Effects of individual risk and state housing factors on adverse outcomes in a national sample of youth transitioning out of foster care

A Scoping Review of Factors Associated With the Mental Health of Young People Who Have "Aged Out" of the Child Welfare System

Young people who grow up in care and then exit care around the age of 18 (care-leavers) are a particularly vulnerable group, at increased risk for mental health problems even relative to other care-experienced groups. Yet, little is understood about the factors underpinning this association. We used scoping review methods to synthesize the quantitative and qualitative literature on factors that are associated with mental health problems for care-leavers. Following rigorous methods, we systematically searched three scientific databases spanning psychology and social care and identified 23 peer-reviewed studies for inclusion. This review highlights the heterogeneity of this research, in terms of methodology and topics investigated. Topics included are as follows: pre-care maltreatment, care-related experiences, psychological factors (emotion regulation), social support, education, and adult functioning (e.g., housing, finances, employment). We found mixed and inconsistent findings across research studies. The strongest evidence-base is around the influence of social support upon the mental health of recent care-leavers, though methodological problems are discussed. The field benefits from several large-scale observational and longitudinal research studies. However, there is an over-reliance upon retrospective reporting, and the use of unvalidated measures is common. It is apparent that there are significant gaps in our current understanding of the mental health of care-leavers, in particular around modifiable factors. We discuss potential directions for future empirical research, both in terms of methodology and factors investigated.

The multifaceted nature of risk behaviour among adolescents-A document analysis of patient and aftercare service providers' records

AIM

The aim of this study was to describe the forms and the prevalence of risk behaviour among adolescents in aftercare services, as well as identify the associated factors and use of services by adolescents.

BACKGROUND

Adolescents in aftercare services represent a vulnerable group that struggles with several aspects of life. The challenges they face are known to accumulate in certain individuals, and the problems that are relevant for this group tend to have an intergenerational nature.

DESIGN

The research applied retrospective document analysis, with the analysed data comprising information on 698 adolescents in aftercare services in one large Finnish city from the fall of 2020.

METHODS

The data were analysed using descriptive statistics and multivariate methods.

RESULTS

Risk behaviour was identified among 616 of the studied adolescents (88.3%), and manifested as substance abuse, reckless sexual behaviour and/or use of money, nicotine use, self-destructive behaviour, delinquency and functional dependencies. Regarding the associations between risk behaviour and background variables, an adolescents' child's clientship in child protection or the child's placement in foster care, adolescent's need for support in parenting, problems with daily rhythm and problems with studying were found to influence the prevalence of risk behaviour. Forms of risk behaviour were also found to be associated with each other. Adolescents displaying risk behaviour commonly did not use the social counsellor, psychiatric outpatient care and study counselling services, even if they would have needed them.

CONCLUSIONS

The interconnections between different forms of risk behaviour mean that this issue should be prioritized when developing aftercare services.

IMPACT

This is the first time that risk behaviour among adolescents in aftercare services has been comprehensively examined. Understanding this phenomenon is key to identifying future research topics, guiding decision-making and helping stakeholders truly understand the needs of these adolescents.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution as the study was based on a document analysis.

A Meta-Regression of Racial Disparities in Wellbeing Outcomes During and After Foster Care

Children in foster care face heightened risk of adverse psychosocial and economic outcomes compared with children in the general population. Yet, the effects of foster care as an intervention are heterogeneous. Heterogeneity outcomes by race and ethnicity are of particular interest, given that Black and Indigenous youth experience foster care at higher rates than other racial/ethnic groups and experience group differences in setting, duration, and exits to permanency. This meta-regression explores racial disparities in education, employment, mental health, and behavioral outcomes during and following foster care. A systematic search of PsycINFO, ERIC, and Academic Search Complete using a series of search terms for studies published between January 2000 and June 2021 found 70 articles and 392 effect sizes that provided outcomes of US-based foster care by race/ethnicity. Findings reveal that Black foster care impacted persons (FCIPs) have 20% lower odds (95% CI: .68-.93) of achieving employment or substantial financial earnings and have 18% lower odds (95% CI: .68-1.00) of mental health concerns compared to White FCIPs. Hispanic FCIPs have 10% lower odds (95% CI: .84-.97) of achieving stable housing compared to non-Hispanic FCIPs. Moderator analyses revealed certain study features (i.e. publication type, timing of the study, location of the study, and placement status of the participants) have a significant impact on the gap between Black and non-Black and Hispanic and non-Hispanic FCIPs. The findings provide important implications for racial disparities in foster care outcomes, as well as highlight important gaps and missing information from published studies.

