Mental Health Needs Of Children In Care In Turkey: Stakeholders’ Perspective And Experiences Of Stakeholders

Background: Looked after children have high levels of unmet mental health needs across the world. This service gap is particularly pronounced in low- and middle-income countries such as Turkey. Research aims. The aims of this research were to explore the views and experiences of looked after children, carers, social workers and mental health professionals in relation to their mental health needs,

supports within the care system, and interventions from mental health services. Methods: A qualitative design was employed. Semi-structured interviews were conducted with 15 children aged 14-18 years from four care homes in Istanbul, who had previously attended mental health services. In addition, interviews were undertaken with carers (n=9), social workers (n=7) employed in care settings, and psychiatrists (n=5). These were audio-taped, transcribed verbatim and analysed through a thematic framework. Results: difficulties, available supports within the are system, and experiences of mental health services. Children often felt abandoned and rejected within care settings, which led them to develop their own coping strategies such as through withdrawal, crying, isolation and loneliness. Fear of stigma, poor referral systems and lack of inter-agency working were perceived as key barriers to access and engage with mental health services. Interventions were largely based on pharmacological treatment, which was mostly viewed as ineffective. Engagement of children, psychotherapeutic interventions, inter-agency collaboration, and capacity-building for carers and staff were the main recommendations by stakeholders. Conclusions: These findings can enable policy-makers, service developers and professionals to better understand the nature of mental health needs experienced by looked after children and gaps in service provision; thus use this evidence-base to improve the quality of their mental health care in Turkey and other similar contexts around the world.