Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies
Open accessAbstract
While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3-17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6-66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33-2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks.
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Care-experienced children and young people have a higher rate of diagnosable mental health problems compared to non-care-experienced samples.
“They have a higher rate of diagnosable mental health problems when compared to non-care-experienced samples (Dubois-Comtois et al., 2021; Engler et al., 2022; Seker et al., 2021)”
From Effectiveness of Mental Health and Wellbeing Interventions for Children and Young People in Foster, Kinship, and Residential Care: Systematic Review and Meta-Analysis (2024) · cites this paper as Seker et al., 2021
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“They have a higher rate of diagnosable mental health problems when compared to non-care-experienced samples (Dubois-Comtois et al., 2021; Engler et al., 2022; Seker et al., 2021), and are at increased risk of poor subjective wellbeing (Long et al., 2017) and suicide attempts (Evans et al., 2017).”
Background
- Authors
- Seker, S., Boonmann, C., Gerger, H., Jäggi, L., d’Huart, D., Schmeck, K., & Schmid, M.
- Affiliations
- University of Basel (CH)
- Corresponding author
- Seker, Süheyla
- ORCID
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2021-06-24
- Volume
- 31
- Issue
- 12
- Pages
- 1963-1982
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC9663399
- OpenAlex
- W3174473397
- Cited by
- 82
- References
- 13
- Citations by year
- 2026: 17 · 2025: 26 · 2024: 19 · 2023: 12 · 2022: 8
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
- Funders
- Bundesamt für Justiz
- Universität Basel
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- mental illness, out-of-home care, foster care, residential care, child welfare, juvenile justice, former foster children, coming of age, prevalence, mental health risk
- MeSH terms
- Adolescent, Adult, Mental Disorders, Child, Child Welfare, Home Care Services, Humans, Juvenile Delinquency, Longitudinal Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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