Mental Health Management Among Older Youth in Foster Care: Service Utilization and Preparedness

Michelle R Munson; Colleen C Katz; Nathanael J Okpych; Mark E Courtney

doi:10.1016/j.jadohealth.2020.02.017

Mental Health Management Among Older Youth in Foster Care: Service Utilization and Preparedness

J Adolesc Health. 2020 Aug;67(2):225-231. doi: 10.1016/j.jadohealth.2020.02.017. Epub 2020 Apr 18.

Authors

Michelle R Munson¹, Colleen C Katz², Nathanael J Okpych³, Mark E Courtney⁴

Affiliations

¹ Silver School of Social Work, New York University, New York, New York. Electronic address: michelle.munson@nyu.edu.
² Silberman School of Social Work at Hunter College, City University of New York, New York, New York.
³ School of Social Work, University of Connecticut, Hartford, Connecticut.
⁴ School of Social Service Administration, University of Chicago, Chicago, Illinois.

PMID: 32317206
DOI: 10.1016/j.jadohealth.2020.02.017

Abstract

Purpose: The aim of the study was to document mental health service use (counseling and medication) among youth in foster care, examine how prepared they feel to manage their mental health, and investigate predictors of service use and preparedness.

Methods: The study includes a representative sample of youth in California foster care at age 17 years who participated in in-person, structured interviews (n = 727). Survey measures captured youth characteristics, their mental health service use, and their level of preparedness to manage their mental health. Data from a child welfare worker survey were used to capture county-level service availability, helpfulness, and coordination. Binary and ordered logistic regression were used to predict mental health service use and preparedness.

Results: Youth reported high rates of mental health service use and one-fifth of the sample reported feeling less than prepared to manage their mental health. Youth who screened positive for mental disorders were less prepared than their peers to manage their mental health. Physical (odds ratio [OR] = 1.44; p < .05) and sexual abuse (OR = 2.04; p < .001) predicted past year use of counseling. Sexual abuse also predicted medication use (OR = 1.97; p < .01). Youth who identified as 100% heterosexual were less likely than non-100% heterosexual peers to use counseling (OR = .58; p < .05). The results also suggest geographic variation in use. Finally, caseworkers' perception of greater helpfulness of services in the county they worked predicted greater mental health preparedness (OR = 1.23; p < .05).

Conclusions: Mental health service use remains high among youth in foster care. Youth with particular characteristics may benefit from interventions aimed at preparing them for managing their mental health in adulthood.

Keywords: Child welfare; Foster care; Geographic variation; Mental health management; Mental health service use; Transition-age youth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Child Welfare
Foster Home Care
Humans
Mental Disorders* / therapy
Mental Health
Mental Health Services*