Adolescents in aftercare services who are transitioning from out-of-home care, also called care leavers, face more challenges in their lives, and engage in more risk behaviors, than their peers. However, no previous reviews have comprehensively addressed this issue to identify future research needs. The aim of this systematic review was to gather, assess, and synthesize previous studies concerning care leavers’ high-risk behavior. The search was conducted in six databases, with sixteen articles included in the final review. The selected research highlighted five forms of high-risk behavior: substance abuse, delinquency, sexual behavior, irresponsible use of money, and self-destructive behavior. The incidence of high-risk behavior among care leavers varied noticeably between the studies. Some of the studies reported significant connections between high-risk behavior and gender, race, reason(s) for placement, and the form and number of placements. The synthesized findings revealed a fragmented, limited view of care leavers’ high-risk behavior that highlighted substance abuse and delinquency. The development of adolescents, particularly care leavers, includes multiple factors that have either a conducive or protecting effect for high-risk behavior. Comprehensive research regarding care leavers’ high-risk behavior, including the associated factors, is needed to better support healthy development and success in transitioning to independent living.

AimThe aim of this study was to describe the forms and the prevalence of risk behaviour among adolescents in aftercare services, as well as identify the associated factors and use of services by adolescents.BackgroundAdolescents in aftercare services represent a vulnerable group that struggles with several aspects of life. The challenges they face are known to accumulate in certain individuals, and the problems that are relevant for this group tend to have an intergenerational nature.DesignThe research applied retrospective document analysis, with the analysed data comprising information on 698 adolescents in aftercare services in one large Finnish city from the fall of 2020.MethodsThe data were analysed using descriptive statistics and multivariate methods.ResultsRisk behaviour was identified among 616 of the studied adolescents (88.3%), and manifested as substance abuse, reckless sexual behaviour and/or use of money, nicotine use, self‐destructive behaviour, delinquency and functional dependencies. Regarding the associations between risk behaviour and background variables, an adolescents’ child's clientship in child protection or the child's placement in foster care, adolescent's need for support in parenting, problems with daily rhythm and problems with studying were found to influence the prevalence of risk behaviour. Forms of risk behaviour were also found to be associated with each other. Adolescents displaying risk behaviour commonly did not use the social counsellor, psychiatric outpatient care and study counselling services, even if they would have needed them.ConclusionsThe interconnections between different forms of risk behaviour mean that this issue should be prioritized when developing aftercare services.ImpactThis is the first time that risk behaviour among adolescents in aftercare services has been comprehensively examined. Understanding this phenomenon is key to identifying future research topics, guiding decision‐making and helping stakeholders truly understand the needs of these adolescents.Patient or public contributionNo patient or public contribution as the study was based on a document analysis.