Psychological well-being among at-risk young adult Arabs in Israel

The current exploratory study investigates the psychological well-being (PWB) of 196 at-risk young adult Arabs in Israel (18-26 years old), identifying the personal and environmental factors (objective and subjective indicators in the areas of income, housing and social support) that contribute to their PWB, and the mediating role of self-efficacy and hope in explaining the mechanism between these factors and PWB. Results showed that the subjective indicators in the areas of housing and social support contributed to the young adults' PWB. The mediation model revealed an indirect positive contribution of income sufficiency to the young adults' PWB via the sequential mediation of both self-efficacy and hope. Housing satisfaction and social support contributed to PWB only via hope. The discussion highlights the importance of designing interventions that include both objective aspects and nonmaterial subjective aspects, and suggests possible explanations for the underlying mechanism that was revealed.

Do Independent Living Services Protect Youth Aging Out Foster Care From Adverse Outcomes? An Evaluation Using National Data

OBJECTIVE

Youth aging out foster care are at high risk of experiencing adverse outcomes. Federal funded programs have provided independent living services (ILSs) to these youth. This study evaluated the effectiveness of the continuity of ILSs at ages 17-19 in protecting youth aging out foster care from homelessness and incarceration at ages 19-21.

METHOD

This study used data on 4,853 foster youth from the National Youth in Transition Database and the Adoption and Foster Care Analysis and Reporting System. Logistic regression was used to regress two binary outcomes on seven ILS variables and covariates.

RESULTS

The results suggest that remaining in foster care, continuous receipts of academic support, and financial assistance services at ages 17-19 protected foster youth from experiencing homelessness. Remaining in foster care and continuous receipt of financial assistance services at ages 17-19 protected foster youth from incarceration at ages 19-21. But, surprisingly, continuous receipt of housing education and home management training, and health education and risk prevention training at ages 17-19 were each associated with increased risk of homelessness at ages 19-21. The results also showed statistically significant effects of several covariates.

CONCLUSION

Implications are provided based on the importance of financial assistance and academic support services.

Risk and Resilience Factors for Youth Homelessness in Western Countries: A Systematic Review

OBJECTIVES

The experience of homelessness for young people can affect social, emotional, and physical development, resulting in poorer physical and mental health outcomes. To reduce rates of youth homelessness, a better understanding of both risk and resilience is needed to inform future intervention development. This article presents a systematic review of published research reporting risk or resilience factors related to homelessness among young people in Western countries.

METHODS

After thorough examination for inclusion criteria, 665 abstracts of peer-reviewed quantitative studies of risk or resilience factors for homelessness among young people (ages 0-25) that included an adequate comparison group (e.g., not homeless) were selected. After abstract and full-text screening, 16 articles were reviewed. A primary prevention framework was used to create an explanatory model for the onset of homelessness using risk and resilience factors.

RESULTS

Common risk factors for youth homelessness included difficulties with family, mental health or substance use problems, a history of problem behaviors, a history of foster care, homelessness as a child, and running away. Common protective factors included a supportive family, a college education, and high socioeconomic status. Findings were integrated into a provisional developmental model of youth homelessness risk. Clinical implications of the model for service development are discussed, and a model for monitoring homelessness risk and resilience factors is proposed.

CONCLUSIONS

Factors affecting homelessness risk among youths and adults differ, with family, foster care, and schooling playing a much more important role among youths. Findings highlight opportunities for youth homelessness prevention strategies and monitoring.

Resilience factors in youth transitioning out of foster care: A systematic review

OBJECTIVE

Youth who emancipate from the foster care system often experience poor outcomes during their transition into independent living (e.g., criminal justice involvement and homelessness). Yet, some youth are resilient and achieve positive outcomes. The purpose of this study is to review the resilience factors identified in the literature for youth transitioning out of care.

METHOD

A systematic review of the literature was conducted using PsycINFO, PubMed, and EMBASE databases. A total of 12 studies met our inclusion criteria.

RESULTS

A total of 38 different resilience factors were identified across the studies reviewed. From these resilience factors, 18 were statistically significant, including four assets and 14 resources.

CONCLUSION

Understanding the assets and resources that promote resilience can aid clinicians in assessing and capitalizing on youths' strengths and can help researchers develop effective interventions and target gaps in the literature. Further, it can assist policymakers in generating legislation to improve outcomes for foster youth transitioning out of care. To assist in this process, we systematically reviewed studies to provide a summary of resilience factors currently identified in the literature. (PsycInfo Database Record (c) 2022 APA, all rights reserved).