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

This article reports on the barriers experienced by out-of-home care (OOHC) service providers to finding timely and appropriate mental-health supports and services for the children and young people in their care. All children in care will have experienced trauma in some form. 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. Utilising the experience and practice wisdom of OOHC service providers, we identified common barriers to the provision of services to this vulnerable cohort. The most significant barrier, given its implications, 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, as is health professionals’ lack of 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.