Psychopathology and mental health service use among youth in foster care admitted to a psychiatric inpatient unit: a 4-year retrospective controlled study

Abstract

Youth in foster care (FC) are at increased risk of poor psychosocial outcomes. The aim of this study was to assess psychopathology and mental health service use among youth living in FC who require psychiatric hospitalisation. All individuals admitted to our Children and Adolescent Inpatient Psychiatry Unit between 2014 and 2017 who were in FC were systematically reviewed. The control group was defined as all youth living with their immediate family and hospitalised in our unit throughout 2016. We identified 89 patients placed in FC and 247 controls. Socio-demographic and clinical data were retrospectively collected from computerised charts. A survival analysis of emergency department visits and readmission to the hospital was conducted. Compared to controls, the FC group presented significantly higher rates of conduct disorder (78.7% vs 14.6%; p < 0.001) and substance use disorder (49.4% vs 27.5%; p < 0.001), mainly cannabis use (34.8% vs 16.6%; p < 0.001); higher rates of comorbidity (96.6% vs 55.9%; p < 0.001) and mean number of comorbid diagnoses (3.3 ± 1.1 vs 2.3 ± 0.5; p < 0.001). The FC group had a higher number of emergency room visits before and after admission than controls. FC youth were also 2.77 times more likely to visit the emergency department after discharge, and in a shorter time period, than controls (p = 0.004). Disruptive behaviours, substance use disorder, and comorbid psychopathology were all more prevalent among FC youth than controls. Specific strategies are needed to optimize community mental health resources and address the increased use of emergency services by these youth before and after hospitalisation.

What Role for Long-Acting Injectable Antipsychotics in Managing Schizophrenia Spectrum Disorders in Children and Adolescents? A Systematic Review

“…Other situations such as substance abuse, violence or legal conflicts are also risk factors for lack of adherence [ 12 , 13 , 71 , 72 ]. Adolescents placed in foster care could be another indicator for considering the use of LAIA, due to a higher risk of non-adherence, and increased incidence of behavioral difficulties and substance use comorbidities [ 73 ]. In fact, youth in foster care comprised 23.3% of the patients included in one of the studies reviewed [ 28 ] and 16% of the children and adolescents with at least one prescription of LAIA in the study conducted in the Indiana Medicaid system [ 74 ].…”

The Relationship Between Temperament Characteristics and Emotion Regulation Abilities in Institutionalized and Noninstitutionalized Children

“…Despite the negative effects of residential care on children’s development, which are extensively described (Baptista et al, 2018 ; Cicchetti & Lynch, 1993 ; Landgren et al, 2010 ), some studies pinpoint the ‘positive/neutral’ effects of residential settings, especially for children who were previously exposed to severe adverse contexts before institutionalization (Knorth et al, 2008 ; Little et al, 2005 ; Perry et al, 2019 ; Solerdelcoll et al, 2022 ; Wendt et al, 2019 ). For example, Wendt et al ( 2019 ) showed that institutionalized children and adolescents reported higher life satisfaction regarding friendship and non-violence compared to when they lived with their biological families.…”