Changes in Mental Health of Children and Young People in Residential Care: Outcomes and Associated Factors.

Several studies have evidenced that children in out-of-home care (OOHC), including foster family care and residential care, reveal high levels of mental health disorders (ranging from 40% to 88%). This study examines the outcomes in mental health reported by key residential workers in a group of children and youth (N = 492) between 8-17 years old who were in residential child care (RCC) in Spain. The research also aims to explore the relationship between mental health outcomes and the provision of mental health services (i.e., receiving any mental health treatment) as well as the influence of child, family, and placement factors. The design of this study includes two measures: a baseline (T1) and a follow-up two years later (T2). The results indicated that 29.9% of young people enjoyed sustained mental health; 26% meaningful improvement in their mental health; 23.5% meaningful deterioration; and the remaining 20.5% showed no meaningful change. One of the main findings was that receiving mental health treatment had a significant impact on mental health outcomes. It is crucial to establish protocols and systematic detection tools to assess mental health and ensure detection and referral to proper treatment.

La investigación en el ámbito de la protección a la infancia ha destacado la presencia de un alto porcentaje de niños, niñas y adolescentes (NNA) en acogimiento residencial y familiar con trastornos de salud mental (entre el 40% y el 88%). Este estudio tiene como objetivo examinar los cambios experimentados en la salud mental de los NNA durante el proceso de acogida según informan sus educadores de referencia en un grupo de 492 NNA entre 8-17 años que se encontraban en hogares de protección en España. El estudio también tiene como objetivo explorar la relación entre los resultados en salud mental y el tratamiento recibido desde diferentes servicios de salud mental, además de la influencia que puedan ejercer factores del NNA, su familia o el proceso de protección. El diseño del estudio se basa en dos medidas: línea base (T1) y seguimiento dos años después (T2). Los resultados indican que el 29.9% de los NNA mantenía una buena salud mental en las dos medidas, 26% manifestaron una mejora significativa partiendo de niveles clínicos, 23.5% manifestaron un deterioro significativo y el 20.5% no mostraron cambios significativos, manteniendo niveles clínicos en ambas medidas. Una de las principales conclusiones fue que estar recibiendo o no tratamiento en salud mental resultó ser un factor clave en la evolución de los NNA. Por tanto, resulta crucial establecer sistemas de detección de problemas de salud mental en esta población con el fin de derivar precozmente a tratamientos adecuados.

Changes in Mental Health of Children and Young People in Residential Care: Outcomes and Associated Factors / Los cambios en la salud mental de los niños y jóvenes en acogimiento residencial: resultados y factores asociados

Several studies have evidenced that children in out-of-home care (OOHC), including foster family care and residential care, reveal high levels of mental health disorders (ranging from 40% to 88%). This study examines the outcomes in mental health reported by key residential workers in a group of children and youth (N = 492) between 8-17 years old who were in residential child care (RCC) in Spain. The research also aims to explore the relationship between mental health outcomes and the provision of mental health services (i.e., receiving any mental health treatment) as well as the influence of child, family, and placement factors. The design of this study includes two measures: a baseline (T1) and a follow-up two years later (T2). The results indicated that 29.9% of young people enjoyed sustained mental health; 26% meaningful improvement in their mental health; 23.5% meaningful deterioration; and the remaining 20.5% showed no meaningful change. One of the main findings was that receiving mental health treatment had a significant impact on mental health outcomes. It is crucial to establish protocols and systematic detection tools to assess mental health and ensure detection and referral to proper treatment. (AU)

La investigación en el ámbito de la protección a la infancia ha destacado la presencia de un alto porcentaje de niños, niñas y adolescentes (NNA) en acogimiento residencial y familiar con trastornos de salud mental (entre el 40% y el 88%). Este estudio tiene como objetivo examinar los cambios experimentados en la salud mental de los NNA durante el proceso de acogida según informan sus educadores de referencia en un grupo de 492 NNA entre 8-17 años que se encontraban en hogares de protección en España. El estudio también tiene como objetivo explorar la relación entre los resultados en salud mental y el tratamiento recibido desde diferentes servicios de salud mental, además de la influencia que puedan ejercer factores del NNA, su familia o el proceso de protección. El diseño del estudio se basa en dos medidas: línea base (T1) y seguimiento dos años después (T2). Los resultados indican que el 29.9% de los NNA mantenía una buena salud mental en las dos medidas, 26% manifestaron una mejora significativa partiendo de niveles clínicos, 23.5% manifestaron un deterioro significativo y el 20.5% no mostraron cambios significativos, manteniendo niveles clínicos en ambas medidas. Una de las principales conclusiones fue que estar recibiendo o no tratamiento en salud mental resultó ser un factor clave en la evolución de los NNA. Por tanto, resulta crucial establecer sistemas de detección de problemas de salud mental en esta población con el fin de derivar precozmente a tratamientos adecuados. (AU)

