Children in foster care: Mental health, service use and costs
Abstract
Objective To assess the prevalence of mental health problems in children in foster care, their families' use of services and the associated costs.Methods Information on mental health problems, service use and costs was collected, by postal questionnaires and home interviews, on 182 children, their foster carers and teachers from 17 local authorities in Central Scotland.Results Over 90% of the children had previously been abused or neglected and 60 % had evidence of mental health problems including conduct problems, emotional problems, hyperactivity and problems with peer relations. When compared with 251 children from local schools, the children in foster care had significantly higher symptom scores for Reactive Attachment Disorder. Those children with highest scores for mental health problems were attracting a high level of service support from a wide range of agencies, except Child and Adolescent Mental Health Services (CAMHS). Costs were associated with learning disability, mental health problems, and a history of residential care.Conclusions Children in "mainstream" foster care are at greater risk of mental health problems, and are attracting greatest costs, but CAMHS are not successfully targeting these problems. CAMHS may need to develop new models of service delivery.
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The grouping of disorders corresponded to that used in Ford et al.'s study of looked-after children.
“This grouping of disorders corresponded to that used in Ford et al.’s study of looked-after children [16].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
The study by Ford, Vosansis, Meltzer and Goodman reported a point-prevalence of 38.6% in younger foster children.
“They reported a point-prevalence of 38.6%”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
In the prior study, prevalence was only reported for broader diagnostic groups and not for single disorders among children living in foster families.
“Furthermore, the prevalence was only reported for broader diagnostic groups and not for single disorders among children living in foster families.”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
The prevalence of mental disorders was higher for youths placed in congregate care.
“Consistent with other studies, [12,15,16] the prevalence was higher for youths placed in congregate care [14].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
Whether the age-related increase in prevalence could be attributed to later placement and longer exposure to neglect and abuse was not explored in the prior study.
“Whether this age-related increase could be attributed to later placement and longer exposure to neglect and abuse was not explored.”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
The study's point-prevalence of 50.9% was higher than the 33.0-38.6% range reported by US and British studies.
“Our point-prevalence of 50.9% was high, compared to the recent 33.0–38.6% range reported by US and British studies [14,16], and it was closer to the 66.0% rate recently reported for children referred to by specialist mental health services in Norway [47].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
In Ford et al.'s study, Behavioural disorders (32.3%) were more than 3 times more frequent than Emotional disorders (9.7%) and Hyperkinetic disorders (8.5%).
“These 3 main diagnostic groups had fairly equal rates of prevalence in our sample, contrasting the findings from the study of Ford et al. [16], in which Behavioural disorders (32.3%) were more than 3 times more frequent than Emotional disorders (9.7%) and Hyperkinetic disorders (8.5%) [16].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [16]
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Tarren‐Sweeney, M., & Goemans, A. (2019) · Developmental Child Welfare · doi:10.1177/2516103219874810 · Cited by 20 · see citing works
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Self-citationAutism and attachment disorder symptoms in the general population: Prevalence, overlap, and burden
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Turner, F., Venturini, E., Kainth, G., Crawford, K., O’Connor, R. C., Balestrieri, M., Macdonald, S., & Minnis, H. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105585 · Cited by 18 · see citing works
Self-citationThe feasibility of a randomised controlled trial of Dyadic Developmental Psychotherapy
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The economic cost of child maltreatment in the UK
Conti, G. (2017) · doi:10.1920/re.ifs.2081.0143 · Cited by 18 · see citing works
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Reactive Attachment Disorder Symptoms in Adults with Intellectual Disabilities
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Development of a radical foster care intervention in Glasgow, Scotland
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Enhancing Adoptive Parenting: A Cost‐Effectiveness Analysis
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Assessment of attachment disorder symptoms in foster children: comparing diagnostic assessment tools
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Evaluating integrative services in edge-of-care work
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A Developmental Psychopathology Perspective on Foster Care Research
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- Authors
- Minnis, H., Everett, K., Pelosi, A. J., Dunn, J., & Knapp, M.
- Affiliations
- University of Glasgow (GB)
- Hairmyres Hospital (GB)
- London School of Economics and Political Science (GB)
- Corresponding author
- Minnis, Helen
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2006-03
- Volume
- 15
- Issue
- 2
- Pages
- 63-70
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- OpenAlex
- W2069070597
- Cited by
- 198
- References
- 31
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 17 · 2023: 8 · 2022: 12 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 16 · 2017: 13 · 2016: 8 · 2015: 15 · 2014: 19 · 2013: 5 · 2012: 9
- FWCI
- 17.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- foster children, child mental health, reactive attachment disorder, child abuse, conduct problems, hyperactivity, peer relationships, service utilization, service costs, child and adolescent mental health services, learning disabilities, residential care, foster parents
- MeSH terms
- Adolescent, Catchment Area, Health, Child, Child Behavior Disorders, Child, Preschool, Female, Foster Home Care, United Kingdom, Humans, Male, Mental Health Services, Surveys and Questionnaires, Prevalence, Mood Disorders
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