Abstract

Placement instability for children in foster care is high, with children experiencing nearly 4.5 placement moves per 1,000 days in care on average. While prior research has demonstrated a predictive relationship between mental health problems and placement instability, few studies have examined the associations of specific mental health diagnoses or utilization of mental health (MH) services. To this end, this study seeks to investigate associations between MH service utilization, mental health diagnosis, and placement instability (rate of placement moves) for foster children. We analyzed statewide integrated administrative data to examine MH service utilization and mental health diagnosis on placement instability among foster children. We used SAS 9.4 to conduct descriptive, bivariate, and multiple linear regression models to address the objectives of the study. The retrospective cohort was composed of 1,002 children in foster care. The multivariable linear regression reveals that receiving in-patient services, receiving out-patient services, being diagnosed with conduct disorder, being Black children, older children, and female children, being placed in intensive case management, being sexually abused, having a single household family structure at time of removal, and having a high number of intakes significantly increased the rate of placement moves. The findings of this study have significant implications for the provision of mental health services to foster children and the promotion of placement stability, highlighting the role of child welfare professionals in fostering protective factors and mitigating risk factors to promote placement stability. Implications for practice and policy improvement are discussed.

中文翻译：

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东南部州寄养儿童心理健康服务利用和心理健康诊断与安置不稳定的关系

摘要

寄养儿童的安置不稳定程度很高，平均每 1,000 天的儿童会经历近 4.5 次安置变动。虽然先前的研究已经证明心理健康问题与安置不稳定之间存在预测关系，但很少有研究探讨特定心理健康诊断或心理健康 (MH) 服务利用之间的关联。为此，本研究旨在调查寄养儿童的 MH 服务利用、心理健康诊断和安置不稳定（安置移动率）之间的关联。我们分析了全州综合管理数据，以检查 MH 服务利用率和寄养儿童安置不稳定的心理健康诊断。我们使用 SAS 9.4 建立描述性、双变量和多元线性回归模型来实现研究目标。回顾性队列由 1,002 名寄养儿童组成。多变量线性回归显示，接受住院服务、接受门诊服务、被诊断为品行障碍、是黑人儿童、年龄较大的儿童和女童、被置于集中案件管理、遭受性虐待、拥有单一家庭搬迁时的家庭结构以及大量的入学人数显着增加了安置搬迁的比率。这项研究的结果对于提供寄养儿童的心理健康服务和促进安置稳定性具有重要意义，凸显了儿童福利专业人员在培育保护性因素和减轻风险因素以促进安置稳定性方面的作用。讨论了对实践和政策改进的影响。