Homelessness and Health Care Access After Emancipation

Kushel, Margot; Yen, Irene H.; Gee, Lauren; Courtney, Mark E.

doi:10.1001/archpedi.161.10.986

Cited by 65 publications

(13 citation statements)

References 40 publications

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“…DHHS,, 2012). It is well documented that in comparison to the general population, young people with foster care experience are more likely to experience a variety of behavioral, physical, mental health, social, educational, and economic challenges (Ahrens, Richardson, Lozano, Fan, & DuBois, 2008; Carpenter, Clyman, Davidson, & Steiner, 2001; Courtney, Dworsky, Lee, & Raap, 2010; Courtney et al, 2005; Courtney, Terao, & Bost, 2004; Keller, Salazar, & Courtney, 2010; Kushel, Yen, Gee, & Courtney, 2007; McMillen et al, 2005; Merikangas et al, 2010; Narendorf & McMillen, 2010; Pecora et al, 2005; Pecora, White, Jackson, & Wiggins, 2009; Pecora et al, 2003; Pilowsky & Wu, 2006; Vaughn, Ollie, McMillen, Scott, & Munson, 2007; Zlotnick, Tam, & Soman, 2012). …”

Section: Introductionmentioning

confidence: 99%

Adapting an evidence-based parenting program for child welfare involved teens and their caregivers

Barkan

Salazar

Estep

et al. 2014

Children and Youth Services Review

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The scarcity of caregivers and the unique vulnerability of teens involved with the child welfare system necessitate effective strategies for ensuring that caregivers are prepared and supported in the important role they play with children and youth within the child welfare system. They are in a position, through the establishment of a strong, positive, supportive connection with the youth, to potentially minimize the impacts of recent trauma and interrupt a negative trajectory by preventing the youth’s initiation of high-risk behavior. In this paper we describe the process used to systematically adapt Staying Connected with Your Teen™, an evidence-based, prevention-focused parenting program found in other studies to reduce the initiation of teens‘ risky behaviors, for use with foster teens and their relative or foster caregivers. This work has been guided by the ADAPT-ITT framework developed by Wingood and DiClemente (2008) for adapting evidence-based interventions. Qualitative work conducted in Phase 1 of this study identified the need for the development of a trusted connection between foster youth and their caregivers, as well as tools for helping them access community resources, social services, and educational supports. This paper describes the process used to develop new and adapted program activities in response to the needs identified in Phase 1. We conducted a theater test with dyads of foster youth and their caregivers to get feedback on the new activities. Findings from the theater test are provided and next steps in the research are discussed which include examining program usability, fidelity, feasibility, and testing this new prevention program that has been tailored for child welfare involved youth and their caregivers. This intervention program has the potential to fill an important gap in the availability of preventive programming for caregivers of teens in foster care.

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Section: Introductionmentioning

confidence: 99%

Adapting an evidence-based parenting program for child welfare involved teens and their caregivers

Barkan

Salazar

Estep

et al. 2014

Children and Youth Services Review

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“…Homeless young adults are at elevated risk for psychiatric disorders (1, 2), with affective and anxiety disorders nearly twice as likely compared to housed individuals around the same age (3, 4). Psychiatric disorders are associated with considerable impairment in functioning (5) that may impede the development of independent living skills and efforts to obtain and retain housing (6–8).…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Disorders and Treatment Among Newly Homeless Young Adults With Histories of Foster Care

Thompson¹,

Hasin²

2012

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Objective While foster care placement is often preceded by stressful events such as childhood abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. However, whether a history of foster care elevates the likelihood of psychiatric disorders and treatment among homeless young adults, after adjustment for childhood abuse, is unknown. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults, controlling for childhood abuse and other covariates. Methods Among a consecutive sample of 424 newly homeless young adults (18 to 21 years) in a crisis shelter, logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, psychotic) and psychiatric treatment, adjusted for demographics, childhood abuse, substance abuse, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Results Homeless young adults with histories of foster care were 70% more likely to report any psychiatric disorder (AOR=1.70) and twice as likely to have received mental health counseling for a psychiatric disorder (AOR=2.17), been prescribed psychiatric medication (AOR=2.26), and been hospitalized for psychiatric problems (AOR=2.15) than those without such histories. Conclusions Histories of foster care should trigger screening for psychiatric disorders among homeless young adults to aid in the provision of treatment (counseling, medication, hospitalization) tailored to their psychiatric needs.

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“…Emancipation occurs when adolescents leave protective custody, generally between ages 18 and 21, without a permanency arrangement (e.g., guardianship, adoption, reunification). Studies have demonstrated that young people emancipating from protective custody experience significantly higher rates of substance abuse, mental health concerns, and poorer quality of life when compared to their same-aged peers never in protective custody (Dworsky, Ahrens, & Courtney, 2013;Dworsky & Courtney, 2009a;Dworsky & Courtney, 2009b;Dworsky & Courtney, 2010;Fowler, Toro, & Miles, 2011;Kushel, Yen, Gee, & Courtney, 2007). Several mechanisms likely contribute to the increased risk for poor outcomes observed for young people who emancipate from protective custody.…”

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confidence: 99%

Childhood Adversity and Associated Psychosocial Function in Adolescents with Complex Trauma

Beal

Wingrove

Mara

et al. 2018

Child Youth Care Forum

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Background: Childhood adversity is linked to a number of adult health and psychosocial outcomes; however, it is not clear how to best assess and model childhood adversity reported by adolescents with known maltreatment exposure. Objective: This study sought to identify an empirically-supported measurement model of childhood adversity for adolescents in child protective custody and associations among childhood adversity and adolescent outcomes. Methods: Self-report survey data assessed childhood adversity and adolescent outcomes, including psychological wellbeing, quality of life, and substance use, in 151 adolescents ages 16 to 22 in protective custody with a documented maltreatment history. Results: Findings suggest that, among youth with complex trauma histories, it is important to distinguish among risk related to unexpected tragedy (e.g., natural disaster, parental divorce), family instability (e.g., parental substance abuse or mental health concerns), and family violence (e.g., physical or sexual abuse). Family violence was associated with poorer psychological

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Homelessness and Health Care Access After Emancipation

Cited by 65 publications

References 40 publications

Adapting an evidence-based parenting program for child welfare involved teens and their caregivers

Adapting an evidence-based parenting program for child welfare involved teens and their caregivers

Psychiatric Disorders and Treatment Among Newly Homeless Young Adults With Histories of Foster Care

Childhood Adversity and Associated Psychosocial Function in Adolescents with Complex Trauma

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