How did I get here? It sure wasn’t easy!

My enthusiasm for my research stems from my own experience of growing up in local authority care because my first memory of the health care system has traumatised me for life. I was just seven years old when the police arrived at my house to escort my birth mother and me to the local paediatric hospital. They believed that I was being physically abused but they needed evidence before they could apply for a police protection order. That medical examination probably saved my life but it later impacted on my readiness to engage with the health care system. Various adults dressed in white coats stood around the examination bed where I lay naked, humiliated, and paralysed in fear. The examination felt like it lasted a life time because the paediatricians had to count, measure, and photograph every single bruise, cut, abrasion and cigarette burn that was on my body. One paediatrician even put a torch on his head and inspected my genitalia for any abnormalities or signs of sexual abuse. They also kept asking me how I got my injuries but I was too petrified to answer because my birth mother was standing right next to me. She had told me on several occasions that if I told anyone that she or my stepfather had hurt me, she would hurt or kill my little sister. Luckily for me, the police decided that my injuries were non-accidental and as a result, I was taken into emergency foster care and later placed on a full care order.

Becoming a looked after child meant that I had to attend health assessments at the hospital every six months. I could never understand the point of these assessments. I just wanted to be normal like my friends but instead I would have to miss school and go to the hospital where I would be told to strip down to my underwear and perform tasks, such as standing on one leg. I am still not sure what this was meant to achieve other than to humiliate me. But when I was younger I was compulsively compliant and self-reliant because my previous experiences had taught me that if I did not do as I was told I would be beaten, and I could only rely on myself to survive my hostile world. On one occasion I tried wearing a pair of tights instead of socks in the hope that I wouldn’t be told to take them off – but I was. If the paediatrician had allowed me to keep my tights on that day then I probably would have continued to attend the health assessments but instead, at the age of eleven, I just refused to go.

As a child I very rarely caught coughs or colds. I only ever attended the doctors’ surgery for the odd immunisation or asthma check-up. My General Practitioner (GP) seemed to change every time I had an appointment so they were just strangers to me. I didn’t trust adults at that time so I certainly would not have listened to any health advice they had given me. Looking back though, I wonder whether the health assessments would have been more useful during adolescence because no one had talked to me about health or puberty at that time. I was far too embarrassed to ask my GP questions because for some reason they were always male. Plus, they never read my notes and they would become uncomfortable if I told them that I was in local authority care or that I had been abused as a child. I was ashamed of the fact that I was in care because it meant admitting that I wasn’t loved or wanted. I didn’t feel like I belonged anywhere back then and I eventually ran away from my foster family back to my birth mother. I spent a year living with my birth mother and stepfather but the abuse started again after just a couple of weeks. They both drank excessively and would get into fights with each other and would take their anger out on me. I eventually managed to run away and thankfully social services found me a foster home.

I lost my way for a while after this; I became depressed, started self-harming, and got in with the wrong crowd. I knew that they were a bad influence on me but I desperately needed to feel accepted. I began smoking and would regularly drink with my peers at the local park. I distanced myself from my foster carer and in times of distress I would lock myself away in my room – outwardly people thought that I was fine. I had not received any guidance about my emotions and I lacked the understanding in why I felt the way I did. By the time I was fifteen my birth father was back on the scene and I was having regular contact with him including overnight stays. My birth father was an intelligent man and he had a well-paid job but he was probably one of the unhealthiest people I have ever met. He would smoke at least 40 cigarettes a day, ate nothing but fast food, drank alcohol every evening and never even attempted to promote healthy behaviours. Sadly, he died of a heart attack just a few weeks before my GCSEs. I was completely devastated at this point because I felt like I was alone in the world. The only thing that got me through was knowing that my little sister (who has complex health needs) needed me.

Having undertaken an access to higher education course I was eventually accepted into university. However, my time at university was extremely challenging and I faced several adverse circumstances. I struggled to transition into independence and I found it particularly difficult seeing the support that my friends received from their families. The holidays were the worst because everyone would head home to his or her families and I would be left alone on an empty campus. I had to work a large number of hours in order to support myself at university and I struggled with my academic work. I failed several modules and eventually I had to retake my first year. When I handed in an essay about naturists instead of nativism my tutors suggested that I be tested for dyslexia, which was diagnosed about one year later. My biggest challenge though, was dealing with my little sister being admitted to hospital and having to be put on life support. I travelled the 320 miles round trip daily just to be with her because her doctors told me that I had to ‘prepare for the worst’. My own health eventually deteriorated, and in 2011 (with the help of the designated nurse for looked after children) I was diagnosed with narcolepsy and cataplexy. The designated nurse was a godsend because I didn’t know how the health care system worked and I was still trying to complete the final year of my undergraduate degree.

My personal experience gathered from my time in care and my own health experiences inspired my interest in the health of looked after children. After my undergraduate degree I went on to do a Masters in Health Psychology. I developed a range of research competencies such as conducting systematic reviews, and applying psychological theories to practical situations as a means to promote health behaviour and compliance to treatment. For my dissertation I used questionnaires to compare the eating behaviour of looked after children and their non-looked after peers, with a focus on the role of their perceived early childhood attachments. I successfully completed my masters in 2013 and I was awarded the Ann McPherson Fellowship to work with the Health Experiences Research Group at the University of Oxford. I really valued working in an environment of qualitative research expertise and it provided me excellent training in and experience of conducting qualitative research. Throughout my fellowship I continued to reflect on how challenging it was for me to navigate the health system and to learn how to take control of my health, and I wondered how other children in care were finding the health system. Since I have left care there have been many positive changes to the services available to looked after children. However, children in care continue to withdraw from these services and their health status remains poor. Hence, here I am – keen to explore what might be done to improve things for the 69,000 children who are currently in local authority care in England.