Care leavers’ transitions to independence
Mental health and wellbeing after care
- Care leavers' mental health needs
- Coping strategies used by care leavers
- Experiences of accessing mental health services
- Mental health support that helped care leavers'
- Mental health support that care leavers' need
Care leavers' mental health needs
Many of the young people we talked to spoke about anxiety, depression, trauma, and emotional distress linked to childhood experiences, instability, and moving into adulthood without reliable support. They explained that their distress could worsen during transitions such as leaving care, moving placements, living alone or starting university. Several people described going through long periods of struggle before receiving help, and a sense that services often acted too late, or they were cut off from services just when they really needed them.
Elijah said young people with serious mental health needs were put in semi-independent housing without the help they needed.
Elijah said young people with serious mental health needs were put in semi-independent housing without the help they needed.
It was difficult because everyone had very high needs for very different reasons. You know, there were a lot of young people that needed intensive drug and alcohol intervention, and needed a lot of mental health support as well – and weren’t getting it – and with them putting younger and younger people in semi-independent, we were getting more 16/17-year-olds being placed there, and they just weren’t getting the support that they needed either, so it... it was just an insane situation.
Dan explained that anxiety, depression, and trauma left him shut down, and only one social worker who never gave up helped him move forward.
Dan explained that anxiety, depression, and trauma left him shut down, and only one social worker who never gave up helped him move forward.
I don’t know what it is, but I had one social worker when I was growing up who persevered with me, let’s say, because she would come over and wake me up and I wouldn’t get out of bed, and she’d be doing that for six months, and I wouldn’t go anywhere. I’d never leave my house, I’d never do anything with my life, because I was just scared, and I was worried, and I was just anxious, and I was depressed, and all these traumatic things that had gone on, I just couldn’t cope with them but she persevered with me, and that was the only social worker that made me feel like I was a person, which made me help re-engage with social services and actually getting support that I needed.
Coping strategies used by care leavers
Care leavers managed their mental health in their own ways. Some used music, keeping busy or distraction to avoid difficult thoughts and feelings. Others talked about self-harming, isolation, or withdrawing socially when they felt overwhelmed. Coping mechanisms often developed long before support was available, and could remain their only tool when services were slow to respond. A few young people described building resilience through necessity, particularly during the Covid-19 pandemic. But this resilience sometimes masked just how distressed they actually were.
Megan explained that during her lowest points she stayed in her room, didn’t eat, and used self-harm to cope (read by an actor).
Megan explained that during her lowest points she stayed in her room, didn’t eat, and used self-harm to cope (read by an actor).
Like I started acting the way I said I’d act, like... and it weren’t even like... I weren’t violent, I never shouted at anyone, I never like took my shit on anyone, it was just like I wouldn’t come out my room for a full day and I wouldn’t eat for the full day. I’d stay in my room and I’d be cutting myself, stuff like that. And it’s like... it’s not even like I’d walk downstairs with like blood dripping down me. Like I’d clean it myself, I... it was just the way I coped.
Jordan said he coped by masking his feelings, keeping busy, and shutting people out when things got too much.
Jordan said he coped by masking his feelings, keeping busy, and shutting people out when things got too much.
I still struggle, but then I also... I’m also, I’m very good at putting on a front, so I can... I can mask it, and I just... I try and keep myself busy as well so that I’m not focusing on my own stuff. So, like I’ll be doing what I need to do at work, or I’ll be helping out with the care leavers and doing a lot of stuff with the care leavers.
I... I shut everyone out.
Uh-huh.
I’d go off the grid; I wouldn’t... I wouldn’t talk to people.
Mm. So are there things that make you happy at this point, either... is there something?
I wouldn’t say happy, just more like stable, like this music.
Music?
Yeah.
OK. What are you listening to?—
Because I just put... I put my headphones on and it just... you know, it just drowns out the rest of the world.
Mm. Is that a way to help you sort of calm yourself?
I think, again, it’s just another distraction.
OK. So, I see. Does it... does that work, or is it just temporary?
I mean it... it works when I’m... when I’m not busy and I’ve got headphones on, then it’s... but then, I try and keep myself busy so I don’t have to worry about... about that, so it’s a bit of a double-edged sword really.
Experiences of accessing mental health services
Experiences ranged from years spent in therapy through early life, to no meaningful mental health support at all or until adulthood. Some care leavers received support from CAMHS, crisis teams, counselling or university-based services, while others struggled with long waiting lists, service transitions and unclear pathways. Several described falling through gaps between CAMHS and adult services, or losing support after turning 18. Support was easier for young people to access when someone helped them navigate referrals, explained their needs or advocated on their behalf.
Megan said she begged for mental health support but was left waiting and blamed for not getting better instead of being supported (read by an actor).
Megan said she begged for mental health support but was left waiting and blamed for not getting better instead of being supported (read by an actor).
I’d left it like two days, so I rang them and they were like, “Oh, she’s on her break, ’cause she’ll ring you back after her break, I promise straightaway,” ’cause I’d already been told that she didn’t ring back – she never rang me back – and by then I was drained.
So I was like, ‘no, like, they’re not bothering me, no.’ So I went to the supported lodgings carer, I was like, “The home treatment team don’t come on time,” I said, “I haven’t got regular appointments with the doctor’s,” I said, “they don’t even ring me back,” I said, “I am ask...” I said, “I’m begging for help.”
I was like, “I’m begging for it, and I’m not getting it,” I said, 'so you can’t even.' ’cause they were like blaming me, I was like, “you’re pushing the blame onto me,” I said, “but you’ve seen me basically physically go out and try.” And they were like, “Right, we’ll get you help from the doctor’s and ring them again.” I’m like, “I need it now, like I need this help now.” So that was the appointment.
