Burden: A qualitative analysis

• Youth care for multi-problem families can create, exacerbate, or even be harmful to these families. • Interviews with 10 parents, 10 natural mentors, 10 youths, and 10 professionals. • Interviews give insight into factors contributing to and lived experiences of burden. • Mental burden is the most experienced burden from all perspectives. • Balancing expectations and burdens could enhance effectiveness in youth care. Navigating the youth care system may present significant challenges for families and professionals. These challenges may lead to feelings of strain and may contribute to a broader sense of burden among all involved. This qualitative study aims to understand how youth, parents, natural mentors (YIMs), and professionals working with a YIM and the family perceive burden in youth care and the factors contributing to it. Conducted across four Dutch regions, the study involved semi-structured interviews and rich pictures with ten individuals from each perspective. Based on participants’ responses, inductive coding was employed to identify clusters, themes, and subthemes. Participants described the burden in emotional, mental, and physical terms, with mental burden being the most frequently mentioned across all perspectives. Youth reported feelings of powerlessness, while parents expressed frustration over stagnation. YIMs struggled with their dual roles, and YIM professionals felt pressured by conflicting expectations. Factors contributing to this burden involved deficiencies in personal and social agency, challenges in collaboration, and unmet expectations regarding professionals and the youth care system. All participants identified a lack of agency and unmet expectations. YIMs encountered an unequal power balance in their collaboration with YIM professionals, while YIM professionals faced difficulties in interacting with other professionals and parents. The findings highlight the need to address the sources of burden in youth care. Clarifying mutual expectations and collaboratively addressing burdens could improve experiences within youth care.