Southerland, D., Casanueva, C.E., & Ringeisen, H. (2009). Young adult outcomes and mental health problems among transition age youth investigated for maltreatment during adolescence. Children and Youth Services Review, 31, 947-956.
It has become increasingly normative for youth to delay their transition to adulthood, extending dependency on their family in order to pursue educational and employment activities. Youth in care may lack social support during their transition to adulthood.
Using nationally-representative data from the National Survey of Child and Adolescent Well-being (NSCAW), this study examined the functioning of U.S. transition-aged youth involved with child welfare during adolescence. Measures were taken on five occasions between 12 to 15 years of age (baseline interview) and 18 to 21 years of age (N = 620). Associations between social disadvantage, psychosocial risk and presence of a mental health issue were studied in relation to both child welfare involvement and young adult outcomes. Numerous indicators of well-being, including factors related to demographic characteristics, out of home placement, living with a caregiver, economic hardship, marriage/cohabitation status, parenting status and criminal involvement were examined throughout the study. Risk for mental health problems was also assessed through numerous questionnaires.
Results indicate that 45% of the sample was at risk of, or currently struggling with some type of mental illness. Distributions of both demographic and psychosocial characteristics amongst youth in the sample (e.g., gender, race/ethnicity, poverty status, living situation) were compared between those identified with and without mental health problems. Significantly more females than males reported mental health problems. Further, youth who were unemployed or had been arrested in the last 12 months were significantly more likely to report a mental health problem. Post hoc analysis found youth living independently (without a partner or caregiver) had the highest risk for mental health problems, especially when living with a child of their own.
Further analysis, using multivariate logistic regression, was undertaken to determine the contribution of mental health problems to young adult outcomes, including arrest, employment, marital status and early parenting, beyond the effect of demographic and psychosocial risk factors. Arrest was found to be the only young adult outcome where risk for a mental health problem was significant. Compared to youth without mental health problems, youth at risk of mental health problems were four times as likely to have a history of arrest.
In the absence of a comparison group within NSCAW data, characteristics of NSCAW youth were contrasted with those of transition age youth in the general population based upon reports from the U.S. Census and several epidemiological studies. Differences found between the NSCAW sample and the comparison groups indicated a number of vulnerabilities. Youth identified in the NSCAW sample, compared to the general population, were more likely to experience economic hardship, marriage, parenting, and arrest. The authors conclude that health and mental health services should be sensitive to both developmental and institutional transitions, in order to meet the needs of those “aging out” of child welfare services.
The NSCAW survey is limited in some ways. Though a number of instruments were utilized to measure mental health status, all were self-report by youth, thus subjecting the data to both recall and response bias. In addition, data measuring educational outcomes were not available. By using comparison data from other sources, it is possible that the magnitude of differences between the NSCAW sample and the general population are under- or over-estimated.