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Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis
- Authors:
- DUBOIS-COMTOIS Karine, et al
- Journal article citation:
- Children and Youth Services Review, 127, 2021, p.106100.
- Publisher:
- Elsevier
This meta-analysis aims at comparing mental health problems of children in foster care to those living with their biological parents while taking in consideration different protective and risk factors. Across 41 studies with a total of 72 independent effect sizes, a significant but small effect size was found between foster care placement and psychopathology (d = 0.19). Children in foster care showed higher levels of psychopathology compared to those from community samples or matched/at-risk samples. They were as likely to show mental health problems as maltreated children living with their biological parents or children from clinical samples. Results showed that foster children’s mental health problems also varied as a function of type of placement and study methodological characteristics. Being placed in kinship care, longer stay in the same foster home and fewer placement disruptions, all acted as protective factors limiting mental health problems of children in foster care. (Edited publisher abstract)
Mental health outcomes for adults in family foster care as children: an analysis by ethnicity
- Authors:
- VILLEGAS Susy, PECORA Peter J.
- Journal article citation:
- Children and Youth Services Review, 34(8), August 2012, pp.1448-1458.
- Publisher:
- Elsevier
The adult mental health outcomes of maltreated children placed in foster care have not been fully examined across diverse ethnic groups. While data on transitioning youth and young adults has emerged, the impact of ethnicity on adult mental health outcomes has been studied infrequently. Given the overrepresentation of ethnic minority children in foster care, this study examined the relationship between ethnicity and mental health outcomes for a nationally representative sample of 574 white, 123 African American and 113 Hispanic adults in the United States who experienced family foster care as children. Findings indicated that ethnicity was not a significant predictor of adult mental health. However, gender, age of entrance into child welfare, maternal mental health, maltreatment while in care, number of placements, and degree of preparation for leaving care were associated significantly with the adult's mental health outcomes. Implications for research and social work practice are discussed.
Maternal mental illness and the safety and stability of maltreated children
- Authors:
- KOHL Patricia L., JONSON-REID Melissa, DRAKE Brett
- Journal article citation:
- Child Abuse and Neglect, 35(5), May 2011, pp.309-318.
- Publisher:
- Elsevier
Mothers with a mental illness put their children at risk for negative outcomes such as maltreatment and foster care placement. This study investigated the association between maternal mental illness and children's long term safety and stability. Data from the Department of Social Services and Department of Mental included 4,895 low income mother and child dyads first reported to child welfare in 1993 or 1994. Families were followed until March of 2009. Schizophrenic, episodic mood, anxiety and personality disorders were measured. Findings revealed that new reports were more likely for children of mothers with mental illness, regardless of diagnosis. While overall 67% of children had a new report over the course of their childhood, rates ranged from 80 to 90% for children of mothers with mental illness and occurred within a shorter time frame than for other children. Mood and anxiety disorders placed children at greater risk for new reports. The proportion of children with foster placements was more than doubled. Anxiety disorders were strongly associated with the risk of placement. The authors concluded that the services that the mothers’ received may be ineffective in helping them parent safely.
Disentangling the effect of out-of-home care on child mental health
- Authors:
- BALDWIN Helen, et al
- Journal article citation:
- Child Abuse and Neglect, 88, 2019, pp.189-200.
- Publisher:
- Elsevier
Background: Children in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care. Objective: This research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care. Participants and Setting: The sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159). Methods: The mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers. Results: The odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032). Conclusions: These findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care. (Edited publisher abstract)
The relation between dimensions of maltreatment, placement instability, and mental health among youth in foster care
- Authors:
- McGUIRE Austen, et al
- Journal article citation:
- Child Abuse and Neglect, 86, 2018, pp.10-21.
- Publisher:
- Elsevier
Youth in foster care with maltreatment experiences often demonstrate higher rates of mental and behavioural health problems compared to youth in the general population as well as maltreated youth who remain at home. Previous research has demonstrated that dimensions of maltreatment (type, frequency, and severity) and placement instability are two prominent factors that account for high rates of psychopathology (e.g., depression, anxiety, and disruptive behaviour disorders). The present study sought to clarify the relation between maltreatment and mental health among youth in foster care by studying both the isolated dimensions of maltreatment and cumulative maltreatment, and to determine whether the effects of maltreatment on mental health operated indirectly through placement instability. Information on youth in foster care’s (N = 496, Mage = 13.14) mental and behavioural health, maltreatment history, and placement changes were obtained from state records and primary caregivers. Using a SEM framework, the results suggest that maltreatment and placement instability each independently relate to mental and behavioural health problems. Further, none of the maltreatment types predicted greater placement instability in the current models. These findings suggest that placement stability is critical for mental health for youth in foster care, regardless of the type, severity, or frequency of their maltreatment experiences. Results also indicated that, although cumulative maltreatment predicted both internalising and externalising symptoms, maltreatment frequency and severity had direct relations to externalising symptoms only. These findings underscore the utility of comprehensive maltreatment assessment, encouraging researchers and clinicians to assess and carefully consider the relation between maltreatment dimensions and outcomes. (Edited publisher abstract)
The grip of trauma: how trauma disrupts the academic aspirations of foster youth
- Author:
- MORTON Brenda M.
