Barriers and facilitators to screening, assessment and mental health care of Looked After Children

Background: Looked After Children (LAC) have significant needs and are at high risk of mental health difficulties. There is a predominance on views of carers and professionals to understand what helps or hinders LAC in accessing or engaging in mental health services. There is little understanding about the views of LAC themselves on this topic, despite calls for their voices to be heard. Aim: Explore LAC perspectives on barriers or facilitators to mental health care in one UK LAC mental health service. Further explore clinical, social or personal factors that influence or contribute to this. Method: A semi-structured topic guide was developed and employed. Opportunistic sampling was used to recruit young people from one UK LAC mental health service. Interviews were conducted face to face and audio recorded. The data was transcribed verbatim and analysed via thematic analysis. Results: This study recruited five participants. Seven themes were related to barriers and facilitators for help-seeking and engagement - 1) Understanding mental health and emotional wellbeing 2) Perceptions of responsibility for help seeking and engagement 3) Help seeking from others or services 4) Engagement in services 5) Appreciating the parental qualities of the service 6) Developing reflective capacity in young people? and 7) Service development. Both personal and social factors were described within barriers and facilitators. Discussion: Participants voiced complex barriers and facilitators for help seeking and engagement with services. Prominent personal and social factors included in these were stigma, understanding mental health and relationships. Clinical, organisational, policy and research implications of these findings are discussed.