‘I had my guard up for a long time and that probably didn’t help’: Exploring care leavers’ experiences of the barriers to accessing mental health support during adolescence using photo-elicitation and Interpretative Phenomenological Analysis

Abstract

Children in care are more likely to experience significant mental health difficulties and consequently poorer long-term outcomes. However, they are less likely to receive professional mental health support than children living with their birth parents. Exploration of the barriers to accessing support from the perspective of care-experienced young people is limited within the literature; the present study aimed to bridge this gap. Six care leavers aged 18–25 years old engaged in a photo-elicitation-based interview that explored their experiences of the barriers to accessing professional mental health support during adolescence. Data were analysed using Interpretative Phenomenological Analysis (IPA), and five group experiential themes and 10 subthemes were identified. The group themes were ‘A lost cause’, ‘Alone no matter what’, ‘Don’t talk about mental health problems’, ‘Misunderstood’ and ‘Nobody helped us’. The clinical implications are discussed, as well as recommendations for future research.

Plain Language Summary

Children in care are more likely to experience mental health difficulties and longer-term problems than children who are not in care. Despite this, they are less likely to receive professional mental health support. There is limited research exploring what stops young people in care from accessing mental health support when they need it, especially hearing from the young people themselves. This study aimed to bridge this gap. Six care leavers aged 18–25 years old agreed to take part in interviews about their experiences and were asked to present photographs that represented the barriers they encountered to accessing mental health support while in care. They were interviewed about these photographs and the data were analysed. Five main themes and 10 subthemes were identified. The main themes were: ‘A lost cause’, ‘Alone no matter what’, ‘Don’t talk about mental health problems’, ‘Misunderstood’ and ‘Nobody helped us’. The findings indicated that young people in care experience a range of barriers to accessing support; these focus around other people’s misunderstandings of their difficulties, problems trusting others and services being inadequate in meeting their complex needs. There is a need for more trauma-informed services as well as additional training for professionals and carers about mental health presentations associated with past trauma. Further research around successful experiences of accessing services and the role of informal support would be beneficial.