"We are not our case files": A qualitative analysis of child welfare professionals' relationships with young adults with foster care experience.

BACKGROUND: Young adults of color with foster care experience are disproportionately represented in foster care in the United States. Developing meaningful connections with child welfare professionals can help young adults develop healthy relationships in emerging adulthood. OBJECTIVE: This exploratory qualitative study addressed how young adults with foster care experience described their relationships with child welfare professionals and the impact of these relationships on their overall mental health and well-being in young adulthood. PARTICIPANTS AND SETTING: A sample of young adults of color, (ages 18-29) with lived experience in foster care from a performing arts program in New York City. METHODS: Reflexive thematic analysis was conducted on 14 semi-structured interviews with young adults of color with prior or ongoing foster care experience. RESULTS: The following themes were identified: safe space to be myself, listen to more than words, and understand my trauma. Child welfare professionals were dropped from support networks if they were disingenuous or did not attend to their own self-care needs. CONCLUSIONS: The study underscores the importance of promoting positive mental health outcomes for young adults through building stronger connections with child welfare professionals. Future research should explore the incorporation of individualized approaches to better serve this population of young adults.

A systematic review and meta-analysis on adverse childhood experiences: Prevalence in youth offenders and their effects on youth recidivism.

BACKGROUND: Adverse childhood experiences (ACEs) have been found to be more prevalent among youth involved with the criminal justice system compared to their counterparts in the general population. The present study aims to systematically review the existing empirical studies to provide a comprehensive understanding of the prevalence of ACEs among youth offenders aged between 10 and 19 years, and the effects of both cumulative ACEs and individual ACE items on youth recidivism. METHOD: A systematic review approach was employed. Narrative synthesis and meta-analysis were performed to synthesise the data in 31 included studies. RESULTS: The pooled prevalence of cumulative ACEs was 39.4 %. The pooled prevalence of individual ACEs ranged between 13.7 % to 51.4 %. Cumulative ACEs and neglect were positively associated with youth recidivism, with OR = 1.966, 95%CI [1.582, 2.444] and OR = 1.328, 95%CI [1.078, 1.637], respectively. Physical and sexual abuse were not significantly associated with youth recidivism. Regarding the mechanisms underlying the relationship between ACEs and recidivism; moderators included gender, positive childhood experiences, strong social bonds, and empathy. Mediators included child welfare placement, emotional and behavioural problems, drug use, mental health problems, and negative emotionality. CONCLUSION: Developing programs to youth offenders aiming to address the impact of cumulative and individual ACE exposure, strengthen the protective factors and weaken the risk factors would be useful to reduce youth recidivism.

The intersection of adverse childhood experiences and mental health concerns for youth involved in the child welfare system.

The present study sought to identify if there is distinct mental health symptomology among child welfare-involved youth depending on the category of adverse childhood experiences (ACEs) endorsed. A chart review of child welfare-involved youth (N = 129, ages 8-16) and caregiver reported ACEs and mental health/trauma symptoms was conducted. A K-means cluster analysis used ACE scores to identify groups of youth along two dimensions: household dysfunction and child abuse/neglect. The first cluster identified had low ACE scores outside of their system involvement (n = 62), the second predominantly endorsed household dysfunctions (n = 37), and the third predominantly endorsed abuse/neglect (n = 30). One-way analysis of variance tests revealed that youth in the systems-only cluster differed from youth in the other groups, while the two high ACE category groups did not differ from each other on mental health/trauma symptoms. These results have important implications for the screening and treatment referral processes in the child welfare system.

Early childhood maltreatment and profiles of resilience among child welfare-involved children.

Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.

Kinship Care and Child Protection in High-Income Countries: A Scoping Review.

Kinship care is a global phenomenon with a long history, which in high-income countries (HICs) at least, is being increasingly formalized through legislation and policy. There are many benefits to kinship care, including improved child mental health and well-being when compared to other types of out-of-home care. Despite this, kinship care is not without its risks with a lack of support and training for kinship carers putting children at an increased risk of abuse and neglect. This scoping review was conducted across 11 databases to explore the breadth and depth of the literature about abuse and neglect within kinship care in HICs and to provide initial indications about the relationship between kinship care and abuse. Of the 2,308 studies initially identified, 26 met the inclusion criteria. A majority of studies were from the United States, and most used case review methods. From the included studies, rates of re-abuse, and particularly rates of physical and sexual abuse, appear to be lower in kinship care settings when compared to other out-of-home care settings, but rates of neglect are often higher. This review has demonstrated that a small but significant number of children living in kinship care experience neglect or abuse.

