Abstract
This study examines the clinical characteristics of youths who lived away from families at the time of admission to specialty mental health services, and investigates the association between type of nonfamily living situation and admission to residential versus outpatient programs. Of 3995 youths sampled from 1598 mental health programs in the United States, 14% lived away from their own families, either in foster care, group care settings, or correctional settings, or were emancipated. As a group, youths living away from families were more seriously emotionally disturbed and more likely to receive treatment in residential care programs. Youths who lived in foster care were more likely to be admitted to outpatient programs, while youths who lived in group care settings or correctional settings were more likely to be admitted to residential care programs, controlling on demographic and clinical characteristics. Targeting resources to enhance the availability and therapeutic capacity of foster care may facilitate community living, and decrease time spent in institutional settings.
Similar content being viewed by others
References
Altshuler SJ, Poertner J. The child health and illness profile—adolescent edition: assessing well-being in group homes or institutions.Child Welfare. 2002;81(3):495–513.
Kurtz PD, Jarvis SV, Kurtz GL. Problems of homeless youths: empirical findings and human services issues.Social Work. 1991;36(4):309–314.
Rosenfeld AA, Pilowsky DJ, Fine P, et al. Foster care: an update.Journal of the American Academy of Child and Adolescent Psychiatry. 1997;36(4):448–457.
Whitbeck LB, Hoyt DR.Nowhere to Grow: Homeless and Runaway Adolescents and Their Families. New York: Aldine DeGruyter; 1999.
Athey JL. HIV infection and homeless adolescents.Child Welfare. 1991;70(5):517–528.
Garland AF, Hough RL, Landsverk JA, et al. Multi-sector complexity of system of care for youth with mental health needs.Children's Services: Social Policy, Research, and Practice. 2001;4(3):123–140.
Melton GB, Lyons PM, Spaulding WJ.No Place to Go: The Civil Commitment of Minors. Lincoln, Neb: University of Nebraska Press; 1998.
Brady KL, Caraway SJ. Home away from home: factors associated with current functioning in children living in a residential treatment setting.Child Abuse & Neglect. 2002;26:1149–1163.
Farmer EM, Burns BJ, Chapman MV, et al. Use of mental health services by youth in contact with social services.Social Service Review. 2001;74(4):605–624.
Leslie LK, Landsverk J, Ezzet-Lofstrom R, et al. Children in foster care: factors influencing outpatient mental health service use.Child Abuse & Neglect. 2000;24(4):265–476.
Romansky JB, Lyons JS, Lehner RK, et al. Factors related to psychiatric hospital readmission among children and adolescents in state custody.Psychiatric Services. 2003;54(3):356–362.
Milazzo-Sayre LJ, Henderson MJ, Manderscheid RW, et al. Persons treated in specialty mental health care programs, United States, 1997. In: Manderscheid RW, Henderson MJ, eds.Mental Health, United States, 2000. Washington, DC: GPO; 2001:177–222.
Center for Mental Health Services, Sources and qualifications of data from the survey of mental health organizations. In: Manderscheid RM, Henderson MJ, eds.Mental Health, United States, 2002. Department of Health and Human Services Publication No. (SMA) 3938. Rockville, Md: Substance Abuse and Mental Health Services Administration; 2004:369–372.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association; 1994.
World Health Organization.International Classification of Diseases, Version 9.0, Geneva: World Health Organization; 1980.
Friedman RM, Katz-Leavy JW, Manderscheid RW, et al. Prevalence of serious emotional disturbance in children and adolescents. In: Manderscheid RW, Sonnenschein MA, eds.Mental Health, United States, 1996. Washington, DC: GPO; 1996:71–89.
Research Triangle Institute.SUDAAN User's Manual, Release 8.0. Research Triangle Park, NC: Research Triangle Institute; 2001.
Fields J. Living arrangements of children: fall 1996.Current Population Reports. Washington, DC: US Census Bureau; 2001.
Frensch KM, Cameron G. Treatment of choice or a last resort? A review of residential mental health placements for children and youth.Child & Youth Care Forum. 2002;31(5):313–345.
Fors SW, Rojek DG. A comparison of drug involvement between runaways and school youths.Journal of Drug Education. 1991;21(1):13–25.
Yates GL, MacKenzie R, Pennbridge J, et al. A risk profile comparison of runaway and non-runaway youth.American Journal of Public Health. 1988;78(37):820–821.
Clausen JM, Landsverk J, Ganger W, et al. Mental health problems of children in foster care.Journal of Child and Family Studies. 1998;7(3):283–296.
Robinson A, Jivanjee P, Friesen B, Kruzich JM. Barriers and supports to family participation: what residential providers need to know. In Newman C, Liberton C, Kutash K, Friedman RM, eds.The 16th Annual Research Conference Proceedings; A System of Care for Children's Mental Health: Expanding the Research Base. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health; 2004:105–109.
