The mental health of young people in care: Barriers to help-seeking and how to make services more engaging

This post focuses on the mental health of looked after children and young people (LACYP) in Northern Ireland, as this is a very important aspect of our study. We have started fieldwork recently, and we’ve already encountered a few young people who are struggling with mental health difficulties. Our article on the mental health and help-seeking behaviour of young people in care in Northern Ireland has also been recently published online, and I would like to take this opportunity to summarise the main key findings.

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The article is based on the findings of a previous study which examined the physical and mental health of looked after children and young people in Northern Ireland, namely the Mind Your Health Study. In the study, we found that many children had mental health issues, particularly older teens and those in residential care. In addition, many young people found it hard to seek help for their mental health difficulties, and engage with services. You can see some of our findings in the infographic below.

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The study used a variety of methods, including:

  • Focus groups with senior social work managers in each of the five HSC Trusts;
  • Telephone interviews with the carers of 233 LACYP (gathering quantitative data but also qualitative data for 120 of them);
  • Semi-structured interviews with 25 looked after young people; and
  • Four multi-disciplinary focus groups with professionals.

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From the analysis of the data collected through these methods, we identified a range of barriers to help-seeking:

  • Young people’s feelings of embarrassment, stigma, guilt and fear of opening up;
  • Social workers and other professionals not being able to spend enough time with the young people to make them feel comfortable enough to build long-lasting positive strong relationships; and
  • Difficulties accessing the services:
    • Timing issues, e.g. long waiting lists, difficulties in getting a referral due to staff turnover or extremely limited criteria needed for referral;
    • Regional issues, in terms of a lack of local services being available in rural areas, thus the requirement to travel long distances, etc.;
    • Difficulties in providing young people with the most suitable service, due to the challenges in accurately assessing their mental and emotional wellbeing, and gaps in service provision;
    • Lack of information provided regarding the services available and where to ask for help.

The participants in the study offered a range of suggestions to improve service provision and help engage young people, which included:

  • To make services more engaging, by:
    • Providing more outreach mental health support, and more local drop-in centres;
    • Making services more locally accessible, as well as more flexible and ‘less formal’; and
    • Supporting more consistency, in terms of having a long-lasting relationship with one professional;
  • To facilitate and promote more communication between health professionals and all of the agencies responsible for the child/young person, so young people did not have to retell their problems over and over;
  • To set up a multidisciplinary mental health team (OT specialist, clinical psychologists, specialist nurse, etc.);
  • To provide young people and their carers/parents with more and better information on the services available and where to seek help;
  • To extend the upper age limit of CAMHS to twenty-one (and possibly older); and
  • To enable professionals to take the time to develop positive trusting relationships with the young people.

Source: Fargas-Malet, M., & McSherry, D. (2017). The mental health and help-seeking behaviour of children and young people in care in Northern Ireland: Making services accessible and engaging. British Journal of Social Work. doi: 10.1093/bjsw/bcx062

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