Background Children and young people (CYP) who have experienced statutory care are among the most disadvantaged in society and have higher prevalence of mental disorders than the general population. This has been linked to experience of significant childhood adversity including abuse and neglect. Despite indications of high levels of mental health and wellbeing needs in this group, there remains a paucity of empirical research exploring this issue. With an increased chance of experiencing a range of poor health outcomes, it is imperative that key factors for supporting positive development in this group are identified. The aim of this qualitative study was to identify risk and protective factors associated with mental health and wellbeing of care experienced CYP from the perspective of children’s social care and mental health practitioners.

Methods We conducted four focus groups with 23 practitioners from four local authorities (the organisations responsible for the provision of public services within a geographical area) between April and May 2022. A semi-structured topic guide exploring the nature, risk and protective factors of mental health and emotional wellbeing was used. Social care and mental health practitioners were purposively sampled by profession so that the final sample included representation from children’s welfare service including early help, community safeguarding teams and those working with children in care/out of home placements. Data were thematically analysed following an iterative six-step analysis approach and informed by the four levels of the socio-ecological model (SEM).

Results At the individual level, risk factors included the CYP’s emotional health and functioning and included what practitioners described as the sense of shame. Interpersonal level risk factors were the most recurrent risk highlighted during the discussions. They included interactions and influence of the CYP’S personal relationships and adversity within the home environment. At the community level, risk factors consisted of the characteristics of the settings and institutions that increased the risk of the CYP developing mental health and wellbeing difficulties, particularly the school setting. At the societal level, risk factors included broader societal factors like poverty and unemployment. Practitioners maintained that not all care experienced CYP developed mental health difficulties, particularly if they possessed or developed certain protective factors, for example secure attachments and supportive networks.

Conclusion Our study provides evidence suggesting that risk factors for mental health and wellbeing in care experienced CYP operate on multiple, interconnected levels of the SEM. It is imperative that support interventions take this into account and strengthen protective factors like secure attachments and supportive networks when developing interventions for care experienced CYP.