Care leavers’ experience of mental health support systems as they are leaving care

Rimmer, James and Hodge, Suzanne and Lever, Laura (2026) Care leavers’ experience of mental health support systems as they are leaving care. PhD thesis, Lancaster University.

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Abstract

The first section is the literature review. Young people in care often have multiple professionals involved in their lives, raising questions about how this increased professional involvement may be experienced in relation to privacy. This review aimed to synthesise qualitative research exploring young people in care's experiences of privacy in relation to professionals. Seven qualitative studies were identified and analysed using thematic synthesis. The synthesis generated three analytical themes: disclosure diminishes choice and control; secrecy as a protection mechanism; lack of privacy impacts well-being. The findings suggest that limitations in both physical and informational privacy shape young people’s well-being and trust in professionals. Practices surrounding disclosure and surveillance may constrain young people’s sense of agency, while secrecy can function as a strategy to manage stigma and maintain control, although this may also limit connection and reinforce feelings of shame. The second section is the empirical paper. Young people leaving care are more likely to experience mental health difficulties than their peers in the general population. Few studies have explored experiences of a broad range of support, including both formal and informal sources. This study aimed to understand young people leaving care's experiences of mental health support systems. Thirteen recent care leavers participated in semi-structured interviews exploring their experiences of support. Three themes were identified through thematic analysis: connection with others; authentic care; understanding needs. The findings highlight the importance of relational connection, authenticity in caregiving relationships, and understanding of mental health needs in shaping engagement with support. Participants’ accounts also reflected the importance of continuity and a reliance on professionals to sustain supportive relationships during the transition from care. In the third section, the critical appraisal provides insight into personal reflections of the research process, additional clinical implications and links between the two papers.