Influence of Protective Factors on the Mental Health of Transitional Age Youth in Foster Care

Background: On any given day there are about 60,000 California children in foster care; nearly 50% of these children reside in Los Angeles County. The transition out of foster care is a particularly vulnerable time, as those youth transition to adulthood differently than their non-system involved peers. For transition age youth (TAY) with supportive caregivers and not involved with the child welfare system, this period is when they develop the skills needed for adult living. TAY transitioning out of foster care (TAYFC) have lower levels of family support and can have inconsistent relationships; leaving foster care without connections to supportive adults and access to resources increase youths’ risk of homelessness, poverty, and unemployment. Support has the potential to attenuate the negative outcomes associated with maltreatment experiences. In this work, we explore the relationships between protective factors and emotional regulation style on the mental health of TAYFC.

Methods: Data are drawn from cross-sectional study of 197 current and former service-connected foster youth (18 years and older) collected between November 2023 and February 2024 in partnership with a local community-based organization. TAYFC were all recruited from the community-based organization on Los Angeles County who had participated in an independent transition services program (ITSP). The anonymous electronic survey completed in RedCap explored experiences of adversities in childhood (18-item ACEs+PEARLs), mental health (PHQ-8, GAD-7), emotion regulation (10-item Emotional Regulation Scale), protective factors (20-item Protective Factors Resilience Scale), and future orientation (15-item Future Orientation Scale). Ordinal logistic regression was used for analysis.

Results: Models revealed that for depression, after adjusting for other covariates, for every one-unit increase in Protective Factor Scale, the odds of having more depression were 0.96 times lower (CI=0.93-0.99; p<0.001); as one’s expressive suppression score increased, so do the odds of depression (OR 1.10; CI=1.03-1.17; p=0.007). Last, for every one-unit increase in ACE+PEARLS, the negative relationship between Protective Factors Scale and depression level was smaller (CI=1.00-1.02; p=0.036). For anxiety, for every one-unit increase in Protective Factors Scale, the odds of having more anxiety were 0.96 times lower (CI=0.95-0.98; p<0.001). Other factors associated with anxiety were age of foster care entry (OR: 0.91; CI=0.85-0.97; p=0.003), expressive suppression (OR 1.13; CI=1.06-1.21; p<0.001), and childhood adversity (CI=1.00-1.02; p=0.027).

Conclusions and Implications: Needs and outcomes among TAYFC are best understood using an ecological model in which development is embedded in multiple environmental contexts. In this conceptualization, resilience among individuals who have experienced childhood adversities is achieved, in part, on the capacity of one’s social networks to provide support and resources. This work highlights the moderating influence of protective factors on the mental health of TAYFC. Given that supports can be built, the work suggests that interventions targeting the building of social networks has the potential to provide a developmentally grounded support structure during youth’s transition to adulthood.