Adolescents in out-of-home placement have a high prevalence of mental health distress, and their vulnerability to poor mental health outcomes continues during placement. Risk and protective factors may influence mental health outcomes; however, little is known about their relationship to mental health distress in this population. Findings from this population-based school survey of young people reiterate that youth in out-of-home placements have higher levels of mental health distress and lower levels of protective factors compared to other youth. These results offer insights for those working with out-of-home or precariously housed young people.