BACKGROUND:
It
is well documented that a disproportionate number of homeless adults have
childhood histories of foster care placement(s). This study examines the
relationship between foster care placement as a predictor of adult substance
use disorders (including frequency, severity and type), mental illness,
vocational functioning, service use and duration of homelessness among a sample
of homeless adults with mental illness. We hypothesize that a history of foster
care predicts earlier, more severe and more frequent substance use, multiple
mental disorder diagnoses, discontinuous work history, and longer durations of
homelessness.
METHODS:
This
study was conducted using baseline data from two randomized controlled trials
in Vancouver, British Columbia for participants who responded to a series of
questions pertaining to out-of-home care at 12 months follow-up (n = 442).
Primary outcomes included current mental disorders; substance use including
type, frequency and severity; physical health; duration of homelessness;
vocational functioning; and service use.
RESULTS:
In
multivariable regression models, a history of foster care placement
independently predicted incomplete high school, duration of homelessness,
discontinuous work history, less severe types of mental illness, multiple
mental disorders, early initiation of drug and/or alcohol use, and daily drug
use.
CONCLUSIONS:
This
is the first Canadian study to investigate the relationship between a history
of foster care and current substance use among homeless adults with mental
illness, controlling for several other potential confounding factors. It is
important to screen homeless youth who exit foster care for substance use, and
to provide integrated treatment for concurrent disorders to homeless youth and
adults who have both psychiatric and substance use problems.
Table 2
Foster care experiences among Vancouver At Home participants
| N (%) |
|---|
| Lived away from parents before age 18 (n = 445) | 264 (59) |
| Reasons for living away (n = 264)4 | |
| Lived with relatives or friends | 36 (14) |
| Foster home | 98 (37) |
| Group home | 23 (9) |
| Jail or detention | 18 (7) |
| Ran away or kicked out | 75 (28) |
| Moved out | 28 (11) |
| Other | 36 (14) |
| Placed in foster care (n = 442) | 135 (30) |
| Reasons (n = 135)5 | |
| Parental illness or accident | 19 (14) |
| Parental incarceration | 5 (4) |
| Parental abuse or neglect | 54 (40) |
| Behavioural problems | 34 (25) |
| Don’t know | 19 (14) |
| Other | 14 (10) |
| Number of foster care placements (n = 125) | |
| Median (IQR) | 1 (1–4) |
| Age at time of most recent placement (n = 131) | |
| Median (IQR) | 10 (3–13) |
| Duration (months) of most recent placement (n = 122) | |
| Median (IQR) | 18 (8–48) |
| Biological children (currently or in the past) in foster care (n = 447) | 41 (9) |
| Biological children (currently or in the past) adopted or living with someone else (n = 446) | 105 (23) |
4Proportions were derived using 264 as the denominator. Participants could endorse more than one reason.
5Proportions were derived using 135 as the denominator. Participants could endorse more than one reason.
1Faculty of Health Sciences, Simon Fraser University,
8888 University Drive, Burnaby, British, Columbia, Canada.
michelle_patterson@sfu.ca.
2Faculty of Health Sciences, Simon Fraser University,
8888 University Drive, Burnaby, British, Columbia, Canada. Akm_moniruzzaman@sfu.ca.
3Faculty of Health Sciences, Simon Fraser University,
8888 University Drive, Burnaby, British, Columbia, Canada. jsomers@sfu.ca.
No comments:
Post a Comment