Richie described needing ongoing therapy, with a charity providing long-term support and his housing provider offering temporary counselling.
Richie described needing ongoing therapy, with a charity providing long-term support and his housing provider offering temporary counselling.
I’ve done therapy for years, and I’ve recently been referred to the same company I was with years ago, ’cause the [Name] Charity offer something called [wellbeing support programme], and I did that for three years only because my... the person I had, also tracked down my files, so I could find things out about my birth family. So, I did life story work with them as well as therapy, so that’s why it went on for so long. And it kept on getting extended ’cause I needed support. But recently I’ve been referred again and I recently just started it, but... but before this, I had a temporary counselling with my housing provider now, but that was only temporary while I was on the waiting list for [Charity wellbeing support programme].
Mental health support that helped care leavers'
Where support worked well, care leavers spoke about counsellors or workers that listened, understood trauma, and stayed with them through their setbacks and issues. Feeling seen and not judged mattered. Peer spaces, mentoring, and group environments with others who shared similar experiences helped some young people feel less alone. Continuity of staff, emotional availability, and the option for regular check-ins made mental health support more effective and easier for care leavers to engage with.
Megan felt supported when she received trauma-focused therapy, instead of just being given coping techniques that she didn’t find helpful (read by an actor).
Megan felt supported when she received trauma-focused therapy, instead of just being given coping techniques that she didn’t find helpful (read by an actor).
You know, obviously, like I can’t say some cases are worse than the other, but mine is like... literally like the average case that you get. And social workers and stuff treat so normal, like it’s normal to have this trauma, and they kinda like throw you into care and like, ‘crack on,’ do you know what I mean?
So, it’s kinda like after being told that, I was like, ‘oh, my God, that just explains it like... this is explains like the people I know that are in care, like it explains so much.’ So like this service they’re a new thing and it’s... I’ve seen CAMHS, I’ve seen... like I’ve seen CAMHS, I’ve seen like NHS services, I’ve seen like different services here and there.
Other services I’ve seen them. And, this is the only thing that worked for me because instead of them giving me coping mechanisms to deal with the trauma... this therapy basically gets rid of the trauma – well it don’t get rid of it – but it moves it to a good place in your brain.
Chloe explained that workers without lived experience could never understand, and she only felt heard when she started seeing a counsellor with similar experiences.
Chloe explained that workers without lived experience could never understand, and she only felt heard when she started seeing a counsellor with similar experiences.
I struggled with mental health during that time. I think my support worker wasn’t really helpful. The support was kind of just either “keep your spirits up you’ll be fine”, mostly. I appreciate the support that was there. It just, there was no real understanding. Support workers have no lived experience of what it was like and so it made it quite difficult. I found sort of the counsellors and the team at CAMHS, and the safeguarding leads. They have no lived experience what it was like and it was really difficult to resonate and really get that support. And it was only when I found my counsellor at college. Who had actually lived in a foyer like I did when they were younger and also homeless. I thought, oh I finally feel heard. It was really nice and that was the first sort of time I really felt supported. So, yeah.
Mental health support that care leavers' need
Care leavers said support should be proactive rather than crisis-based, with easier access to counselling and someone checking in on them regularly, rather than leaving them to ask for help. Stigma around certain diagnoses, like borderline personality disorder, could lead to people being dismissed or labelled, making it harder for them to seek care. Some young people reflected that counselling might have helped them more if it had been available at a time when they were emotionally ready to use it. Others stressed that therapy, trauma processing and ongoing support should continue well into adulthood, not stop at 18 or 21.
Dan said counselling stopped too early, and no one checked if he was emotionally ready to live alone, which left him feeling like a lost cause.
Dan said counselling stopped too early, and no one checked if he was emotionally ready to live alone, which left him feeling like a lost cause.
I think for me, I really wish that support around the counselling and therapy and all that stuff never stopped because I think... or like that was never asked about again, really. ’cause that would have made a massive difference to me now, you know? And during that time because I used to take it: ‘well, if no one asked me, then they didn’t want... they weren’t really bothered,’ you know? And they were so proactive on whether I was prepared to live by myself, and whether I had the practical means, and no one really asked me whether I was ready emotionally, or if that’s something that I really wanted to do, they just kind of assumed it because I’d been so isolated and independent for so long…
And I think as well, I think it would have been nice just to sort of... it’s hard, I know, because obviously PAs aren’t... you know, the care leaver team, they’re not massive and they’ve got loads on their caseload, but like they’re not always there. And it’s not their fault, and it’s not that, but it’s not like social workers where it’s statutory, every four weeks you’ve got to see the child at least, you know, it’s sometimes it would feel like forever till I’d see my PA, and I’d sometimes... I don’t know whether this is just a me thing, but you get fed up of asking for help all the time, you feel like a lost cause.
Robyn said long NHS waiting lists made it hard to get mental health support, and it wasn’t something the leaving care team could fix.
Robyn said long NHS waiting lists made it hard to get mental health support, and it wasn’t something the leaving care team could fix.
I don’t think that’s on the leaving care team’s back because they did the referral – they did, like, what they needed to do – that’s kind of on the NHS system. But I say that as if I’m not going to be studying to work in it next year, but that’s a me issue. [chuckles] I just think, to be fair, that’s just lack of funding.
Long queue times.
And... yeah, and it’s not generally anything the leaving care team have done, it’s more, you know, circumstantial of the fact that everyone, whether you’re a care leaver or not, is going to have, like, a six-month waiting list minimum to even see anyone, followed by, like, a two-year one that they add you onto for therapy after your original.
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