Mental health help seeking in young people and carers in out of home care: A systematic review

The mental health of children and young people in out-of-home care (OOHC) is a global concern, with consistently poorer outcomes reported within this population. However, it is unknown whether young people living in OOHC, or their carers, are engaging in mental health help-seeking at a rate that is comparable to their mental health need. This systematic review aimed to firstly, explore the experiences of young people aged 12-18 years in OOHC, and their carers, of seeking help for the young person; and secondly, to explore the factors that may act as barriers or facilitators to help-seeking. This PRISMA designed and registered review included qualitative studies published in English in the past 20 years. Five studies met the inclusion criteria, representing a total of 854 consumer perspectives. Findings indicate that young people and carers are not regularly engaging in help-seeking, and that when help-seeking does occur, there is a preference to seek support from informal sources. Barriers to help-seeking included concerns about stigmatisation, confidentiality, service inaccessibility, perceived lack of understanding of the young person or carer's circumstances, and limited opportunities for participation in decision making. Targeted interventions to address these barriers and increase mental health help-seeking skills in this vulnerable OOHC population should be considered.