A new report in England has brought something deeply saddening and uncomfortable into the spotlight. That Young adults leaving care are around three to four times more likely to die between the ages of 18 and 24 than other young people.
In 2025 alone, 112 care leavers aged 18 to 24 died in England. Twenty-two of them were just 18 years old. Around 40 of those deaths were believed to have been suicides, which the report says could mean the suicide rate among care leavers is around five times higher than in the general population.
Those numbers are heartbreaking. But what really hit me wasn’t just the number of deaths. It was the description of what some of these young people were experiencing, isolation, loneliness and the sudden loss of support when they reached adulthood.
The report talks about young people being left with “no safety net” and describes the loss of significant support when they leave care at 18.
And that made me wonder: What is happening in Scotland?
Is Scotland any different?
We don’t currently have an identical Scottish figure telling us that care leavers aged 18 to 24 are four times more likely to die.
But that doesn’t mean Scotland doesn’t have a serious problem.
In fact, Scottish research has found some very worrying differences between care-experienced people and the general population.
The Children’s Health in Care in Scotland (CHiCS) research followed more than 13,000 care-experienced children and young people and linked information from health, education, social work and mortality records. The Scottish Government’s evidence review found that mortality in the care-experienced group was around three times higher than in the comparison population, even after taking account of things such as age, sex, deprivation and disability.
When researchers looked specifically at deaths from external causes, including suicide and drug-related deaths, the difference was even bigger. Mortality from these causes was almost six times higher.
Those are frightening figures.
And they tell us something important. Whatever the exact Scottish equivalent of the English figure might be, care-experienced people in Scotland are clearly facing a much greater risk of dying prematurely.
But this isn’t just about death
It would be easy to read those statistics and think that the problem begins when someone leaves care.
It doesn’t.
Many children enter care because they have already experienced things no child should have to experience, abuse, neglect, domestic violence, parental substance misuse, instability and trauma.
So, when they reach 18, they aren’t necessarily starting adult life from the same place as someone who has grown up with a stable family home, parents who can help them financially, somewhere to return to when things go wrong and somebody who will notice if they’re struggling.
They may already be carrying years of difficult experiences with them. And then we tell them they’re an adult. That’s where the idea of the “care cliff” comes in.
Turning 18 doesn’t magically make you an adult
Think about what being 18 actually looks like for most people.
You might still be living at home. Your parents might be helping you with food, bills, university applications or your first job. You might have a bedroom you can go back to if a relationship ends or you lose your job. You might have someone you can call when you don’t know how to deal with something.
You might not even have to think about where you’re going to live. Now imagine reaching 18 without that.
You’ve already spent your childhood moving through the care system. You may have experienced multiple placements or broken relationships with adults. You may have mental-health difficulties. You may struggle with money, education or employment. You may have very little family support.
And then the system that has been responsible for you tells you that it’s time to become independent.
Of course there are support systems in place. Scotland has Continuing Care and Aftercare, and there are people working incredibly hard to support young people leaving care.
But having support available isn’t necessarily the same thing as feeling supported.
And that’s an important distinction.
Scotland already knows care-experienced people are at greater risk
The Scottish evidence goes far beyond mortality.
Care-experienced people in the CHiCS research were more likely to experience mental-health problems, hospitalisation, self-harm and drug-related harm.
For example, hospital admissions relating to drug poisoning were more than six times as common in the care-experienced group as in the comparison population.
There were also much higher levels of mental-health-related hospitalisation and healthcare use.
These things don’t happen in isolation.
Someone struggling with trauma may develop mental-health problems. Mental-health problems can make education and employment harder. Financial problems can make housing insecure. Housing insecurity can make mental health worse. Substance use can become a way of coping. Isolation can make everything harder.
And if the person doesn’t have a family network to catch them when things start going wrong, there may be very little between them and complete crisis.
That’s why talking about care leavers simply as a group of young people who have “left care” misses the point.
They haven’t left their experiences behind.
I know what some of these statistics look like
This is the part that makes this subject particularly difficult for me to write about.
I’ve known young people who had previously been looked after. Some of them were people I actually lived with.
Some of those young people were dead before we had even reached 18 or 19.
So, when I read that 22 care leavers in England died at the age of 18 last year, I don’t just see a number. I think about the people I knew. I think about how young they were.
And I think about how much life they should have had ahead of them.
It’s very easy to look at statistics about care-experienced people and talk about them as if they’re an abstract group. “Care leavers are more likely to experience homelessness.” “Care leavers are more likely to have mental-health problems.” “Care leavers are more likely to die young. “But these aren’t statistics walking around somewhere They’re people.
They’re the person you sat next to. They’re the person you lived with. They’re somebody’s friend, somebody’s sibling, somebody’s child.
And when a young person dies at 18, 19, 20 or 21, we shouldn’t just shrug and say that they had a difficult background.
We should be asking whether enough was done to help them.
What about Aftercare in Scotland?
Scotland has recognised that young people shouldn’t simply be thrown out of care and expected to figure everything out for themselves. But that wasn’t my experience. I left care at 16, an age when most teenagers are still living at home, going to school and relying on adults to look after them.
There is Continuing Care, which can allow eligible young people to remain in their care placement up to the age of 21. There is also Aftercare support for young people leaving care.
But there is a worrying gap between being entitled to support and actually receiving it.
According to the latest Scottish Government statistics, around 9,386 young people were estimated to be eligible for Aftercare services as of July 2025.
Only 4,545 were actually receiving an Aftercare service.
That’s less than half.
That doesn’t automatically mean that more than half of those young people were completely unsupported. There can be different reasons why someone isn’t recorded as receiving an Aftercare service, and we shouldn’t pretend the statistics tell us more than they do.