US General Accountability Office (formerly US General Accounting Office). Child welfare and juvenile justice: federal agencies could play a stronger role in helping states reduce the number of children placed solely to obtain mental health services.Report to Congressional Requesters. April 2003:1–67. Available at: http://www.gao.gov/new.items/d03397.pdf. Accessed July 16, 2004.
Kashani JH, Cantwell DP. Characteristics of children admitted to inpatient community mental health center.Archives of General Psychiatry. 1983;40:397–400.
Pfeffer CR, Plutchik R, Mizruchi MS. A comparison of psychopathology in child psychiatric inpatients, outpatients, and nonpatients.The Journal of Nervous and Mental Disease. 1986;174(9):529–535.
DeRosa CJ, Montgomery SB, Kipke MD, et al. Service utilization among homeless and runaway youth in Los Angeles, California: rates and reasons.Journal of Adolescent Health. 1999;24:449–458.
Halfon N, Berkowitz G, Klee L. Mental health service utilization by children in foster care in California.Pediatrics. 1992;89(6):1238–1244.
Tuma JM. Mental health services for children: the state of the art.American Psychologist. 1989;44(2):188–199.
US Department of Health and Human Services.Mental Health: A Report of the Surgeon General. Rockville, Md: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.
Burns BJ, Hoagwood K, Mrazek PJ. Effective treatment for mental disorders in children and adolescents.Clinical Child and Family Psychology Review. 1999;2(4):199–254.
Swenson CC, Randall J, Henggeler SW, et al. The outcomes and costs of an interagency partnership to serve maltreated children in state custody.Children's Services: Social Policy, Research, and Practice. 2000;3(4):191–209.
Terling T. The efficacy of family reunification practices: reentry rates and correlates of reentry for abused and neglected children reunited with their families.Child Abuse & Neglect. 1999;23(12):1259–1370.
Lindsey EW, Kurtz PD, Jarvis S, et al. How runaway and homeless youth navigate troubled waters: personal strengths and resources.Child and Adolescent Social Work Journal. 2000;17(2):115–140.
Williams NR, Lindsey EW, Kurtz PD, Jarvis S. From trauma to resiliency: lessons from former runaway and homeless youth.Journal of Youth Studies. 2001;4(2):233–253.
Kidd SA. Street youth: coping and interventions.Child and Adolescent Social Work Journal. 2003;20(4):235–261.
Tyler KA, Cauce AM. Perpetrators of early physical and sexual abuse among homeless and runaway adolescents.Child Abuse and Neglect. 2002;26(12):1261–1274.
Collins ME. Transition to adulthood for vulnerable youths: a review of research and implications for policy.Social Service Review. 2001;75:271–291.
Massinga R, Pecora PJ. Providing better opportunities for older children in the child welfare system.The Future of Children: Children, Families and Foster Care. Winter 2004;14(1):151–173.
Henggeler SW, Schoenwald SK, Borduin CM, et al.Multisystemic Treatment of Antisocial Behavior in Children and Adolescents. New York: Guilford Press; 1998.
Henggeler SW, Schoenwald SK, Pickrel SG. Multisystemic therapy: bridging the gap between university- and community-based treatment.Journal of Consulting and Clinical Psychology. 1995;63(5):709–717.
Henggeler SW, Schoenwald SK, Rowland MD, et al.Serious Emotional Disturbance in Children and Adolescents: Multisystemic Therapy. New York: Guilford Press; 2002.
Henggeler SW, Sheidow AJ. Conduct disorder and delinquency.Journal of Marital and Family Therapy. 2003;29(4):505–522.
Curtis PA, Alexander G, Lunghofer LA. A literature review comparing the outcomes of residential group care and therapeutic foster care.Child and Adolescent Social Work Journal. 2001;18(5):377–392.
Reddy LA, Pfeiffer SI. Effectiveness of treatment foster care with children and adolescents: a review of outcome studies.Journal of the American Academy of Child and Adolescent Psychiatry. 1997;36(5):581–588.
Author information
Authors and Affiliations
Corresponding author
Additional information
This study was supported in part by a grant from the Annie E. Casey Foundation (201.0034) and by a postdoctoral training grant from the National Institute of Mental Health (MH16242) at the Institute for Health, Health Care Policy and Aging Research. The authors thank Ronald W. Manderscheid, Marilyn J. Henderson, and Laura Milazzo-Sayre for technical support and use of the data.
Rights and permissions
About this article
Cite this article
Pottick, K.J., Warner, L.A. & Yoder, K.A. Youths living away from families in the US mental health system. The Journal of Behavioral Health Services & Research 32, 264–281 (2005). https://doi.org/10.1007/BF02291827
Issue Date:
DOI: https://doi.org/10.1007/BF02291827