional involved with the family. It takes into account the young person’s participation in education, training, recreation, and work, and considers if it is appropriate for the young person to provide that care, and, if so, what support they require. The local authority is expected to provide suitable support for the young carer, or sufficient support for the adult being cared for to reduce the caring burden on the young person.
HOW CAN GPS DETECT AND SUPPORT YOUNG CARERS?
Working Together to Safeguard Children states that ‘practitioners should … be alert to the potential need for early help for a child who … is a young carer.’6 Because young carers can go unnoticed by health and social care it is important to take a Think Family approach to consultations with adults where young carers could be involved, or where young carers themselves present with problems associated with their caring role. For example, when adults attend with mental health problems, substance misuse issues, or physically disabling conditions, ask if children or young people help with their care. If a child presents with health problems that could be related to caring for another person, explore the possibility with them. However, parents may be reluctant to admit they rely on their children for care and young people may be embarrassed about the caring role they perform. Broaching the subject in a thoughtful and sympathetic way at this early stage may improve future engagement with relevant services.
Good interagency partnership is fundamental to supporting young carers effectively. When a young carer has been identified, ensure that there are no immediate safeguarding concerns that would prompt a children’s social care referral. Always consider what is best for the child or young person, while, if possible, involving their parents in the discussion. Try to elicit the child or young person’s thoughts about the care they give and what their wishes are in relation to education and leisure opportunities, and any occupational aspirations they might have. Discuss with the child or young person, and if possible their parents, what support they feel they would benefit from and explain to them the local arrangements for coordinating a young carer’s needs assessment. Each local authority will have a young carers’ link on their website to which the child or young person can be signposted. Consider speaking to the school nurse, health visitor, or other relevant health professionals. By identifying and supporting young carers appropriately we can help them not to miss out on their childhood.
- © British Journal of General Practice 2019
REFERENCES
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(2014) Children and Families Act 2014. Chapter 6 (The Stationery Office), .
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