Plano EVA-TO: plano de enfrentamento à violência autoprovocada do Estado do Tocantins com ênfase na atenção integral à saúde / EVA-TO Plan: plan to face self-inflicted violence in the State of Tocantins with an emphasis on comprehensive health care

O Plano de Enfrentamento à Violência Autoprovocada do Estado do Tocantins com Ênfase na Atenção Integral à Saúde foi desenvolvido para fortalecer a rede de atenção psicossocial, em colaboração com o Sistema Único de Saúde (SUS) e o Sistema Único de Assistência Social (SUAS). Elaborado pelo Grupo de Trabalho "Flor de Pequi", o plano tem como objetivo qualificar a Rede de Atenção à Saúde, orientando gestores e profissionais de saúde na prevenção da violência autoprovocada, automutilação e suicídio, além de promover o acolhimento e compartilhamento do cuidado na rede de atenção à saúde. O documento foi elaborado em resposta a demandas relacionadas aos dados de violência autoprovocada, solicitações do Conselho Estadual de Defesa de Direitos da Criança e do Adolescente e do Conselho Regional de Psicologia. A metodologia, discussão, metas, ações e monitoramento também são abordados no plano.

The Plan for Confronting Self-Inflicted Violence in the State of Tocantins with an Emphasis on Comprehensive Health Care was developed to strengthen the psychosocial care network in collaboration with the Unified Health System (SUS) and the Unified Social Assistance System (SUAS). Elaborated by the "Flor de Pequi" Working Group, the plan aims to enhance the Health Care Network by providing guidance to managers and health professionals in the prevention of self-inflicted violence, self-harm, and suicide, while promoting care and support within the health care system. The document was created in response to demands related to self-inflicted violence data, requests from the State Council for the Defense of the Rights of Children and Adolescents, and the Regional Psychology Council. The plan also addresses methodology, discussion, goals, actions, and monitoring.

El Plan de Enfrentamiento a la Violencia Autoinfligida en el Estado de Tocantins con Énfasis en la Atención Integral de Salud fue desarrollado para fortalecer la red de atención psicosocial en colaboración con el Sistema Único de Salud (SUS) y el Sistema Único de Asistencia Social (SUAS). Elaborado por el Grupo de Trabajo "Flor de Pequi", el plan tiene como objetivo calificar la Red de Atención a la Salud, brindando orientación a los gestores y profesionales de la salud en la prevención de la violencia autoinfligida, la automutilación y el suicidio, además de promover el cuidado y apoyo dentro de la red de atención sanitaria. El documento fue elaborado en respuesta a demandas relacionadas con datos de violencia autoinfligida, solicitudes del Consejo Estatal para la Defensa de los Derechos de la Niñez y la Adolescencia y del Consejo Regional de Psicología. El plan también aborda la metodología, la discusión, las metas, las acciones y el monitoreo

Acolhimento institucional de adolescentes: uma intervenção psicossocial / Foster care for youth: a psychosocial intervention / Acogida institucional de adolescentes: una intervención psicossocial

O artigo relata intervenção psicossocial desenvolvida em instituição de acolhimento para adolescentes do sexo masculino com trajetória de vida nas ruas. Tratou-se de atuação em estágio curricular em Processos Psicossociais, tendo como aporte teórico a Psicologia Social Jurídica. A partir do levantamento, por meio da observação-participante, das demandas para capacitação dos educadores dessa instituição, elaborou-se intervenção que visou fortalecer o acolhimento institucional como um local de proteção, por meio do trabalho realizado com os educadores. O despreparo dos integrantes da rede de assistência social e saúde, a insuficiência de políticas públicas voltadas para a juventude no município e outros fatores decorrentes do estigma atribuído aos adolescentes acolhidos, majoritariamente negros e pobres, remetem às situações de violências e de violações de direitos que tem implicações subjetivas, econômicas, políticas, sociais e culturais. Como prática psi de enfrentamento ao racismo estrutural, intervir neste local auxilia na construção de uma sociedade justa e igualitária. (AU)

