Mental health services for youths in foster care and disabled youths

Nigg

Clinical Psychology Review

2009

133

121

Samuel et al. [Samuel, V. J., Curtis, S., Thornell, A., George, P., Taylor, A., Brome, D. R., et al. (1997). The unexplored void of ADHD and African-American research: A review of the literature. Journal of Attention Disorders, 1(4), 197–207.] reviewed the literature on Attention Deficit Hyperactivity Disorder (ADHD) in African Americans, and found a paucity of research. The present review of 73 articles updates this assessment of available research and presents the current understanding of ADHD symptoms, assessment, diagnosis, and treatment in African American children ages 3–18. The authors conducted a qualitative review, as well as a mini meta-analysis of 5 studies of ADHD symptoms and 5 studies of ADHD diagnosis to clarify the question of racial differences in prevalence. African American youth had more ADHD symptoms (Cohen's d = 0.45, p<.001), yet were diagnosed with ADHD only two-thirds as often as Caucasian youth (OR = .66, p<.001). This pattern was not explained by teacher rating bias or by SES, but may be influenced by parent beliefs about ADHD, higher rates of risk, and lack of treatment access and utilization. Lower treatment rates may be related to high rates of classroom behavior problems among African American youth. Findings also suggest that existing assessment tools may not adequately capture ADHD manifestation in African Americans. Findings highlight the need for more investigation and awareness of relevant cultural issues to inform a culturally competent approach to assessment, diagnosis, and treatment of ADHD in African Americans.

Section: Resultssupporting

confidence: 85%

Section: Resultsmentioning

confidence: 95%

Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?

Nigg

Clinical Psychology Review

2009

133

121

“…Consistent with previous reports, the prevalence of antipsychotic use (6, 11) and clinically diagnosed mental disorders (8, 9) among foster youth was substantially higher than that among non-foster Medicaid youth. While demographic characteristics explained a small portion of the difference, mental disorder diagnoses explained a larger share, reducing the odds ratio from 4.19 (adjusted for demographics) to 2.59 (adjusted for demographics and diagnoses).…”

Section: Discussionsupporting

confidence: 90%

Foster Care, Externalizing Disorders, and Antipsychotic Use Among Medicaid-Enrolled Youths

Vanderwerker¹,

Akincigil²,

Olfson³

et al. 2014

Objectives The authors investigated the extent to which clinical externalizing disorder diagnoses explain increased rates of antipsychotic use in foster youth. Methods Medicaid claims data from 44 states for 2009 were analyzed to determine antipsychotic use rates among foster youth (n=301,894) and non-foster youth (n=5,092,574), excluding individuals diagnosed with schizophrenia, bipolar, autistic, or major depressive disorder. Logistic regressions assessed the relationship among foster status, externalizing disorder diagnoses, and antipsychotic use. Results Foster youth had higher rates of externalizing disorder diagnoses (ADHD: 17.3% vs. 6.5%; disruptive behavior disorder: 7.2% vs. 2.5%; conduct disorder: 2.3% vs. .5%) and antipsychotic use (7.4% vs. 1.4%) compared to non-foster youth. Foster care remained a significant predictor of antipsychotic use after controlling for demographic and diagnostic covariates, including externalizing disorder diagnoses (adjusted odds ratio [AOR]=2.59; 95% confidence interval [C.I.]=2.54–2.63). Conclusions High rates of externalizing disorder diagnoses only partially explain elevated levels of antipsychotic use in this vulnerable population.

“…Also, dos Reis et al [35] found higher percentages of mental health assistance use among children on Medicaid because they were in foster care (62%), in comparison with groups receiving Medicaid because of physical, or psychological disability (29%) or poverty (4%). Fostered children had increased rates of attention-deficit hyperactivity disorder (ADHD), depression and adjustment disorders compared with the other groups.…”

Section: Long Term Effects Of Institutionalizationmentioning

confidence: 99%

Language and Psychosocial Skills of Institutionalized Children in Greece

Asimina¹,

Melpomeni²,

Alexandra³

2017

TOFAMSJ

Background:Institutionalization is increasingly acknowledged as a poor policy for the children. Every country has important responsibilities concerning the protection and promotion of children's rights who are already in alternative care. Even a relatively short institutional placement may have long term negative consequences on children's well-being and adult life. Aim:The aim of the present study was to investigate the language and psychosocial skills of Greek institutionalized children in comparison to family raised children. Method:60 preschool children (30 institutionalized children and 30 children brought up in families) participated in the study. The children ranged in age from 4 to 5 years of age. Children's language and psychosocial skills were assessed. Result:The results demonstrated that the institutionalized children had significantly lower scores in the expressive, receptive vocabulary, narrative skills and psychosocial adjustment in comparison to the children raised in families. These results are discussed in relation to their implications for policy makers in order to move towards the development of new policies, where children are taken care of in more supportive surroundings than an institution.