ABSTRACT
The mental health of a representative sample of 230 adolescents residing in foster care in New South Wales, Australia, was estimated in a state-wide epidemiological survey from carer-report responses on the Child Behavior Checklist (CBCL) and the Assessment Checklist for Adolescents (ACA). Rates of CBCL total problems, externalizing and internalizing scores above the borderline range cut-points were 49, 44 and 29% respectively, representing a relative risk of 3.8, 3.7 and 2.7 respectively in comparison to Australian children at large. These rates are 10-14% lower than that previously estimated for pre-adolescent Australian children in foster care. Whereas older age is associated with poorer mental health among pre-adolescent children in foster care, the present study findings suggest that this effect does not extend into adolescence. Around half of adolescents residing in foster care have mental health difficulties requiring referral to treatment services, including attachment- and trauma-related difficulties that are uncommon among clinic-referred children at large.
Subject(s)
Child, Foster/legislation & jurisprudence , Child, Foster/psychology , Foster Home Care/legislation & jurisprudence , Health Surveys , Mental Disorders/epidemiology , Mental Health/statistics & numerical data , Adolescent , Checklist , Child , Child, Foster/classification , Female , Foster Home Care/classification , Humans , Male , New South Wales/epidemiologySubject(s)
Child Protective Services/classification , Child Protective Services/economics , Chronic Disease/classification , Chronic Disease/economics , Foster Home Care/classification , Foster Home Care/economics , Health Services Accessibility/classification , Health Services Accessibility/economics , Health Services Needs and Demand/classification , Health Services Needs and Demand/economics , Terminology as Topic , Chronic Disease/epidemiology , Cross-Sectional Studies , Humans , Quality of Life , Reimbursement Mechanisms/classification , Reimbursement Mechanisms/economics , Treatment Outcome , United StatesABSTRACT
Parental methamphetamine use has drawn significant attention in recent years. Despite prior research that shows that parental substance abuse is a risk factor for lengthy foster care stay, little is known about the effect of specific types of substance use on permanency. This study sought to compare the impact of parental methamphetamine use to alcohol use, other drug use, and polysubstance use on the timing of 3 types of permanency: reunification, guardianship, and adoption. Using an entry cohort of 16,620 children who had entered foster care during a 5-year period, competing risks event history models were conducted for each permanency type. Findings showed that, after controlling for several case characteristics, parent illicit drug use significantly impacted the timing of the 3 types of permanency, but alcohol use did not. Methamphetamine, other drug, and polysubstance with methamphetamine use were associated with lower rates of reunification and higher rates of adoption. Guardianship was also predicted by other drug and polysubstance use without methamphetamine; however, methamphetamine use was not associated with guardianship. Notably, the methamphetamine groups comprised the youngest children and had the shortest median time to adoption. Results suggest that type of parental substance use is predictive of permanency exits and that parental illicit drug use may require tailored strategies for improving permanency outcomes. Further implications of the findings are discussed.