The intend of this article is to present the psychosocial intervention activities carried out in an institutional foster home facility for homelessness youth males. This involves acting in a Psychosocial Internship Curriculum, using Law & Social Psychology as its theoretical foundation. Based on the assessment developed through participant observation, the demands and instrumentation technician education requirements were developed that aimed to strengthen the institutional reception as a place of protection through the work carried out with the educators. The unpreparedness of the health care and social services network members, the inadequacy of public policies aimed at youth in the city of Belo Horizonte, and other factors resulting from the dangerousness speech attributed to the youth males received, mostly black and poor, lead to situations of violence and violations of human rights that it has subjective, economic, political, social and cultural implications. As a psicological practice to confronting structural racism, intervening in this place helps to build a just and egalitarian society. (AU)

Este artículo relata una intervención psicosocial desarrollada en una institución de acogida institucional para adolescentes del sexo masculino con trayectoria de vida en las calles. Esta fue una actuación en prácticas curriculares en Procesos Psicosociales, teniendo como soporte teórico la Psicología Social Jurídica. A partir de una encuesta, a través de la observación participante, de las demandas de capacitación de los educadores de esta institución, la intervención se elaboró con el objetivo de fortalecer la recepción institucional como lugar de protección, a través del trabajo realizado con los educadores. La falta de preparación de los miembros de la asistencia social y salud, la insuficiencia de políticas públicas dirigidas para la juventud en el municipio y otros factores resultantes del discurso de peligrosidad a los adolescentes recibidos, en su mayoría negros y pobres, conducen a situaciones de violencia y violaciones de los derechos que tienen implicaciones subjetivas, económicas, políticas, sociales y culturales. Cómo prática Psi de confrontar al racismo estructural, intervenir en este lugar ayuda a construir una sociedad justa y igualitaria. (AU)

Minding the complexities of psychotropic medication management for children and youth in the foster care system: Paper 1: The facilitators and barriers to learning about trauma-informed medication management.

The phenomenon of inappropriate polypharmacy among the foster care population arises in part due to the challenges related to integrating trauma-informed principles into service delivery. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate, including foster and biological parents, social service agencies, and advocates. Yet, there is limited research about trauma-informed psychotropic medication management interventions for child welfare staff. This pilot study was conducted to evaluate a trauma-informed psychotropic medication management intervention and is reported in two manuscripts, pertaining respectively to the facilitators and barriers to learning, and perceived individual and institutional trauma responsiveness. The intervention comprised of a 2-hour-long training session for child welfare staff and a 3-month web-based curriculum for leadership personnel, aiming to increase their understanding of trauma-informed psychotropic medication management. In the first paper, we report on the facilitators and barriers to learning, grouped into three categories: teacher attributes, learner attributes, and situational factors. In the second paper, in addition to trauma responsiveness ratings, we also provide a detailed account of one participant's life experience and perceptions of the intervention provided, as an exemplar of the psychosocial facets of resilience. The ABC Medication Scale scores that measured staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms showed a significant change in scores following training. Based on these findings, we provide practical solutions to address situational factors that are worth considering when providing training for child welfare staff. PAPER 1 ABSTRACT: THE FACILITATORS AND BARRIERS TO LEARNING ABOUT TRAUMA-INFORMED MEDICATION MANAGEMENT: Given that foster care children experience many challenges that threaten their well-being, their physical and mental health needs tend to be greater than those of their peers who are not in foster care. However, owing to the transient nature of the foster care placements, as well as continuous changes in medical providers and counselors, the screenings, supportive interventions, and treatments they receive may be fragmented. This is particularly problematic when considering that many of these children are medicated as a means of managing their behavior. Moreover, children in foster care are also more vulnerable to having the medications and diagnoses accumulate due to frequent placement changes and lack of treatment continuity. Our research was guided by the question "What are the facilitators and barriers to learning about trauma-informed psychotropic medication management?" We developed an intervention to address the issue of inappropriate polypharmacy and examined the facilitators and barriers to learning using a mixed methods design. The facilitators to learning were instructor-specific (e.g., reputation, teaching style, capacity for selecting and implementing relevant resources), learner-specific (altruism, capacity to see personal relevance in the learning situation, desire for knowledge/competence, career advancement/recognition-seeking), and situational (immediacy/on-demand resources, reinforcement of pleasant learning experience). Barriers were largely situational (workload and family demands). Based on these findings, we provide practical strategies for addressing situational factors that are worth considering when designing training curricula aimed at child welfare staff.

