%0 Journal Article
%T Use of the Strengths and Difficulties Questionnaire to identify treatment needs in looked
%A David Wellsted
%A Hannah Wright
%A Jacqui Gratton
%A Nick Midgley
%A Sarah Jane Besser
%J Developmental Child Welfare
%@ 2516-1040
%D 2019
%R 10.1177/2516103218817555
%X In England and Wales, the single-informant Strengths and Difficulties Questionnaire (SDQ) is used to assess and monitor looked-after children¡¯s (LAC) mental health; and some targeted Child and Adolescent Mental Health Services (CAMHS) include a minimum SDQ score in their acceptance criteria. However, its ability to identify LAC who need mental health treatment is insufficiently understood. One hundred and forty four LAC referrals to a Targeted CAMHS Team were screened as part of a larger study. To establish how well the SDQ identified children who required treatment, Total Difficulties Scores from single-informant SDQs submitted at referral were compared to treatment recommendations following routine CAMHS assessment in a real-world setting. To explain the results, clinicians (n = 9) from the team were interviewed and key themes identified using thematic analysis. AUROC analysis found that the single-informant SDQ discriminated between children who were assessed as needing a mental health intervention and those who did not with low accuracy when SDQs were completed by carers or young people themselves, and moderate accuracy for teacher-completed SDQs. Optimal cutoff scores are calculated and are lower than advised in scoring guidance. Key themes from clinician interviews identified possible gaps and limitations: Developmental trauma and attachment difficulties, A different kind of patient?, Seeing the ¡°bad¡± but neglecting the sad, and The importance of clinical judgment. Contrary to current UK Government policy, this study suggests that the single-report SDQ should not be relied upon as a sole means of identifying mental health difficulties in this vulnerable, high-risk population
%K Looked-after children
%K mental health
%K Strengths and Difficulties Questionnaire
%K SDQ
%U https://journals.sagepub.com/doi/full/10.1177/2516103218817555