But it should still make us stop and ask a very simple question.
Are we doing enough?
Because we know that care-experienced young people face greater risks. We know that the transition into adulthood can be incredibly difficult. We know that housing, mental health, substance use and loneliness can all play a part.
So why would we ever be comfortable with a system where so many young people who are entitled to Aftercare aren’t recorded as receiving it?
We need to know what’s happening to Scottish care leavers now
There’s another problem with comparing Scotland and England.
The English review is looking at deaths that happened in 2025. It’s current. It’s looking specifically at young adults aged 18 to 24 who had left care.
The major Scottish CHiCS mortality research is incredibly valuable, but its mortality follow-up currently goes back to 2016.
That means we don’t have an equally clear, up-to-date picture of what’s happening to Scottish care leavers today.
And frankly, we need one.
If we know that care-experienced people have higher mortality, higher rates of suicide and drug-related deaths, more mental-health difficulties and greater levels of other disadvantage, then we should want to know what those outcomes look like for the young people leaving care right now.
We shouldn’t have to wait for a Scottish version of the English report before we start asking difficult questions.
Leaving care shouldn’t mean losing your safety net
I don’t think the answer is simply throwing more money at the problem. Of course, housing matters. Mental-health support matters. Education and employment matter. Financial support matters. But there’s something else that matters just as much,having somebody there.
Somebody who knows you. Somebody who knows your history. Somebody who notices when you stop answering messages. Somebody you can call when your tenancy is falling apart, when you’re struggling with your mental health, or when you simply don’t know what you’re supposed to do next.
For many young people, that’s a parent. For some, it’s a grandparent, sibling, aunt, uncle or family friend. For a care-experienced young person, that person might not exist.
And this is where I find myself thinking about my own experience.
When I went through Throughcare and Aftercare, I was supported by Edinburgh’s Alison service. Alison wasn’t just a place where I received a service. There were staff members there who knew me. I knew them. I trusted them. I had built relationships with people who understood my history and, importantly, understood me.
That matters more than it might sound.
The Alison service is still operating today, although it has changed significantly since I was a child. Current information describes Alison House as providing accommodation and support for care-experienced young people, including semi-independent flats, allocated key teams and support for young people moving towards independent living. The service itself still provides 24-hour responsive support to young people living there.
But the model I experienced is not the model that exists in the same way today. And that genuinely upsets me.
I still maintained relationships with some of the staff who supported me. These weren’t simply names on a case file. They were people I knew and trusted. People I could speak to.
Older inspections of the Alison service show how important that relationship-based approach could be. One young person told inspectors that they could return to the unit when they were finding independent living difficult and said they couldn’t fault the service. The service was also providing Throughcare and Aftercare alongside outreach to young people who had previously received care.
That is the kind of support I think we risk losing when services become more centralised.
When I wanted to understand what this meant for young people leaving the service, I contacted Steve Harte, a senior officer within Edinburgh Council’s social care services. I asked practical questions about what had replaced the previous 24/7 support and emergency bed provision, how young people could access help during evenings, nights and weekends, and what happened to the relationships young people had built with their workers.
The response I received felt, to me, extremely clinical. I was given an explanation of the structure of the service, but I didn’t feel that the questions I had actually been asking were answered.
And my question wasn’t simply, “Who is responsible for providing a service?”
It was “Who does a young person actually turn to when they are in crisis?”
Those are two very different questions.
If you’re a young person who has grown up in care, there is a huge difference between being told to contact an emergency social work service and being able to pick up the phone and speak to someone you’ve known for years.
One is a system.
The other is a relationship.
And when you’re 16, 17, 18 or 19 years old, potentially dealing with homelessness, mental-health problems, loneliness, substance use, financial problems or simply the terrifying reality of trying to live independently, that relationship can be the thing that makes you pick up the phone rather than give up.
This isn’t about saying that the old Alison model was perfect, or that services should never change. Services have to evolve, and there may be legitimate reasons for changing how support is delivered.
But we also need to be honest about what can be lost when that happens.
You can redesign a service on paper and still remove something incredibly valuable. The person who knows the young person.
That is what concerns me when we talk about the care cliff.
We spend years telling care-experienced young people that they have support. We tell them there are services, workers, pathways and emergency contacts. But if the person they actually trust disappears and is replaced by a generic service, have we really given them the same safety net?
Or have we simply given the safety net a new name?
We shouldn’t wait for Scotland’s headline statistic
The English report should make Scotland pay attention.
Not because we can simply take the English figure and apply it to Scotland. We can’t. And not because every care leaver is destined to experience the same things. They aren’t.
Care-experienced people are not statistics. They are not a problem to be solved. They are people who deserve the same opportunity to build a safe and happy adult life as anyone else. But the evidence we already have in Scotland is enough to tell us that something is seriously wrong.
Care-experienced people are dying younger.
They are experiencing higher rates of suicide and drug-related deaths.
They are more likely to experience mental-health difficulties and self-harm.
They are more likely to experience homelessness and other forms of disadvantage.
And many are trying to navigate all of this without the family safety net that other young people can rely on.
We already know enough to act.
We shouldn’t wait until Scotland can produce its own statistic saying that four times as many care leavers are dying.
Because by then, we’re talking about people who have already died.
The question shouldn’t be “How many care leavers can we afford to lose?”
It should be “What are we going to do to make sure we don’t lose them?”
https://pubmed.ncbi.nlm.nih.gov/39357978
https://www.celcis.org/knowledge-bank/search-bank/when-child-no-longer-child
https://www.edinburgh.gov.uk/downloads/file/28412/throughcare-aftercare