Minding the complexities of psychotropic medication management for children and youth in the foster care system: Paper 2: Levels of trauma responsiveness among child welfare staff.

BACKGROUND: Foster care children tend to have greater physical and mental health needs compared to those of their peers who are not in foster care due to many challenges that threaten their well-being. Yet, owing to frequent placement changes, their treatment may be fragmented. Moreover, if foster children are unable to provide important information about their own health status, and the same cannot be obtained from their families of origin, the resulting incomplete and/or inconsistent health history puts them at risk for unrecognized problems and conflicting diagnoses. Paradoxically, foster parents and resource providers often request psychotropic medications for children and youth in their care as a means of managing their behaviors. The phenomenon of inappropriate polypharmacy arises due in part to the difficulties related to integrating trauma-informed principles into the care process. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate including foster and biological parents, social service agencies, and advocates. In this second paper, we report on the same intervention as that discussed in the first paper, focusing on the effectiveness of the live 2-hour face-to-face training for child welfare staff and the 3-month web-based curriculum for leadership personnel in improving the participants' trauma responsiveness. RESEARCH QUESTIONS: 1. What are the child welfare staff's perceptions of their own knowledge, attitudes, and communication behaviors associated with medications used to treat mental health symptoms and monitoring for side-effects of psychotropic medication use in children? 2. What is the level of trauma responsiveness among child welfare staff? METHODOLOGY AND PARTICIPANTS: The ABC Medication Scale was employed to measure staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms before and after the intervention to determine if the training resulted in any improvements. Individual- and organizational-level trauma responsiveness was rated on a continuum of the Missouri Model: A Developmental Framework for Trauma-Informed Approaches. Artifacts of the web-based curriculum and qualitative interview data were analyzed by applying grounded theory methods. FINDINGS/RESULTS: There was a significant increase in The ABC Medication Scale scores following the training. The qualitative findings further revealed that majority of the participants rated themselves as "trauma aware" or "trauma responsive" on the Missouri Model, while indicating that their agencies could work harder to become more fully trauma-informed. As trauma-informed child welfare workforce that understands the complexity and advocacy requirements of psychotropic medication management is needed, further longitudinal research is required is to assess the training effects over time. In particular, the aim should be to establish (a) how knowledge and attitude shifts correlate with greater degrees of trauma responsiveness, and (b) if and how such trainings translate into improved systems of support.

Using machine learning to determine the shared and unique risk factors for marijuana use among child-welfare versus community adolescents.

OBJECTIVE: This study used machine learning (ML) to test an empirically derived set of risk factors for marijuana use. Models were built separately for child welfare (CW) and non-CW adolescents in order to compare the variables selected as important features/risk factors. METHOD: Data were from a Time 4 (Mage = 18.22) of longitudinal study of the effects of maltreatment on adolescent development (n = 350; CW = 222; non-CW = 128; 56%male). Marijuana use in the past 12 months (none versus any) was obtained from a single item self-report. Risk factors entered into the model included mental health, parent/family social support, peer risk behavior, self-reported risk behavior, self-esteem, and self-reported adversities (e.g., abuse, neglect, witnessing family violence or community violence). RESULTS: The ML approaches indicated 80% accuracy in predicting marijuana use in the CW group and 85% accuracy in the non-CW group. In addition, the top features differed for the CW and non-CW groups with peer marijuana use emerging as the most important risk factor for CW youth, whereas externalizing behavior was the most important for the non-CW group. The most important common risk factor between group was gender, with males having higher risk. CONCLUSIONS: This is the first study to examine the shared and unique risk factors for marijuana use for CW and non-CW youth using a machine learning approach. The results support our assertion that there may be similar risk factors for both groups, but there are also risks unique to each population. Therefore, risk factors derived from normative populations may not have the same importance when used for CW youth. These differences should be considered in clinical practice when assessing risk for substance use among adolescents.

Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study.

BACKGROUND: Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood. METHODS: Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed. RESULTS: In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples. CONCLUSIONS: Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.

The Long-Term Effects of Early Childhood Resilience Profiles on School Outcomes among Children in the Child Welfare System.

This study aimed to examine the association between early childhood resilience profiles and later school outcomes (academic achievement and school involvement) among children in the U.S. child welfare system. This study compared 827 children aged 3-5 years in three latent profile groups (poor emotional and behavioral resilience, low cognitive resilience, and multi-domain resilience) to their baseline profiles using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). At the three-year follow-up, children with low emotional and behavioral resilience profiles and children with the multi-domain resilience profile had significantly higher basic reading skills, reading comprehension, and math reasoning compared to children with low scores on the cognitive resilience profile. Furthermore, children with the multi-domain resilience profile had significantly higher levels of emotional school engagement than did those with the low emotional and behavioral resilience profile and considerably higher levels of behavioral school engagement compared to those with the low cognitive resilience profile. The findings highlight the persistent effects of early resilience into the later childhood years. Moreover, our results suggest the need for early identification of and intervention for children with low cognitive or emotional/behavioral resilience during the preschool years to promote academic success and school engagement during the school-age years.

The influence of self-esteem and (cyber) bullying on adolescents’ well-being: a question of gender? / La influencia de la autoestima y el (ciber)acoso en la dimensión afectiva del bienestar subjetivo en la adolescencia: ¿”una” cuestión de género?

Subjective well-being consists of a subjective component (life satisfaction) and an affective component (positive and negative affect). Levels ofwell-being tend to decline during adolescence, which could have physical and mental health consequences. Multiple factors influence adolescent well-being, such as self-esteem, bullying and cyberbullying, as well as gender. In this paper, we study the relationship between self-esteem,bullying (face-to-face and virtual) and the affective dimension of subjective well-being in adolescence, considering the moderating effect ofgender. 797 Spanish adolescents between 14 and 18 years old (54.2% girls; Mage=15.5; SD=.68) participated in the study. The RosenbergSelf-Esteem Scale (RSE), the Positive and Negative Experience Scale (SPANE), and Cyberbullying and Peer Bullying Screening were used.Statistical analyses were performed using the SPSS 24.0, and EQS 6.4 packages. T-test, bivariate correlations and structural equations (SEM)were performed. The results suggest that girls have lower levels of self-esteem (t = 4.10; p < .001) and well-being (t = 2.46; p < .05) than boys,while boys more often report being bullies (t = 2.67; p < .01) and cyberbullies (t = 2.55; p = .01), as well as victims of bullying (t = 2.16; p <.05). The variables that influence adolescents’ affective well-being are self-esteem and bullying victimization. Gender moderates the influenceof self-esteem on well-being. For boys, a negative assessment of themselves impacts their negative affection more strongly than girls [χ²(df)=15.69(3); p < .001]. These results highlight the need to develop effective prevention and intervention programs to promote the well-being ofadolescents, taking gender differences into account. (AU)

El bienestar subjetivo está formado por un componente subjetivo (satisfacción con la vida) y un componente afectivo (afectos positivos y negativos). Elbienestar tiende a disminuir durante la adolescencia, lo que podría tener consecuencias para la salud física y mental. Múltiples factores influyen enel bienestar de los adolescentes, como la autoestima, el acoso escolar y el género. El objetivo fue estudiar la relación entre la autoestima, el acoso(presencial y virtual) y la dimensión afectiva del bienestar subjetivo en la adolescencia, considerando el efecto moderador del género. Participaron797 adolescentes españoles entre 14 y 18 años (54.2% chicas; M = 15.5; DT = .68). Se utilizó la Escala de Autoestima de Rosenberg (RSE), laEscala de Experiencias Positivas y Negativas (SPANE) y el Ciberbullying y el Screening de Acoso entre iguales. Los análisis estadísticos se realizaron con SPSS 24.0 y EQS 6.4. Se realizaron pruebas t, correlaciones bivariadas y ecuaciones estructurales (SEM). Los resultados sugieren quelas chicas tienen niveles más bajos de autoestima y bienestar que los chicos, mientras que los chicos declaran con más frecuencia ser acosadoresy víctimas de acoso y ciberacoso. La variable que más influye en el bienestar de los adolescentes es la autoestima positiva. La victimización reducelos sentimientos positivos y las experiencias placenteras entre los adolescentes. El género modera la influencia de la autoestima en el bienestar. Enel caso de los chicos, una valoración negativa de sí mismos influye más negativamente en su bienestar que en el de las chicas. Estos resultadosponen de manifiesto la necesidad de desarrollar programas eficaces de prevención e intervención para promover el bienestar de los adolescentes,teniendo en cuenta las diferencias de género. (AU)

