Jackson, B., Holland, M. L., Smye, V., Lowe, S., & Sadler, L. S. (2025). “Finally my turn to write my story”: A convergent mixed methods study exploring the perceptions and experiences of emerging adults who aged out of foster care in Canada. PLOS ONE, 20(12), e0338574. https://doi.org/10.1371/journal.pone.0338574
Summary
For many young people leaving state care, the transition to adulthood is not a simple developmental milestone but a structural rupture shaped by systemic inequities. This Canadian convergent mixed methods study examined how structural violence influences mental health and positive adaptation among 203 emerging adults (18-29 years) who had aged out of care, with 31 participants completing in-depth qualitative interviews. Greater exposure to adverse childhood experiences (ACE’s), discrimination, and chronic perceived stress was significantly associated with higher symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression, while benevolent childhood experiences were linked to stronger resilience and flourishing. Although these associations are supported by pre-existing literature, the study’s key contribution lies in demonstrating how structural forces operate in lived experience: participants described abrupt withdrawal of formal supports, housing and employment precarity, stigma, and navigating adulthood alone, alongside reclaiming their narratives, cultivating self-reliance, and engaging in advocacy and altruism as forms of meaning-making. Integrated findings suggest that adaptation after aging out of care is not merely an individual outcome but a process embedded within structural conditions.
Methodological Notes
The authors employed a convergent mixed methods design, collecting quantitative and qualitative data concurrently and integrating findings. Validated self-report measures assessed structural adversity (ACE’s, discrimination, perceived stress), protective factors (benevolent childhood experiences), and mental health and adaptation outcomes (PTSD, anxiety, depression, resilience, flourishing). Block (sequential) multiple linear regression was used to examine the incremental contribution (ΔR²) of theoretically clustered variables, while controlling for intersectional covariates. Large effect sizes in these regression models indicate that structural constructs contribute meaningfully to mental health outcomes beyond demographic factors, reinforcing that the transition out of care is shaped less by the individual and more by systemic constraint. These findings were interpreted alongside qualitative themes to strengthen credibility through triangulation. The quantitative component was notably well-powered for a hard-to-reach population, suggesting strong recruitment and participant engagement. However, it is worth nothing that youth with lived experience do not appear to have been directly involved in study co-design, which may have limited inclusion of youth-prioritized constructs. Future research would benefit from longitudinal and multi-informant designs to clarify directionality, expanded participatory approaches, and consecutive qualitative inquiry to further contextualize quantitative patterns from youths’ perspectives. Despite these limitations the study makes a meaningful contribution to child welfare research by empirically centering structural inequities in shaping post-care mental health outcomes while simultaneously documenting the resilience and agency of youth aging out of care.