When the System Goes Away, Does Treatment Need Follow? Behavioral Health Needs and Service Use Among Youth Aging Out of Foster Care
Methods: Data for these analyses were taken from four waves of the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal survey of youths in three states who exited foster care between their 17th and 22st birthdays. Participants were ages 17 or 18 at baseline (N= 732) and followed until ages 23 or 24 (response rate + 82%). At baseline, 64.8% of the sample was from a state which offered foster care until age 21.
Descriptive statistics were used to explore the change in service need and utilization over time. Binary logistic regressions were used to estimate the relationship between remaining in foster care after age 18 and service receipt, net self-reported need for services.
Results: Descriptive statistics showed a decline over time in receipt of substance abuse and mental health services among youth with indicated need for services; the greatest drop occurred between baseline and age 19-20. Those remaining in care at ages 19-20 were both significantly more likely to receive services and less in need of those services than those who had exited care. Logistic regressions controlling for service need showed that remaining in care was associated with an increase in service receipt at age 19-20, but had no effect at later waves when all youth had left care.
Implications: Allowing foster youth to remain in care beyond age 18 is associated with receipt of services that many of these young adults have a clear need for and are otherwise not getting. Further research is needed to explain why youth who remain in care exhibit fewer symptoms of problematic behavioral health than those who leave. Perhaps youth with greater symptoms choose to exit or are pushed out of care earlier. Alternatively, increased service receipt while in care may improve youths’ behavioral health.