No one ever asked us. young people's evaluation of their residential child care facilities in three different programs / Nadie nos ha preguntado nunca. La evaluación de los jóvenes sobre sus hogares de acogimiento residencial en tres programas diferentes

Background: Residential child care is a very complex measure and has been the subject of heated debate in many countries. However, there is a paucity of studies that examine quality assessments of these services, much less that have asked the children and young people receiving those services about their own evaluations. Method: This study interviewed 209 young people between 11 and 20 years of age, in 21 residential facilities, about their degree of satisfaction with the care they receive. These residential facilities are differentiated into three types of programs that will be compared: preparation for adult life (PAL), therapeutic care for behavioral problems (TRC) and general programs for children and young people without any specific profile (GRC). The instrument used is an interview that includes both quantitative and qualitative assessments. Results: The results show a trend toward positive average scores on practically all aspects, highlighting the support from as well as the connection they feel with the educators who care for them. On the other hand, young people in TRC displayed lower scores on almost all aspects evaluated while those in PAL were the most positive. Conclusions: The main implications for the practice will be discussed from these youths' perspective

Antecedentes: el acogimiento residencial es una medida compleja y que ha sido objeto de intensos debates en muchos países. Sin embargo, no existen muchos estudios sobre la evaluación de la calidad de estos servicios y mucho menos que hayan tenido en cuenta la opinión de los niños y jóvenes que los reciben. Método: en este estudio se entrevista a 209 jóvenes entre 11 y 20 años, que se encuentran en 21 hogares de acogimiento residencial, acerca de su satisfacción con la atención que reciben. Estos hogares de acogida se diferencian en tres tipos de programas que se compararán: preparación para la vida adulta (PAL), acogimiento terapéutico para problemas de conducta (TRC) y programas generalistas sin perfil específico (GRC). El instrumento empleado es una entrevista que recoge valoraciones cuantitativas y cualitativas. Resultados: los resultados muestran una tendencia a valoraciones con promedios positivos en prácticamente todos los aspectos, destacando el apoyo y la vinculación con los educadores que los atienden. Por otra parte, los jóvenes en TRC muestran puntuaciones más bajas en casi todos los aspectos, mientras que los jóvenes en PAL presentan las más altas. Conclusiones: se discutirán las principales implicaciones para la práctica desde esta perspectiva de los jóvenes

No one ever asked us. Young people's evaluation of their residential child care facilities in three different programs.

BACKGROUND: Residential child care is a very complex measure and has been the subject of heated debate in many countries. However, there is a paucity of studies that examine quality assessments of these services, much less that have asked the children and young people receiving those services about their own evaluations. METHOD: This study interviewed 209 young people between 11 and 20 years of age, in 21 residential facilities, about their degree of satisfaction with the care they receive. These residential facilities are differentiated into three types of programs that will be compared: preparation for adult life (PAL), therapeutic care for behavioral problems (TRC) and general programs for children and young people without any specific profile (GRC). The instrument used is an interview that includes both quantitative and qualitative assessments. RESULTS: The results show a trend toward positive average scores on practically all aspects, highlighting the support from as well as the connection they feel with the educators who care for them. On the other hand, young people in TRC displayed lower scores on almost all aspects evaluated while those in PAL were the most positive. CONCLUSIONS: The main implications for the practice will be discussed from these youths’ perspective.

School Functioning of a Particularly Vulnerable Group: Children and Young People in Residential Child Care.

A large proportion of the children and young people in residential child care in Spain are there as a consequence of abuse and neglect in their birth families. Research has shown that these types of adverse circumstances in childhood are risk factors for emotional and behavioral problems, as well as difficulties in adapting to different contexts. School achievement is related to this and represents one of the most affected areas. Children in residential child care exhibit extremely poor performance and difficulties in school functioning which affects their transition to adulthood and into the labor market. The main aim of this study is to describe the school functioning of a sample of 1,216 children aged between 8 and 18 living in residential child care in Spain. The specific needs of children with intellectual disability and unaccompanied migrant children were also analyzed. Relationships with other variables such as gender, age, mental health needs, and other risk factors were also explored. In order to analyze school functioning in this vulnerable group, the sample was divided into different groups depending on school level and educational needs. In the vast majority of cases, children were in primary or compulsory secondary education (up to age 16), this group included a significant proportion of cases in special education centers. The rest of the sample were in vocational training or post-compulsory secondary school. Results have important implications for the design of socio-educative intervention strategies in both education and child care systems in order to promote better school achievement and better educational qualifications in this vulnerable group.