In one extreme case, the team who conducted the consultation with children in one facility were informed ten days after that one of the children who had participated in the session had died due to a non-identified and non-treated illness, which exemplified the severe lack of adequate medical facilities there. Moreover, some felt that those with disabilities or complex health needs were sometimes at a disadvantage, not catered for appropriately or experiencing additional risks. A transgender boy in one setting reported that he could not access hormones. Treatment outside the institutions was reserved for emergencies or specialised care. While it was generally stated that this was provided, some concerns were raised regarding access including the treatment of children during their transfer to medical facilities: ‘We don’t [have] access to good medical care, [the centre] office doesn’t move us out for treatment’. (M/13-17/1:APG) ‘This is shameful, we are transferred to hospital by the accompaniment of the police’. (M/14-17/1:WEOG) There was less satisfaction with access to psycho-social support. Psychologists/psychiatrists and social workers were available within some institutions, yet reports on engagement with these varied however. While the value of an in-house therapist was noted in an institution housing LGBTI children, others told us that availability did not always equate with effectiveness: ‘In mental health, they motivate you but don’t help you put it into practice. The group encounters we had with psychology were never sincere, and they forced us to attend, and one already learned what one had to say. Those spaces were uncomfortable’. (M/17/1:LAC) Yet the need for, and importance of, support for children’s mental health needs was evident given the abuse and trauma experienced by many of the children. In two orphanages, for instance, it was noted that there was no access to psychologists or mental health support despite the need for this. Children in a number of child justice institutions also felt there could be better access to psychologists and mental health support rather than this being provided sporadically or in crisis situations: ‘Mental health is not part of the treatment. Only when they’re extreme cases’. (F/1720/1:LAC) 91