Children in UK care system deliberately self-harming to avoid losing support, research finds

A new report by researchers examining the UK care system has shed light on what experts describe as a deeply troubling survival strategy among some of the most vulnerable children. According to the findings, a number of young people in residential therapeutic care are deliberately harming themselves to avoid being moved out of the facilities they rely on for stability and support. The threat of being discharged when they improve or when they turn 18—often into adult services that are either unavailable or inadequate—has driven them to extreme behaviours.

Abi Booth, a psychotherapist who works directly with children and young people in the care system, said some are in a “catastrophic situation” where they feel compelled to make themselves more ill in order to stay in care. “They have learned that getting better or getting older means being abandoned,” she said. “So they harm themselves to prove they are still unwell enough to deserve a place.”

The research highlights a systemic failure in the transition from child to adult care services. Many young people leaving the care system at 18 face a sudden loss of support, often with insufficient housing, mental health services, or financial aid. This “cliff edge” has been documented for years, but the new findings suggest it is now actively harming children’s recovery and wellbeing.

The report calls for immediate reforms, including extending care and mental health support beyond age 18 and ensuring that improvements in a child’s condition do not result in the removal of services. It also urges better training for staff to recognise such survival behaviours and to address the underlying fear of abandonment.

Child welfare advocates have welcomed the research but say the problem is not new. They argue that underfunding of children’s social care and mental health services has created a system where young people must compete for limited resources—often by demonstrating the highest level of need.

The UK government has acknowledged the challenges facing the care system and has announced reviews into care leavers’ support. However, critics say action has been slow, and the new research underscores the urgency of moving beyond inquiries to concrete changes.

For anyone affected by these issues, support is available. In the UK, Papyrus can be contacted on 0800 068 4141, and Samaritans on 116 123. In the US, the 988 Suicide & Crisis Lifeline is available. In Australia, Lifeline is 13 11 14. Other international helplines can be found at befrienders.org.

Why This Matters

Direct harm to vulnerable children: The research reveals that young people are engaging in self-harm as a direct consequence of systemic gaps in care, posing immediate risks to their physical and psychological health.
Broader systemic failure: The findings point to a deeper crisis in how the UK transitions young people from child to adult services, with a ‘cliff edge’ that leaves many without support precisely when they most need it.
Policy urgency: The report adds to growing pressure on the UK government to reform care leavers’ support, extend the age of care, and ensure that therapeutic placements are not conditional on continuing illness.

Background

For years, child welfare campaigners have highlighted the difficult transition faced by young people leaving the care system at 18. Many lack family networks, stable housing, and adequate mental health support. A series of reviews and inquiries—including the 2016 ‘Care leavers’ transition’ report and subsequent parliamentary committees—have called for extended support to age 21 or 25. However, funding pressures and a fragmented system have meant that progress is slow. The new research appears to be the first to systematically document how this gap is driving deliberate self-harm as a means of retaining care.

Key Perspectives

Children and young people in care: Their primary interest is in maintaining stable, supportive placements. The research shows they fear that recovery or age will trigger discharge, leading them to act against their own wellbeing to avoid abandonment.

Psychotherapists and frontline staff: They see the immediate consequences of these systemic gaps. Abi Booth and others advocate for unconditional therapeutic care that does not penalise improvement, and for support to continue well beyond 18.

Government and policymakers: The Department for Education has acknowledged the need for reform but has been constrained by budgets and competing priorities. Some argue the research provides evidence for targeted investment, while others worry about the cost of extending support to all care leavers.

Critics and campaigners: Child welfare charities argue that the system has been ‘failing for decades’ and that the new findings are a damning indictment of inaction. They call for immediate legislative change to end the cliff edge and for a review of how care placements are funded and allocated.

What to Watch

Government response to the report: Will ministers announce additional funding or a pilot programme for extended care? An official reaction is expected within the next month.
Ofsted inspections: Scrutiny of therapeutic care homes may increase, with inspectors asked to look for signs of this behaviour and to assess how homes handle transitions.
Parliamentary debate: The report is likely to be raised in the House of Commons, potentially triggering a backbench debate or a formal inquiry by the Education Select Committee.

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