Factors associated with reunification and placement move for children placed in kinship care under the age of thirteen.

BACKGROUND: When a child needs to be placed in substitute care by child protection services, social workers are encouraged to use kinship care (KC), mainly because of the greater stability associated with it. However, current state of knowledge on reunification and placement stability is essentially based on studies that combined children in KC and children in other types of substitute care setting. OBJECTIVES: This paper aims to describe longitudinally the placement trajectory of children placed in KC and to identify the factors associated with the type of exit from KC (move to another substitute care setting or reunification). METHOD: All children in a Québec child protection services agency who started a KC placement in 2014-15 under the age of 13 are observed for three years (N = 172). Data come from the child's casefile and from telephone questionnaires with the caseworker at the beginning and at the end of placement (or at the end of observation if the child has not exited). RESULTS: Several children remained in the same KC setting during the observation (39%). The others were reunified (34%) or moved to another substitute setting (27%). Multivariate regression analyzes indicated that reunification was mostly determined by higher frequency of parent-child contacts, less registrations in clinical programs and absence of parental mental health problems, while placement move was mostly associated with placement beginning as provisional measure, higher frequency of parent-child contacts and presence of parental mental health problems. CONCLUSIONS: This study highlights determinants of stability and permanency that may be specific to kinship placements.

Trauma Exposure and Mental Health Needs Among Adolescents Involved With the Juvenile Justice System.

Justice-involved adolescents typically report high levels of lifetime trauma exposure, although research on juvenile justice system-wide screenings is limited. Further, there is little evidence from research on the psychological and substance abuse treatment related needs of youth relative to the trauma levels or types of trauma experienced by justice-involved adolescents. We documented lifetime exposure to traumatic events and its relation to psychological and substance use concerns in a sample of adolescents admitted to custody in the New Jersey Juvenile Justice Commission. This study examined lifetime exposure to traumatic events experienced by justice-involved adolescents (N = 627) using negative binomial regression modeling and zero-inflated negative binomial regression modeling to identify which adolescents have the greatest trauma exposure, and determine how cumulative types of trauma relate to youths' mental health and substance use needs. Adolescents reported experiencing an average of 4 of 17 traumatic exposures on the Life Events Checklist. The most common traumas experienced directly and indirectly were physical assault and assault with a weapon. Considering particular traumas, there were differences in exposures based on race and ethnicity, sex, child welfare involvement, and gang affiliation. Higher levels of some types of traumatic exposure were consistently related to higher levels of mental health needs. Results indicate that adolescents enter the juvenile justice system with high levels of polytraumatization. These adverse events are associated with elevated mental health and substance use needs that should be considered in case planning.

Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies.

While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3-17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6-66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33-2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks.

Experiencias comunitarias, crianzas compartidas y políticas de cuidado / Experiências comunitárias, políticas compartilhadas de pais e cuidados / Community experiences, shared upbringing and care policies

