TY - JOUR
AU - N. Asseffa
AU - F. H. Astawesegn
AU - S. Giri
AU - N. Ross
AU - K . Y. Ahmed
AU - M. G. Bore
AU - S. Mahmood
AU - S. Thapa
A1 - 
AB - BACKGROUND: Supporting children and young people (≤24 years) who have experienced adverse childhood experiences (ACEs) is challenging due to limited access to specialized mental health services and systemic barriers that hinder continuity of mental health care. OBJECTIVE: This qualitative evidence synthesis investigated the pathways and continuum of mental health care among children and young people experiencing ACEs and mental health challenges. METHODS: Articles were identified through searches of electronic databases and manual searches of reference lists. The candidacy framework guided our thematic synthesis, focusing on how young people access, navigate, and remain engaged in mental health care. RESULTS: Twenty-one studies evaluated the health seeking practices for young people with ACEs. Many children and young people with ACEs do not seek treatment, and others discontinue care due to distress or alienation. Early help-seeking was often delayed due to low awareness, fear of disclosure, and parental reluctance. Access to services was limited by fragmented systems, logistical and financial barriers, and lack of information. Engagement was undermined by emotional discomfort, cultural or language barriers, re-traumatization risks, and negative provider attitudes, while sustained use depended on trust, culturally appropriate care, and service continuity. As a coping, many young people turned to informal support from peers, teachers, and online resources when formal services were inaccessible. Structural challenges, including insufficient training, weak referral pathways, and limited resources, further undermined continuity of care. CONCLUSIONS: Recognizing informal and alternative pathways, combined with integrated, contextually adapted, cross-sectoral care models, can help address unmet mental health needs of children and young people with ACEs globally.
AD - School of Social Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.; Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia; College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.; Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia.; School of Social Work, Dalhousie University, K'jipuktuk Halifax, Nova Scotia, Canada.; Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia; Discipline of General Practice, School of Medicine, Adelaide University, Adelaide, SA, Australia.; Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia; Menzies School of Health Research, Hearing and Ear Health, Charles Darwin University, Darwin, Northern Territory, Australia.; Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia. Electronic address: suthapa@csu.edu.au.
AN - 41887134
BT - Child Abuse Negl
C5 - Healthcare Disparities
DA - May
DO - 10.1016/j.chiabu.2026.108005
DP - NLM
ET - 20260325
JF - Child Abuse Negl
LA - eng
N2 - BACKGROUND: Supporting children and young people (≤24 years) who have experienced adverse childhood experiences (ACEs) is challenging due to limited access to specialized mental health services and systemic barriers that hinder continuity of mental health care. OBJECTIVE: This qualitative evidence synthesis investigated the pathways and continuum of mental health care among children and young people experiencing ACEs and mental health challenges. METHODS: Articles were identified through searches of electronic databases and manual searches of reference lists. The candidacy framework guided our thematic synthesis, focusing on how young people access, navigate, and remain engaged in mental health care. RESULTS: Twenty-one studies evaluated the health seeking practices for young people with ACEs. Many children and young people with ACEs do not seek treatment, and others discontinue care due to distress or alienation. Early help-seeking was often delayed due to low awareness, fear of disclosure, and parental reluctance. Access to services was limited by fragmented systems, logistical and financial barriers, and lack of information. Engagement was undermined by emotional discomfort, cultural or language barriers, re-traumatization risks, and negative provider attitudes, while sustained use depended on trust, culturally appropriate care, and service continuity. As a coping, many young people turned to informal support from peers, teachers, and online resources when formal services were inaccessible. Structural challenges, including insufficient training, weak referral pathways, and limited resources, further undermined continuity of care. CONCLUSIONS: Recognizing informal and alternative pathways, combined with integrated, contextually adapted, cross-sectoral care models, can help address unmet mental health needs of children and young people with ACEs globally.
PY - 2026
SN - 0145-2134
SP - 108005
ST - Mental health continuum of care for children and young people with adverse childhood experiences: A qualitative evidence synthesis
T1 - Mental health continuum of care for children and young people with adverse childhood experiences: A qualitative evidence synthesis
T2 - Child Abuse Negl
TI - Mental health continuum of care for children and young people with adverse childhood experiences: A qualitative evidence synthesis
U1 - Healthcare Disparities
U3 - 10.1016/j.chiabu.2026.108005
VL - 175
VO - 0145-2134
Y1 - 2026
ER -