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Abstract
Recent prevalence studies in Great Britain have revealed that children who are looked after are almost five times more likely to have a mental disorder than children in the general population. Looked after children are already vulnerable to developing mental health problems by the time they become looked after. They are more likely to come from disadvantaged families where social/environmental risks are present. Many have lived in families where there has been mental illness, alcohol/drug misuse or domestic violence. A large proportion of children who now enter the care system have experienced abuse and/or neglect. The care experience itself and, in particular, the high rate of placement instability, may also contribute to this vulnerability. The general challenges facing child and adolescent mental health service provision for looked after children are considered and issues related to therapeutic work highlighted.