How might we improve the mental health and well-being of care-experienced children and young people? Review and map of intervention theories

Summary This article presents a review and map of program theories used in mental health and well-being interventions tested with care-experienced children and young people (foster care, kinship care, residential care). Program theories are important in knowing how interventions should bring about change, how they might be implemented, and how they will be influenced by contextual factors. Currently, we do not fully understand if and how interventions are using program theories. We synthesized the international evidence base for interventions targeting subjective well-being, mental health, and suicide-related outcomes among care-experienced individuals aged ≤ 25 years. We identified interventions’ theories of change, implementation theories, and context theories. Study reports were retrieved through 16 electronic databases and 22 websites, expert recommendations, citation tracking, and screening of systematic reviews. We charted interventions and their associated theories, constructing narrative, and visual summaries. We further conducted stakeholder consultations to identify which theories should be prioritized in the UK. Findings The review identified 13 interventions, with 24 study reports. Most interventions primarily drew on interpersonal theories of change ( n = 12), notably Attachment, Positive Youth Development, and Social Learning Theory. These targeted mental health, behavioral, or neurodevelopmental disorders, with minimal focus on well-being or suicide-related outcomes. Reports were limited by a lack of theoretical clarity and coherency, scare implementation and context theories, and minimal stakeholder involvement in theory development. Applications Future interventions need to explicitly articulate their program theory. Stakeholders suggested drawing on theories that will help interventions strengthen relationships and bring about structural change.