Suicide risk, protective factors, and interventions for young people in out-of-home care: a scoping review

Young people in out-of-home care (OOHC) experience disproportionately high rates of suicide and self-harm, yet suicide prevention remains underdeveloped within child protection systems. This scoping review synthesises international peer-reviewed literature and relevant Australian gray literature from the past decade to identify risk factors, protective factors, and interventions associated with suicidality among care-experienced young people.

This review was guided by the PRISMA-ScR guidelines and followed Arksey and O'Malley's five-step framework. With the support of a research librarian, a search strategy was developed to capture both peer-reviewed and gray literature. Four electronic databases (Medline, CINAHL, PsycINFO, and ProQuest) were searched via carefully selected keywords, covering publications from 2014 to February 2025.

Seventeen studies met the inclusion criteria and spanned diverse methodologies and geographic contexts. The key risk factors included a history of trauma, placement instability, mental health comorbidities, and systemic failure in OOHC. Protective factors centred on relational safety, emotional regulation, and culturally affirming support. Interventions ranged from high-intensity therapeutic models to low-intensity relational programs, with promising outcomes linked to caregiver connection and trauma-informed practice.

The findings demonstrate the need for gender-sensitive, relationally driven approaches and more robust multi-item assessment tools. This review highlights critical gaps in young people's voice inclusion and calls for codesigned interventions with care-experienced young people. The implications for policy and practice include strengthening professional development for carers and adapting existing suicide prevention frameworks to the OOHC context.