Understanding how care-experienced young people in England seek help for mental health problems
| ISRCTN | ISRCTN61644978 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN61644978 |
| National Institute for Health and Care Research (NIHR) | 207636 |
| PROSPERO | CRD420251047424 |
| Sponsor | University of Birmingham |
| Funder | National Institute for Health and Care Research |
- Submission date
- 26/05/2026
- Registration date
- 29/06/2026
- Last edited
- 29/06/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Care-experienced young people in England often have high levels of mental health needs, but many do not receive the support they need. There is limited research on how they try to get help, what barriers they face, and what kinds of support work best, especially for those with multiple marginalised identities (for example, being LGBTQ+, from ethnically minoritised backgrounds, neurodivergent, or living with disabilities).
The aim of this study is to understand how young people aged 13 to 25 with experience of out-of-home care seek help for mental health problems, and how services can be improved to better meet their needs.
Who can participate?
Young people in England who have experience of out-of-home care, including foster care, residential care, or kinship care (living with friends or relatives).
For the survey: young people aged 13 to 25 years
For interviews: young people aged 16 to 25 years
Participants must have been in care within the past 10 years for at least 3 months. Young people currently receiving urgent or crisis mental health care will not be able to take part.
What does the study involve?
The study includes three parts.
First, a review of existing research will be carried out to understand what is already known about help-seeking in care-experienced young people.
Second, an online survey (about 150 participants) will ask about mental health, how participants seek help, and any difficulties they experience when trying to access support.
Third, online interviews (about 20 to 30 participants) will explore these experiences in more detail, particularly for young people from under-represented groups. Some interviews may be supported by trained peer researchers with lived experience of care.
Findings from each part of the study will contribute to an overall understanding of help-seeking and how support can be improved.
What are the possible benefits and risks of participating?
There are no direct benefits to participants, but the study will help improve mental health and social care services for care-experienced young people in the future.
Some participants may feel upset when thinking about difficult experiences. To reduce this risk, the study is designed to be sensitive and supportive. Participants can skip questions, take breaks, or stop at any time. Information about support services will be provided, and interviewers are trained to respond appropriately to distress.
Participants may receive a small voucher as a thank you for taking part.
Where is the study run from?
University of Birmingham (UK)
When is the study starting and how long is it expected to run for?
January 2026 to November 2026
Who is funding the study?
The study is funded by the National Institute for Health and Care Research (NIHR) Research Programme for Social Care (RPSC) (UK)
Who is the main contact?
Dr Willem Stander, w.stander@bham.ac.uk
Contact information
Principal investigator, Scientific, Public
University of Birmingham, Edgbaston
Birmingham
B15 2TT
United Kingdom
 ORCID ID |
0000-0002-3664-4647 |
|---|---|
| Phone | +44 (0)1214143114 |
| w.stander@bham.ac.uk |
Study information
| Primary study design | Observational |
|---|---|
| Observational study design | Cross sectional study |
| Scientific title | Care-experienced yOung peopLe’s mentaL heAlth help-seekinG bEhaviours (COLLAGE): A mixed-methods observational study using a cross-sectional survey and follow-up qualitative interviews to investigate mental health help-seeking among care-experienced young people in England |
| Study acronym | COLLAGE |
| Study objectives | Care-experienced young people in England experience high levels of mental health need, yet many do not access appropriate support. There is limited evidence on how they seek help, the barriers and facilitators they encounter, and how these differ for those with intersecting marginalised identities. The aim of this study is to investigate mental health help-seeking among young people aged 13–25 with experience of out-of-home care in England. The specific objectives are: 1. To examine patterns of help-seeking behaviour, including formal and informal sources of support 2. To identify barriers and facilitators to accessing support 3. To explore how intersecting marginalised identities (e.g. sexual orientation, gender identity, ethnicity, neurodivergence, disability) shape help-seeking experiences 4. To explore in-depth experiences of help-seeking among under-represented groups through qualitative interviews 5. To generate an overall understanding of mental health help-seeking by drawing on findings from the different study components to inform recommendations for improving mental health and social care services. |
| Ethics approval(s) |
Approved 18/12/2025, University of Birmingham Humanities and Social Sciences Research Ethics Committee (Research Governance Team, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom; +44 (0)1214143114; ethics-queries@contacts.bham.ac.uk), ref: ERN_4998 |
| Health condition(s) or problem(s) studied | Mental health help-seeking in young people with experience of out-of-home care in England |
| Methodology | This is a mixed-methods observational study including an evidence synthesis, a cross-sectional online survey, and follow-up qualitative interviews. First, a systematic review of international literature will be conducted to identify existing evidence on mental health help-seeking among care-experienced young people. Second, a cross-sectional online survey will be administered to approximately 150 young people aged 13–25 years in England with experience of out-of-home care. The survey will be hosted on Qualtrics and will collect data on help-seeking behaviours, barriers and facilitators to accessing support, mental health indicators (including anxiety, depression, self-harm and suicidality), and demographic and care-related characteristics. Data will be analysed using descriptive statistics and regression modelling to examine patterns and associations. Third, semi-structured online interviews will be conducted with a purposive sample of approximately 20–30 young people aged 16–25 years, with a focus on those with intersecting marginalised identities. Interviews will explore experiences of mental health help-seeking, barriers and facilitators, and preferences for support. Interviews will be audio-recorded, transcribed, anonymised, and analysed using reflexive thematic analysis. Findings from each study component will contribute to an overall understanding of mental health help-seeking among care-experienced young people. The study is co-produced with a Young Advisors Group of care-experienced young people, who contribute to study design, data collection, and interpretation. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
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| Completion date | 30/11/2026 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 13 Years |
| Upper age limit | 25 Years |
| Sex | All |
| Target sample size at registration | 175 |
| Key inclusion criteria | 1. Aged 13 to 25 years (survey); 16 to 25 years (interviews) 2. Experience of out-of-home care in England (including foster care, residential care, or kinship care) 3. Out-of-home care experience within the past 10 years and lasting at least 3 months 4. Able to provide informed consent (or assent where appropriate) |
| Key exclusion criteria | 1. No experience of out-of-home care in England 2. Out-of-home care experience less than 3 months or more than 10 years ago 3. Currently receiving mental health crisis care or emergency mental health support (e.g., inpatient psychiatric care or intensive crisis services) |
| Date of first enrolment | 05/01/2026 |
| Date of final enrolment | 31/08/2026 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
-
-
England
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Editorial Notes
26/05/2026: Study's existence confirmed by the University of Birmingham Humanities and Social Sciences Research Ethics Committee.
