Exploring the Impacts and Responses to COVID-19 in Youth Residential Care Programs: A Qualitative Content Analysis

Background and Purpose: COVID-19 mandates requiring social distancing and stay-at-home orders required youth residential group homes to adjust their program structures. The rapid closure of schools limited youths’ learning opportunities, negatively impacted their wellbeing, and increased the prevalence of behavioral health symptoms. Accordingly, residential care providers were challenged to quickly adapt their services while adhering to state and local mandates. Mandates limiting face-to-face encounters, such as family visitation, increased youth, family, and care provider stress, while potentially disrupting reunification efforts. The current study explored the challenges experienced by residential care providers as a result of COVID-19 and ways in which these organizations responded to challenges. The research questions guiding this study included: 1) How did COVID-19 impact services, procedures, and living conditions in youth residential care programs? 2) How did residential care providers respond to challenges presented by COVID-19?

Methods: Data for this exploratory study were drawn from a larger, statewide study of the quality of care in residential group homes. The original study sample included 1,150 participants, who completed the Quality Standards Assessment (QSA) online, representing 159 residential programs. The current study sample was limited to participants who completed the QSA between January 2020-December 2021 who provided open-ended comments about residential providers’ experiences during the COVID-19 pandemic. The study sample (n = 87) included 30 state licensing specialists, 29 program directors, 14 lead agency personnel, and 14 direct care specialists across 38 residential programs. A qualitative content analysis was used to classify open-ended text into interpretable categories.

Results: Comments reflected that COVID-19 presented significant challenges to residential care providers. Respondents indicated that areas most impacted by COVID-19, were involvement in activities, especially in the community (36.5% coverage), education and schooling (15.3% coverage), routine program procedures (e.g., relicensing, staff meetings; 14.1% coverage), staffing issues (12.9% coverage) and family contacts (11.8%). Among the noted impacts were closing campus to visitors including family, discontinuing and/or limiting involvement in off campus activities, observed difficulty with youth staying engaged in online schooling resulting in declining grades, staff shortages, delays in training, and gaps in regular supervision. Responses to challenges included creating activities on-campus (e.g., planting a community garden), conducting family visits virtually, shifting to on-campus schooling when possible (versus virtual), inviting teachers and community volunteers to participate in drive-thru parades to support youth, and conducting re-licensing inspections virtually.

Conclusions and Implications: Residential programs encountered many difficulties during the COVID-19 shut down. Programs adapted to challenges in some ways, while in other areas gaps remained. Issues with school and being isolated from family and community were experienced among youth within and outside of residential care during the COVID-19 shut down. However, as a highly vulnerable population, this challenge may present greater risks – particularly with disrupting often tenuous family connections and exacerbating educational delays that are well documented among youth in residential care. An important observation was the demonstration of how programs adapted to challenges to meet youths’ needs and maintain normalcy. We discuss recommendations for adapting residential care practices and preparing for the future.