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Barriers to mental-health support in out-of-home care services

This article, by Dr Lindy Annakin, Lottie Harris and Professor Daryl Higgins, presents a practitioner-informed view of critical barriers that out-of-home care (OOHC) service providers face when connecting children and young people in care with timely and appropriate mental-health services and supports.

Children and young people in out-of-home care often fall under the radar. All children in care will have experienced trauma in some form. Their vulnerable circumstances place them in a challenging environment that is likely to lead to negative long-term health outcomes. The mental-health challenges and poor outcomes for children and young people in OOHC, including the risk of self-harm and suicidal ideation are well documented.

In this paper - Barriers to mental-health support and services for children and young people in out-of-home care: The Children in Care Collective’s audit findings - the authors drew on the experience and practice wisdom of OOHC service providers to identify common barriers to the provision of services to this vulnerable cohort. The most significant barrier was the lack of understanding of complex trauma resulting in the diagnoses of children that do not account for their trauma history and the misunderstanding of trauma symptoms as behavioural rather than mental-health concerns.

The scarcity of mental-health services is a clear barrier to accessing timely and appropriate services. Health professionals also lack understanding of the structures, processes and legal requirements of OOHC systems. The Children in Care Collective suggests three actions that would contribute to better services without waiting for the outcome of complex negotiations over increased health funding and resources: priority access to mental-health services for children and young people in OOHC; a focus on prevention and early intervention; and development of shared understanding between OOHC service providers and healthcare providers.

The authors conclude that connecting children and young people in care with timely and appropriate mental-health supports through systemically addressing barriers is essential for avoiding or mitigating the long-term negative mental-health outcomes that are otherwise the likely consequence.

• Watch authors talking about the research in this short video recording
• Read article (free and open access) in Children Australia