Interventions to support reproductive and mental health among care leavers: A systematic review

Abstract

Compared to other teenagers, young care leavers tend to have poorer sexual/reproductive and mental health; mental health difficulties may increase risk for poor sexual/reproductive health. This systematic review addresses a gap in knowledge regarding the effectiveness of existing interventions that support care leavers’ sexual/reproductive health (e.g., contraception, pregnancy choices, early parenting). Eight published articles spanning six interventions were eligible. Interventions were associated with improvements in a range of sexual/reproductive health measures (e.g., sexual health knowledge; knowledge of where to get support; attitudes to sexual health practices), with some indicative improvements in self-esteem. However, some studies suggested these improvements may not be sustained. Interventions tended to include a broad age range, with limited programmes specifically aimed at care leavers. While some programmes focused on attitudes toward reproductive health and pregnancy (i.e., contraception), we identified no programme focusing on parenthood choice. We also identified no sexual/reproductive health programme that targeted or assessed associated mental health problems, despite evidence of associations between sexual health and mental health difficulties. Findings suggest that care leavers may benefit from specific sexual/reproductive health supports, but further evidence is needed. Findings also indicate a need for more holistic supports that integrate mental health supports with reproductive/sexual health and consider care leaver decision-making.