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Cited by 164Child Welfare and AdoptionChild Abuse and TraumaChild and Adolescent Psychosocial and Emotional Development

Prevalence and timing of diagnosable mental health, alcohol, and substance use problems among older adolescents in the child welfare system

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Keller, Thomas E., Salazar, Amy M., Courtney, Mark E.·2010·Children and Youth Services Review
DOI 10.1016/j.childyouth.2009.12.010PMC PMC2840264
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Abstract

This study reports the prevalence of PTSD, major depression, alcohol abuse/dependence and substance abuse/dependence diagnoses assessed with a structured clinical interview protocol in a population-based, multi-state, age cohort of older adolescents about to exit child welfare systems. PTSD was the most common diagnosis and was observed at rates above those seen in the general population. Rates of specific diagnoses varied according to gender, race, type of child welfare placement, and state of residence. In general, African American youth and those in kinship family foster care were less likely to have mental health and substance use problems. Analysis of the timing of onset relative to entry into care revealed that Caucasian youth were more likely to have diagnoses prior to entry into state custody, and race differentials were less pronounced for diagnosis after placement in foster care. Observed state-to-state differences suggest that age of entry into care and the likelihood of pre-existing mental health and substance use conditions could be attributable to child welfare policies regarding screening and placement.

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Crossref · 10.1016/j.childyouth.2009.12.010

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  • Youth in foster care have elevated mental health challenges, including 60% lifetime disorder at ages 17-18, and twice the normative rate of depression and PTSD.

    “Further, although youth in foster care have elevated mental health challenges—including 60 % lifetime disorder at ages 17–18, and twice the normative rate of depression and PTSD (Havlicek et al., 2013; Keller et al., 2010; Mcmillen et al., 2005; Salazar et al., 2013)—they are also more likely to have unmet service needs.”

    From Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking (2023) · cites this paper as Keller et al., 2010

    The Discussion (page not provided) reports that PTSD was substantially more common among youth about to exit foster care than among community adolescents. It also says this sample’s lifetime depression rate was 10.5%, versus 13.5% for 17–18-year-olds in the general population—not twice the normative rate. The Results (page not provided) do not report the claimed 60% lifetime-disorder figure. (LLM, conf=0.88)

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  • The prevalence of mental health problems in foster children estimated by symptom checklists is in the range of 42.7% to 61.0%.

    “The prevalence of mental health problems in foster children has primarily been investigated using symptom checklists, providing an overall estimated prevalence of mental health problems in the range of 42.7% to 61.0% [6-11].”

    From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [10]

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Research works printed but not linked: 2

  1. Cottler LB Compton WM 1993 Advantages of the CIDI family of instruments in epidemiological research of substance use disorders International Journal of Methods in Psychiatric Research 3 109 119
  2. Henry GT 1990 Practical sampling 21 Newbury Park, CA Sage Publications

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Authors
Keller, T. E., Salazar, A. M., & Courtney, M. E.
Affiliations
  • Portland State University (US)
  • University of Washington (US)
Corresponding author
Keller, Thomas E.
ORCID
Venue
Children and Youth Services Review
Publisher
Elsevier BV
Published
2010-04
Volume
32
Issue
4
Pages
626-634
ISSN
0190-7409 (ISSN-L)
DOI
10.1016/j.childyouth.2009.12.010
PMC
PMC2840264
OpenAlex
W1998883768
Cited by
164
References
67
Citations by year
2026: 2 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 8 · 2020: 11 · 2019: 13 · 2018: 11 · 2017: 15 · 2016: 14 · 2015: 17 · 2014: 11 · 2013: 12 · 2012: 9
FWCI
24.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Children and Youth Services Review (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
National Institute of Mental Health (R03MH070525)
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
child welfare system, older adolescents, post-traumatic stress disorder, major depressive disorder, alcohol abuse, substance abuse, mental illness, substance use disorders, foster care, kinship care, racial disparities, gender differences, timing of diagnosis, child welfare policy

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