When are attachment difficulties an indication for specialist mental health input?

This article presents the characteristics of 83 looked after and 67 adopted children at the time of their first assessment by a designated mental health team in the context of potential appropriateness of this service. Attachment and mental health problems were significantly associated across most subscales of the Relationships Problems (RPQ) and the Strengths and Difficulties Questionnaires (SDQ). Adopted children were younger and were rated higher on both measures. One-third of the children were rated below the clinical cut-off SDQ score. The service appeared to adopt broad referral criteria to include attachment difficulties rather than just mental health disorders. The findings are discussed in relation to the varied interpretation of the constructs of attachment difficulties and disorders, and the future development of care pathways for looked after and adopted children.