This briefing sets out a vision for a new ecosystem of care for children in complex situations and at risk of being deprived of their liberty. It is based on the learning points and case for change developed by members of a peer collaborative convened by Nuffield Family Justice Observatory.
What is the issue?
The phrase ‘children in complex situations’ is used to describe children who have multiple and intersecting needs – including mental health problems and behavioural, emotional and educational difficulties. These children have reached adolescence and are likely to be experiencing developmental trauma from past experiences, including abuse and neglect. They have often experienced poverty and discrimination. They may have underlying neurodevelopmental conditions or physical or learning disabilities. They may be at risk and harm from their behaviours or the behaviour of others, including from criminal or sexual exploitation. Their relationships and connections with family, friends and their communities are likely to be fractured.
Their needs are currently not being recognised or responded to adequately by children’s social care and mental health services, despite children’s long histories with them and the best intentions of the professionals involved. Most of these children are already in care and will have experienced high levels of instability and frequent moves – creating more barriers to accessing services that could help them.
Delayed support can lead to escalation and crisis – and serious concerns about the levels of risk or harm. Efforts to keep children safe when they have reached this point can include depriving them of their liberty, with a focus on managing immediate, short-term risks rather than providing recovery and opportunities to thrive in the long term. But placement options are limited, and if children are deprived of their liberty under the inherent jurisdiction of the high court, they can be placed in unregulated and often unsuitable secure settings. The use of deprivation of liberty orders is increasing, and applications vastly outnumber those to place children in registered secure accommodation.
What have we been working on?
Between August 2024 and September 2025, Nuffield Family Justice Observatory convened representatives from Children and Adolescent Mental Health Services (CAMHS), children’s social care, regional care cooperatives,1 NHS England and the Department for Education to form a peer collaborative.
The members were from seven areas of England where better ways to respond to children in complex situations are being tested.2 Participants shared their learning from the variety of approaches being taken, gathered insight to complement the Framework for Integrated Care3 and Principles of Care for Children with Complex Needs and Circumstances,4 and helped develop a shared vision for change, outlined in Caring for children in complex situations: Five learning points and a case for change.
Five learning points from the Peer Collaborative
- The children aren’t ‘complex’ – the services and systems are
We regard children and their needs as ‘complex’ – but the reality is that services and systems have failed to meet their multiple, intersecting needs. - At crisis points, care is even less effective
As a child’s distress increases and a point of crisis is reached, services become less able to respond effectively – and children are less likely to be involved in decisions, listened to or heard. - Services struggle to flex
Professionals are often constrained by service pathways, practice and culture – this can lead to mechanistic responses that prevent children gaining access to the tailored care they need. - Short-term decisions to keep children safe can cause long-term harm
A preoccupation with eliminating risk can disconnect children from important relationships and their communities. - The ‘system’ can make things worse for children
Overwhelmed, stuck and fragmented systems and services can be harmful.
