Teens and adults with prior foster care history are more likely to experience higher prevalence rates of mental health problems and co-occurring negative psycho-social outcomes versus those without foster care involvement (Courtney, et al., 2005). Despite need, however, studies reveal Latino and African American children in foster care are less likely than their Caucasian counterparts to access and utilize culturally sensitive, evidence-based mental health services (Garland, Landseverk, & Lau, 2003). However, no research studies to date have specifically focused on examining rates and predictors of mental health disorders and service utilization among teens from different racial/ethnic backgrounds preparing to exit the foster care system. In light of this significant gap, this study addressed two important questions: 1) Does the presence of selected mental health and substance use disorders among youth in foster care approaching the transition to adulthood vary by race and/or ethnicity?, and 2) Are there disparities associated with race and/or ethnicity in the likelihood that foster youth will receive mental health or substance abuse services given the need for such services?
The current study employed a descriptive analysis based on data collected from The Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study of 732 youth making the transition to adulthood from foster care. The focal point of this analysis was on data collected through in-person interviews with 17-18 years old teens who were still under the jurisdiction of the state child welfare system. Data were collected via Computer Assisted Personal Interviewing (CAPI). Interviewers were trained to gather mental health diagnostic information using the Composite International Diagnostic Interview. Data on service utilization was gathered via self-report data, and participants were asked to report whether or not they had received any psychological or emotional counseling and/or if they went to a susbtance abuse program within the past year. Binary logistic regression was conducted to determine predictors of diagnoses and service use.
Bivariate findings showed that Caucasian teens preparing to exit foster care were more likely than African Americans to be diagnosed with a mental health and substance abuse disorder. Controlling for race, ethnicity, gender, type of placement and diagnoses of mental health/substance abuse disorder, multivariate findings showed that Caucasians are three times more likely to receive mental health services than African Americans. Hispanic ethnicity was not a predictor of diagnoses or receipt of mental health or substance abuse treatment services.
Conclusions and Implications
Results underscore the need to unlock the specific contextual and cultural factors that both increase and decrease the risk and onset of mental health disorders and pathways to services among racially and ethnically diverse adolescents in foster care. Study findings add to concerns raised regarding racial disparities in receipt of quality mental health services and call for better ongoing assessment of the mental health of youth in foster care and more focused attention by child welfare and mental health service providers to the need for quality mental health services for African Americans.