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Predictive factors for changes in quality of life among children and adolescents in youth welfare institutions

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Abstract

Purpose

Children and adolescents living in youth welfare institutions often have a below average quality of life (QoL), for reasons that include developmental difficulties, history of traumatic experiences, and mental disorders. Youth welfare measures are needed that would have a positive impact, but there is a lack of longitudinal research on which measures are most effective. This study investigated what factors are associated with an improvement in QoL during residential stay.

Methods

Residents of youth care facilities in Switzerland and their professional caregivers completed questionnaires that addressed QoL, psychopathology, and experience of traumatic events at two time points. In addition, information regarding mental disorders was obtained through structured clinical interviews. Analyses were conducted on the data obtained from 204 respondents aged 11–18 years. Comparisons with a school sample were conducted.

Results

Compared to a school sample, a majority of participants rated their QoL equal, whereas their caregivers rated it as lower. Factors predictive of a poorer QoL were high levels of internalizing and externalizing psychopathology, presence of co-morbidities, and female gender. At the second assessment, the caregivers reported a small improvement, which was associated with reductions in both internalizing and externalizing psychopathology.

Conclusions

The finding that a reduction in severity of psychopathology may result in an improvement in QoL underlines the importance of providing professional support for mentally ill residents of youth welfare institutions. Further research is needed to determine the causality of this association.

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Acknowledgements

The authors would like to thank to all participating instructors, co-workers, residents, and caregivers for their engagement and support in this study, and the Federal Office of Justice in Switzerland for the financial support.

Funding

The pilot project and the data collection were funded by the Federal Office of Justice in Switzerland.

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Author notes

  1. Claudia Dölitzsch and Marc Schmid contributed equally.

Authors and Affiliations

  1. Child and Adolescent Psychiatry of Grisons, Masanserstrasse 14, 7000, Chur, Switzerland

    Tamara Gander

  2. Department of Child and Adolescent Psychiatry, University of Basel, Schanzenstrasse 13, 4056, Basel, Switzerland

    Cyril Boonmann, Klaus Schmeck, Alain Di Gallo & Marc Schmid

  3. Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany

    Jörg M. Fegert, Michael Kölch & Claudia Dölitzsch

  4. Department of Child and Adolescent Psychiatry, Brandenburg Medical School, Fehrbelliner Straße 38, 16816, Neuruppin, Germany

    Michael Kölch

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  1. Tamara Gander
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Correspondence to Claudia Dölitzsch.

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Ethical approval

The study design was reviewed by ethics committees in Basel, Lausanne (Switzerland), and Ulm (Germany), and all participants provided informed consent (for those younger than 18 years, consent from the parent or legal guardian was obtained as well).

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Gander, T., Boonmann, C., Fegert, J.M. et al. Predictive factors for changes in quality of life among children and adolescents in youth welfare institutions. Soc Psychiatry Psychiatr Epidemiol 54, 1575–1586 (2019). https://doi.org/10.1007/s00127-019-01724-8

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