Poster #54 - Children’s behavioral health and foster care: Examining why children are “voluntarily” placed into foster care

• In Event: Poster Session 09

Abstract

Background: The prevalence of children and adolescents’ behavioral health difficulties is considered a significant public health crisis, overwhelming caregivers, schools, and treatment facilities. Moreover, access to effective treatment is often unduly burdensome for many caregivers. Since the 1970s, scholars and advocates have raised awareness about the phenomenon of “voluntarily” placing children into the child welfare system (“foster care”) as a means for caregivers to acquire resources, treatment, and support to address their children’s behavioral health circumstances. This arrangement requires that caregivers relinquish custodial care of their children to state child welfare agencies. Though it has been estimated that such “voluntary” placements for mental health care affects thousands of families every year, the extent of this problem is poorly understood, and scant research describes the context and circumstances of caregivers’ voluntary placement of children into foster care. Study goals included exploring: 1) factors for all voluntarily placed children (VP’d) in US; and 2) between group differences for VP’d children when in foster care.

Methods: The data are from the Adoption and Foster Care Analysis and Reporting System (AFCARS), administrative data on children who were in foster care in the US for FY19, restricted to only those who were voluntarily placed into foster care during this period (n = 14,770). Latent Class Analysis (LCA) was conducted with 9 distinct removal reasons to understand how these risk factors grouped together, resulting in 11 classes of risks. After combining the classes into four groups, bivariate analyses were conducted to examine between group differences across a range of foster care placement and case related factors.

Results: LCA results show that 11 classes emerged, each distinguished by different probability for association with classes based on 9 risk factors for removal from caregivers. The 11 classes were re-grouped into four groups, using similar risk categories: Group 1: Caregiver Abandonment/Relinquishment (30% of sample); Group 2: Child Maltreatment (21%); Group 3: Child Behavioral Health/Disabilities (28%); Group 4: Caregiver Substance Use Disorders (21%) (Table 1). Chi-Square and One-way ANOVAs were conducted for comparing the four groups regarding demographic and foster care placement variables; post-hoc tests (i.e., Tukey’s) were conducted for pairwise analyses. Group 3 was significantly more likely to be male, older (14.21 years) and from 2-parent households. Additionally, Group 3 was more likely to have children previously adopted, had a higher number of foster care placements, lived in restricted settings, had higher incidence of running away and a history of out of state placement. Group 3 was also more likely to have reunification as case goal (Table 2).

Discussion: While children who are voluntarily placed in foster care may have a variety of risk factors, there is a distinct group of youth who come to the attention of child welfare authorities due to behavioral health and developmental disabilities, and not for reasons of abuse and neglect. Such youth convey a distinct set of risk factors and may reflect a stressed family unit which might be unable to cope with and/or access effective treatment for these behavioral difficulties.

Authors

• Cassandra A Simmel, Rutgers University - New Brunswick
  Presenting Author

• Liwei Zhang, Washington University in St. Louis

• Genevieve Graf, University of Texas, Arlington