RESUMEN En el presente artículo, escrito en el contexto de la pandemia 2020-2021 y en el marco del cumplimento del Aislamiento Social Preventivo y Obligatorio (ASPO), analizamos dos experiencias comunitarias vinculadas al cuidado de las infancias y adolescencias que se desarrollan en las provincias de Neuquén y Río Negro (Patagonia Argentina). Dicho análisis es resultado de una investigación cualitativa realizada desde la perspectiva de la Psicología Social Crítica y las Políticas Públicas en la que buscamos recuperar los saberes sociales que estas iniciativas comunitarias pueden aportar al diseño y reformulación de las políticas públicas de cuidado. Específicamente, las experiencias que aquí presentamos son: la Asociación Civil GAIA-Nueva Crianza, conformada por familias de niñes y adolescentes trans; y la Asociación Civil Lazos Azules, integrada por familias de niños y adolescentes con TEA (Trastorno del Espectro Autista). Si bien las dos asociaciones son muy diferentes entre sí, ambas coinciden en estar protagonizadas por familias que, a partir de haber escuchado y prestado atención a las necesidades de sus hijo/a/es, se organizaron colectivamente para visibilizar la realidad de sus niño/a/es y adolescentes generando distintas acciones. Dichas acciones tienden no sólo a hacer efectivos los derechos de las infancias y adolescencias, especialmente aquellos vinculados a la identidad, la educación y la salud, sino que están orientadas a incidir en las políticas públicas de cuidado a nivel local desde lo que Boaventura de Sousa Santos denomina la sociología de las emergencias y desde lo que Rita Segato designa como una politicidad en clave femenina anfibia.

RESUMO. Neste artigo, escrito no contexto da pandemia 2020-2021 e no quadro do cumprimento do Isolamento Social Preventivo e Obrigatório (ASPO), analisamos duas experiências comunitárias relacionadas com o cuidado de crianças e adolescentes que ocorrem nas províncias de Neuquén e Río Negro (Patagônia Argentina). Esta análise é resultado de uma pesquisa qualitativa realizada na perspectiva da Psicologia Social Crítica e das Políticas Públicas, na qual buscamos resgatar o conhecimento social de que essas iniciativas comunitárias podem contribuir para o desenho e reformulação das políticas públicas de atenção. Especificamente, as experiências que aqui apresentamos são: a Associação Civil GAIA-Nueva Crianza, formada por famílias de crianças e adolescentes trans; e a Associação Civil Lazos Azules, formada por famílias de crianças e adolescentes com TEA (Transtorno do Espectro do Autismo). Embora as duas associações sejam muito diferentes entre si, ambas coincidem no fato de serem lideradas por famílias que, depois de ouvir e atentar para as necessidades dos filhos, se organizam coletivamente para tornar visível a realidade dos filhos. a / es e adolescentes gerando diferentes ações. Essas ações tendem não só a efetivar os direitos da criança e do adolescente, especialmente aqueles vinculados à identidade, educação e saúde, mas visam influenciar as políticas públicas de atenção em nível local a partir do que Boaventura de Sousa Santos denomina a sociologia das emergências e do que Rita Segato designa como feminilidade anfíbia chave de politicidade.

ABSTRACT In this article, written in the context of the 2020-2021 pandemic and in compliance with the Preventive and Compulsory Social Isolation (ASPO), we analyze two community experiences related to the care of children and adolescents that take place in the provinces of Neuquén and Río Negro (Argentinian Patagonia). This analysis is the result of a qualitative study carried out from the perspective of Critical Social Psychology and Public Policy, in which we seek to recover the social knowledge that these community initiatives can contribute to the design and reformulation of public care policies. Specifically, the experiences we present here are the GAIA-Nueva Crianza Civil Association, made up of families of trans children and adolescents; and the Lazos Azules civil association, made up of families of children and adolescents with ASD (autism spectrum disorder). Although the two associations are very different from each other, they both coincide in being led by families who, after having listened and paid attention to the needs of their children, they organized collectively to make visible the reality of their children and adolescents by generating different actions. These actions tend not only to make effective the rights of children and adolescents, especially those linked to identity, education and health, but are also aimed at influencing public care policies at the local level, from what Boaventura de Sousa Santos calls the sociology of emergencies and from what Rita Segato designates amphibious feminine key politicity.

Does mental health screening and assessment in child welfare improve mental health service receipt, child safety, and permanence for children in out-of-home care? An evaluation of the Gateway CALL demonstration.

