Helping Young People in Out-of-Home Care: Basic Elements

Abstract

Children and adolescents (young people) who experience maltreatment early in life and are subsequently placed in out-of-home care (OOHC) are specifically at risk of poor mental health outcomes1 . Though rates vary by survey and location, up to half of these young people have clinical-level mental health difficulties, and another 20 - 25% have difficulties approaching clinical significance2 . These difficulties are characterized by high symptom complexity and severity, and include maltreatment-related mental health symptoms2 . Many young people in OOHC are difficult to engage with and retain in treatment, compounded by a lack of specialized mental health services3 , and a history of problematic social interactions with supports.4 They are often reluctant to seek help, due to stigmatization and confidentiality concerns, limited opportunities for decision making, service inaccessibility, distrust of mental health services and their perception that professionals don’t understand their circumstances.5 We propose six clinical practice modifications for mental health services working with young people in OOHC to enhance therapeutic engagement and maximize their therapeutic outcomes.