Chapin Hall

Prevalence of Mental Health Disorders Suggests Youth Reaching Age of Majority in Foster Care Need Special Attention

This report examines mental health and substance use problems of foster youth at age 17, as well as related services provided to the participants. Researchers describe the prevalence of current mental health and substance use disorders, receipt of mental health and substance abuse treatment services, use of psychotropic medication, and selected predictors of service receipt.

What We Did

This report draws on data from the Wave 1 youth survey when most participants were 17 years old (n = 727). We assessed the prevalence of selected mental health and substance use disorders using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and assessed suicidal ideation and attempts among youth using selected questions from the Composite International Diagnostic Interview (CIDI). Youth were also asked several questions about the mental health and substance abuse treatment services they received, including their use of psychotropic drugs.

What We Found

We found that the most prevalent mental and behavioral health disorders were major depression and dysthymia, mania and hypomania, psychotic disorders, substance abuse and dependence, and alcohol dependence. Compared to males, females were more likely to report symptoms consistent with current major depression, dysthymia, and PTSD. More than 50% of CalYOUTH participants were found to have a positive diagnosis for one or more current mental and behavioral health disorders, with females receiving a positive diagnosis more often than males. Compared to their peers, sexual minority youth reported higher rates of mental health/substance use disorders and suicidal ideation and behavior. Females were more likely than males to report past suicidal ideation and past suicidal attempts. Over half of study participants had received counseling in the past year, with females and sexual minority youth being more likely than their counterparts to have received counseling. About three in ten youth had received medication for their emotions in the past year, and most of these youth reported feeling included by their physician in decisions about their psychotropic medications. However, a significant proportion of youth expressed some level of concern about the effects these drugs have on their lives, and over 30 percent do not believe that the good things about the medication outweigh the bad.

What It Means

Given the prevalence of mental health and substance use disorders among these youth, child welfare agencies should pay special attention to the behavioral health service needs of youth approach­ing the age of majority in care. In particular, routine periodic screening for mental health and substance use disorders should be common practice when work­ing with older youth in foster care. Our study findings also highlight the importance of continuing efforts to better moni­tor the use of psychotropic drugs with youth in care. Future research should further explore potential disparities in receipt of mental health and substance abuse treatment services associated with gender and sexual orientation.