- Journal article citation:
- Child Abuse and Neglect, 75, 2018, pp.73-81.
- Publisher:
- Elsevier
The academic challenges foster youth encounter during their P-12 education have been widely reported. Yet, despite these challenges, the majority of foster youth desire postsecondary education. What is less known is the reason why so few foster youth alumni who desire a four-year college degree, achieve this goal. For the participants in this four-year longitudinal study, maltreatment, resulting in foster care placement, and the ensuing exposure to the foster care system, resulted in trauma histories and mental health diagnoses. Anxiety, depression, and posttraumatic stress disorder (PTSD), were the most common diagnosis. The participants shared the ways in which these mental health challenges manifested throughout their college education. Of those in the study, almost half successfully graduated from college, a third dropped out, and only two remain enrolled. This study provides a unique and critical insight into the experiences of foster youth, enrolled in a four-year university, by sharing their stories. (Publisher abstract)
Systematic review of kinship care effects on safety, permanency, and well-being outcomes
- Authors:
- WINOKUR Marc A., HOLTAN Amy, BATCHELDER Keri E.
- Journal article citation:
- Research on Social Work Practice, 28(1), 2018, pp.19-32.
- Publisher:
- Sage
Objective: Children in out-of-home placements typically display more educational, behavioural, and psychological problems than do their peers. This systematic review evaluated the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. Methods: Review authors independently read titles and abstracts identified in the searches, selected appropriate studies, assessed the eligibility of each study, evaluated the methodological quality, and extracted outcome data for meta-analysis. Results: Outcome data from the 102 included quasi-experimental studies suggest that, as compared to children in foster care, children in kinship care experience fewer behavioural problems and mental health disorders, better well-being, less placement disruption, fewer mental health services, and similar reunification rates. Conclusions: This review supports the practice of treating kinship care as a viable out-of-home placement option. This conclusion is tempered by methodological and design weaknesses of the included studies. (Edited publisher abstract)
Reshaping child welfare’s response to trauma: assessment, evidence-based intervention, and new research perspectives
- Authors:
- AI Amy L., et al
- Journal article citation:
- Research on Social Work Practice, 23(6), 2013, pp.651-668.
- Publisher:
- Sage
Growing evidence has linked early trauma with severe psychiatric consequences. Posttraumatic stress disorder (PTSD) is a potentially debilitating mental health condition found among some youth in foster care and foster care alumni. However, the current child welfare practice response has not met the demands in both assessment and intervention. This critical review aims to use the evidence to reshape the child welfare response to trauma in children and adolescents. The article begins by looking at research on the psychiatric consequences of child maltreatment and issues related to diagnostic assessment for PTSD. Next, it compares major foster care/alumni studies showing considerably higher rates of PTSD among young foster care recipients and alumni than among nationally comparable groups. To inform practice on childhood trauma, the article then summarises current evidence-based interventions showing effectiveness with PTSD. Finally, new dimensions, such as gene–environment research, posttraumatic growth, and implications for reshaping child welfare practice and foster care are explored. (Edited publisher abstract)
The moderating effect of marijuana use on the relationship between delinquent behavior and HIV risk among adolescents in foster care
- Authors:
- AUSLANDER Wendy F., et al
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 13(2), 2014, pp.179-197.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Adolescents in foster care experience mental health and substance use problems that place them at risk for HIV, yet the exact nature of the relationship remains unclear. This study examined the co-occurring influences of mental health problems and substance use on HIV risk and determined whether substance use moderated the effect of mental health problems on HIV risk behaviours among adolescents in foster care. Regression analyses of cross-sectional data collected through structured interviews with 334 adolescents, aged 15 to 18 years, determined which mental health problems and substances increased HIV risk behaviours. Adolescents with delinquency and anxiety/depression engaged in significantly more HIV risk behaviours than their counterparts, controlling for race, gender, and type of childhood abuse. Further, any marijuana use significantly moderated the effects of delinquent behaviours on HIV risk, differentially increasing HIV risk among those who engaged in delinquent behaviours. (Edited publisher abstract)
The youngest victims of violence: examining the mental health needs of young children who are involved in the child welfare and juvenile justice systems
- Authors:
- WHITTED Kathryn S., DELAVEGA Elena, LENNON-DEARING Robin
- Journal article citation:
- Child and Adolescent Social Work Journal, 30(3), 2013, pp.181-195.
- Publisher:
- Springer
Children placed in the state's custody due to neglect, abuse or maltreatment are one America's most vulnerable populations. 75% of child victims of maltreatment are under the age of 12. Not only is their suffering a problem, these children are also at increased risk for delinquent behaviour later in life. While research has documented the potential long-term consequences of child abuse and neglect, the mental health needs of young children involved in the foster care and juvenile justice systems have been largely overlooked. This study examines the social, emotional and behavioural difficulties of 670 children, age 3-11, who were involved in the child welfare and juvenile justice systems. children in the study were living in residential treatment facilities, group homes, foster care homes or were receiving intensive home-based services.The children's mental health needs were assessed and finding indicated a high prevalence of mental health problems. (Edited publisher abstract)