BACKGROUND: Unmet mental health service needs among children in out-of-home care are sometimes attributed to poor assessments and referrals in child welfare. The Gateway CALL project implemented mental health screening, diagnostic assessment, and referral to treatment practices. OBJECTIVE: We examined the effectiveness of Gateway CALL for improving children's mental health service receipt, safety, and permanency outcomes. PARTICIPANTS AND SETTING: Participants included 538 children (birth to 18 years) in out-of-home placements through a county-based child welfare agency over a 17-month period. METHODS: We compared the mental health service receipt, safety, and permanency outcomes for 175 children who received Gateway CALL with 175 children who received "services as usual" identified through propensity score matching. Participant demographics, safety, and permanency outcomes were drawn from child welfare administrative records, and mental health service visits and diagnoses were drawn from Medicaid billing records. RESULTS: Gateway CALL appeared to increase the number of mental health service visits children received (z = 2.14, p = 0.032), although not the likelihood of receiving services. In terms of child safety, children in Gateway CALL had a greater number of screened-in calls after the intervention than those in the comparison group [t(348) = -1.92, p = 0.03]; there were no differences in substantiations. There were also no observed effects on permanency. CONCLUSIONS: Despite systematic efforts to identify, assess, and refer children to mental health services through the Gateway CALL intervention, substantial unmet mental health service needs among children persisted. Results have implications for designing interventions that promote cross-system service access.

Understanding trauma experiences and needs through a comprehensive assessment of transition age youth in child welfare.

BACKGROUND: In the context of child welfare, Transition Age Youth (TAY) have high rates of trauma experiences (TEs) and are more likely to exhibit negative outcomes as they transition into adulthood. OBJECTIVE: This study describes the frequency and distribution of TEs among TAY in child welfare, as a whole and across sex and race/ethnicity. This study also examines the relationship between TEs and Child and Adolescent Needs and Strengths (CANS) needs. PARTICIPANTS AND SETTING: Participants included 3324 TAY (14.5 to 21-year-olds) who were under the care of the Illinois Department of Child and Family Services (IDCFS) and in out-of-home care for at least one year. METHODS: The CANS was the primary measure for this study. Administrative and clinical data were examined for youth who met the identified criteria. Pearson's chi-square tests of association were conducted to determine differences in TEs across race/ethnicity and sex. Negative binomial regressions were used to determine the association between TEs and needs. RESULTS: Most TAY had at least one TE (91%) and the majority had four or more TEs (52%). Significant differences occurred in relation to sex and race/ethnicity. Furthermore, TEs were significantly associated with needs across all CANS domains examined (e.g., behavioral/emotional needs, life domain functioning). CONCLUSIONS: This is one of the few empirical studies to examine TEs and related functional, behavioral, and emotional needs of TAY in child welfare. Overall, findings suggest a need for improving trauma-informed approaches and interventions that serve TAY.

Percepciones y sentimientos de niños argentinos frente a la cuarentena COVID-19 / Perceptions and feelings of Argentine children regarding the COVID-19 quarantine

La Subcomisión de Derechos del Niño y el Comité de Pediatría Social, de la Sociedad Argentina de Pediatría, realizaron un trabajo de campo que permitiera dar voz a nuestros niños, niñas y adolescentes (NNA) durante la cuarentena y el aislamiento social obligatorio impuestos en nuestro país por la pandemia mundial por la enfermedad por el nuevo coronavirus (COVID-19). Los objetivos fueron relevar el impacto sobre sus sentimientos, emociones y deseos; evaluar y comparar las repercusiones personales, familiares y sociales antes, durante y después de la cuarentena; e identificar las necesidades de apoyo y contención.Los resultados de la investigación permiten afirmar que los niños han sido los más afectados y los menos escuchados. La cuarentena ha tenido un enorme impacto individual, social y familiar en los NNA, y reclama un abordaje holístico, comprometido y mancomunado de la sociedad civil, las familias, los profesionales de la salud, los docentes y las autoridades políticas.

The Subcommittee on the Rights of the Child and the Social Pediatrics Committee of the Sociedad Argentina de Pediatría carried out a fieldwork that allowed us to give a voice to our children and adolescents (NNA), during quarantine and social isolation mandatory imposed in our country by the global pandemic COVID-19. The objectives were to analyze the impact on their feelings, emotions and desires; evaluate and compare personal, family and social repercussions pre, intra and post quarantine; and identify support and containment needs.The results of the research allow us to affirm that children have been the most vulnerable and the least listened to. The quarantine has had an enormous individual, social and family impact on children and adolescents and calls for a holistic, committed and joint approach from civil society, families, health professionals, teachers and political authorities