Keeping the Promise - health and wellbeing of care experienced children and young people: longitudinal quantitative evidence review

Methodology

Population

The target population was care experienced children and young people in Scotland. Although The Promise does not provide one single, rigid age definition, it broadly aligns with existing legal and policy frameworks:

• Children: under the Children (Scotland) Act 1995, a child is usually defined as someone under the age of 18. The Promise’s work typically uses this same threshold in line with the Children and Young People (Scotland) Act 2014: National Guidance on Part 12 defining a ‘child' or 'children' as persons who have not yet attained the age of 18. Accordingly, the present review refers to children as anyone under the age of 18.
• Young people: The Promise Plan explicitly acknowledges that care experience does not abruptly end at 18. It frequently refers to care experienced young people up to the age of 26, reflecting Scotland’s broader legal and policy framework, including the Children and Young People (Scotland) Act 2014, which entitles some care leavers to aftercare support until their 26th birthday. In line with this, the present review refers to young people as anyone aged between the ages of 18 and 26.

The Promise uses the term ‘care experienced’ to refer to anyone who was looked after at any point. It moves beyond the legal term ‘looked after’ to capture the wider lived experience. Thus, the current review generally uses the terms:

• care experienced: to describe anyone who was care experienced at any point in their life, regardless of current status; and
• looked after: to describe any child who was under the care of their local authority at the point of data analysis.

Outcomes

Key health and wellbeing outcomes of interest (based on The Promise Health Plan 24-30) included:

• Mental health and emotional wellbeing: access to mental health services; waiting times for mental health support; experiences of trauma and support to recover; stability and security in relationships (e.g., attachment, trusted adults); sense of identity, belonging, and connection.
• Physical health: general health outcomes (e.g., hospital admissions, prevalence of chronic conditions); early intervention and preventive health care (e.g., child health reviews, immunisations, developmental assessment); dental health; and sexual and reproductive health service access.
• Subjective wellbeing: self-reported wellbeing and happiness; experiences of stigma or discrimination; feelings of safety and security; and perception of being listened to and respected.
• Substance use: patterns of use and access to support, recognising strong links to both mental and physical health, as well as subjective wellbeing.

Any sources relating to the population of interest that did not assess health and wellbeing outcomes (e.g., Education Outcomes for Looked After Children) were excluded. The focus of this review was on quantitative evidence measuring health and wellbeing outcomes, as outlined above.

Search strategy

The timeframe for the search was the past 10 years between 2015 and 2025. A focused desktop search was undertaken, drawing on publicly available sources. Specifically, publications were included if they:

1. focused on care experienced Scottish populations, or presented sub-analyses of Scottish samples within broader UK-wide studies; and

2. applied longitudinal quantitative methods, including population-wide or administrative survey data. This was interpreted broadly to include datasets capable of tracking outcomes over time, either through repeated observations or linkage across datasets. Some sources (e.g., the Census) that were not inherently longitudinal by design, were also included to help inform methodology and potential linkage opportunities for future research; and

3. addressed health and wellbeing outcomes of interest, relevant to mental health and emotional wellbeing, physical health, or subjective wellbeing (as outlined above); and

4. were published in the public domain, such as government reports and academic outputs.

Phase one of the search focused on identifying relevant methodologies and analyses by reviewing established repositories of routinely collected administrative data, household surveys, and the Census. This included exploring key quantitative data sources and, where available, examining their associated publication lists:

• Looked After Children Longitudinal Dataset and the associated Children's social work statistics
• Scotland's Census and the associated Scottish Longitudinal Study
• Growing Up in Scotland
• Understanding Society
• UK Birth Cohort Studies (Millennium Cohort Study; 1970 British Cohort Study; 1958 National Child Development Study)
• Early Child Development Statistics

The search strategy varied by repository and included (1) applying filters to identify a list of relevant studies, and/or (2) using keywords ‘care experienced’ and ‘looked after children’ in search toolbars or via the browser’s find function of the aforementioned datasets.

During the second phase of the search, Google scholar was used to help identify research published in the public domain, which were not already covered by the initial phase of the search. The following search terms were used:

(("care experienced" OR "looked after child") AND Scotland AND ("mental health" OR "physical health" OR wellbeing OR health) AND (("administrative data" OR “population survey” OR "CLAS") AND longitudinal)

This search generated 219 results (as of 6 August 2025). All articles were briefly screened by title, and any articles deemed as potentially relevant were subsequently screened by abstract. Studies deemed as likely relevant by abstract were scrutinised in more detail. Those in scope following full text review were included. In some cases, references of interest within some of the studies were also reviewed in more detail if deemed potentially relevant and not picked up by either phase of the search.

Lastly, any studies or projects flagged as relevant by Scottish Government analysts after the formal search was completed were also considered for inclusion. This includes ongoing initiatives identified through professional networks.

During the second phase, eight studies were deemed eligible for inclusion (for list see Annex 1). An additional four ongoing/feasibility projects of interest were also identified, although these do not currently include analytical results (see Ongoing research section).