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Existing research has established child welfare (CW) clients as a vulnerable group for developing negative life trajectories, including mental health problems, work-and education-related challenges and premature mortality. Knowledge of later life conditions including suicidality of clients within child welfare services (CWS) in the Nordic countries is scarce. The overall aim is therefore to gain updated knowledge on how children and youth who have received or are receiving CWS interventions from the Nordic CWS fare in relation to suicidality. The population, intervention, comparator, outcome (PICO) framework guided the search through five multidisciplinary bibliographical databases. The population were former and current CWS clients; comparators were from the general population. Six cohort studies were identified (i.e., one Finnish study and five studies from Sweden), all showing evidence of a significantly elevated risk for suicide and suicide attempt in former CWS clients. CWS clients systematically fare worse concerning suicide and suicide attempt compared to their peers from the general population. In particular, former CWS clients should be recognized as being at high risk for suicide and suicidal behaviour later in life. These findings have substantial implications for CWS practice and service delivery regarding long-term follow-up.

Youth within the child welfare system (CWS) have often experienced adverse life events, and many need support from health services. This study aimed to compare mental health problems and health service use among adolescents receiving in-home services (IHS), living in foster care (FC) and general population youth (GP). Data stem from the youth@hordaland survey, a population-based study of adolescents (N = 10,257, age 16-19) conducted in 2012 in Hordaland County, Norway. The adolescents provided self-reported data on CWS contact, health service use, adverse life events and multiple instruments assessing mental health problems. The IHS and FC groups had significantly higher symptom scores across most mental health measures than peers from the GP. Youth receiving IHS had significantly higher scores on measures of general internalizing and externalizing problems, attention deficit hyperactivity disorder (ADHD) and depression compared with peers in FC. Those receiving IHS reported the highest health service use. Adverse life events accounted for a substantial part of the differences between the groups. Mental health problems are frequent among older adolescents within the CWS, especially among youth receiving IHS. Service providers and policymakers should be aware of the present and likely continued challenges faced by many of these youth.adolescence, adverse life events, child welfare, health services, mental health, youth | BACKGROUNDChildren exposed to poverty, inadequate parenting or maltreatment are at risk of mental health problems (

Ensuring that young people in foster care receive the support they need at the right time, is a pressing issue across health- and social services. In this study, we aim to broaden the knowledge base on what constitutes appropriate help and support from the perspective of young people in long-term foster care in Norway. As part of a larger survey, young people in foster care (N = 178) aged eleven to eighteen years provided written accounts on the open-ended question: ‘What advice would you give adults who help young people living in foster care?’. We conducted a systematic content analysis to identify themes and categories across the data. Four main themes were identified: enable participation; build trusting relationships; ensure appropriate follow-up; and cultivate belonging. Participation served as a pivoting point across the themes, as a prerequisite for young people in care to receive the services they need and develop a positive self-relationship. Our findings indicate that services must be tailored to recognise how the strengths and needs of young people in foster care change over time and differ across individuals. Developing practice tools that enhance young people’s participation is therefore paramount, as social workers, foster parents and other adults are crucial to processes of well-being and belonging.

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