Practitioners’ perspectives on enablers of improved mental health outcomes for children and young people in out-of-home care: Beyond a “scattergun approach”

In Australia, children and young people in out-of-home care (OOHC) face high rates of complex mental health challenges, yet no systemic framework exists to address their needs effectively. As a result, this population’s mental health care needs remain largely unmet. This study aimed to identify key enablers the OOHC sector can leverage to improve mental health outcomes for this cohort. 27 Australian OOHC practitioners in diverse roles (case worker, therapeutic specialist, clinical lead, executives) participated in semi-structured interviews in which a phenomenological approach was applied. Drawing on evidence derived from an earlier literature review on the same topic; participant interview data was thematically analysed and subsequently mapped onto the ecological model for targeted identification and investment. Practitioners endorsed all 11 enablers identified in the literature and introduced four new ones: (1) fostering belonging through community connections, (2) building sustainable workforces, (3) embedding clinical teams within OOHC services, and (4) promoting collective investment in the mental health of children and young people. Greater investment and advocacy by the OOHC sector for the systematic implementation of these enablers is likely to improve the mental health of children and young people. Future practice and research should evaluate these enablers systematically to ensure comprehensive mental health care for this population. • OOHC sectors can and must facilitate improved mental health outcomes for children and young people in care. • 27 Australian OOHC practitioners endorsed 11 previously identified enablers and detailed four new enablers of improved mental health outcomes. • New themes included: connection to community, a sustainable workforce, clinical teams embedded within OOHC services and a societal investment in youth mental health. • Enablers span all ecological levels, but most are positioned at the institutional level.