Original articlePediatric to Adult Mental Health Service Use of Young People Leaving the Foster Care System
Section snippets
Patients and Methods
The study used a longitudinal cohort design, with older youth interviewed about their mental health service use every 3 months from age 17 to 19 (nine interviews).
Results
Multivariate logistic regression analyses to predict retention revealed that the following characteristics were associated with decreased odds of being retained in the study: being male (odds radio [OR] = 0.34, p < .001), having past year posttraumatic stress disorder at initial interview (OR = 0.36, p = .025), having a history of juvenile detention by first interview (OR = .26, p = .016), and being released from the state's custody prior to age 19 (OR = .26, p < .0001). The resulting sample
Discussion
This is the first study known to systematically examine mental health service use as older youth leave the foster care system. Four findings deserve discussion: the severe drop-off in service use, the terminations often initiated by the patient, the role of Medicaid in service use, and the lack of predictors of continued service use.
Service discontinuity in mental health services was the norm for youth leaving the foster care system. Rates of mental health service utilization for youth from the
Acknowledgments
This work was supported by grants from the National Institute of Mental Health (R01 MH61404 and P30 MH068579).
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2020, Children and Youth Services ReviewCitation Excerpt :It is therefore unsurprising that, when making the transition away from a system of care intended to provide space and support for healing, youth with emotional disabilities (and unresolved trauma) struggle to succeed. Leaving care may jeopardize youth’s access to health insurance and healthcare, including mental health services (McMillen & Raghavan, 2009), and may shift the burden of advocacy for services and accommodations from the foster care system to the youth, themselves. Whether due to costs of care, stigma associated with mental healthcare (Brannan & Heflinger, 2006; Mukolo, Heflinger, & Wallston, 2010), or hesitancy to reach out for help (Okpych & Courtney, 2019), many youth with emotional disabilities will find this new responsibility of self-care to be a significant, and in some cases, insurmountable challenge.