Meeting the mental health needs of adolescents in out-of-home care and care-leavers

: (Alternative Format Thesis)

Abstract

The majority of care-experienced people have experienced childhood maltreatment, alongside several other adverse experiences (poverty, frequent placement changes). Some young people enter care and are not reunited with birth family, which means they are likely to transition into independent living around the ages of 16-18. These young people are considered especially vulnerable in young adulthood, but there is very little research investigating their experiences and outcomes. Early trauma, ongoing in-care disruption, inconsistent care-giver support and early independence puts children in care and care-experienced adults at much greater risk of poor mental health. Unaddressed mental health needs are considered a key driver for some of the negative outcomes recorded for care-experienced adults, such as homelessness or contact with the criminal justice system. It is imperative that care-experienced people have their mental health needs addressed. With this PhD, I have explored whether the current provision of mental health support in the United Kingdom addresses the needs of young people in care and care-leavers, in particular around the transition out of care, as well as factors which influence help-seeking behaviour, and access to mental health support from formal and informal sources of support. In study one I use secondary data analysis children’s social care records to explore whether there are gaps in the provision of mental health support provided to children in care with mental health problems. In study two I used qualitative interview methodology to investigate experiences of trying to access mental health support for a group of young people who recently ‘aged out’ of care. Recognising a lack of research into care-leavers mental health outcomes, in study three I explored factors which are associated with poorer mental health outcomes in care leavers, using scoping review methodology. In study four I explored preferences for support, help-seeking behaviour and predictors for this, with around 90 16- and 17-year-olds in care who are approaching the transition out of care. Finally, in study five I broadened my focus to all young people with pots-traumatic stress disorder. I used systematic review methodology and meta-analyses to examine whether evidence-based manualised therapies for young people with post-traumatic stress disorder, improve social and interpersonal outcomes. This thesis provides insight into some of the challenges young people in care face when trying to access mental health support from formal and informal sources of support, as well as identifies key individuals who are important for providing mental health and wellbeing support to this vulnerable group of young people.

Date of Award	26 Jun 2024
Original language	English
Awarding Institution	University of Bath
Supervisor	Sarah Halligan (Supervisor), Rachel Hiller (Supervisor), Iris Lavi (Supervisor), John Macleod (Supervisor) & David Wilkins (Supervisor)