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与原生家庭分离的年轻人中的安置不稳定状况及其可能对心理健康产生的影响。

Placement Instability Among Young People Removed from Their Original Family and the Likely Mental Health Implications.

作者信息

Rice Simon, Cotton Sue, Moeller-Saxone Kristen, Mihalopoulos Cathrine, Magnus Anne, Harvey Carol, Humphreys Cathy, Halperin Stephen, Scheppokat Angela, McGorry Patrick, Herrman Helen

机构信息

Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.

Centre for Youth Mental Health, The University of Melbourne, Australia.

出版信息

Shanghai Arch Psychiatry. 2017 Apr 25;29(2):85-94. doi: 10.11919/j.issn.1002-0829.216090.

Abstract

BACKGROUND

Young people in out-of-home care are more likely to experience poorer mental and physical health outcomes related to their peers. Stable care environments are essential for ameliorating impacts of disruptive early childhood experiences, including exposure to psychological trauma, abuse and neglect. At present there are very few high quality data regarding the placement stability history of young people in out-of-home care in Australia or other countries.

OBJECTIVES

To undertake the first systematic census of background, care type and placement stability characteristics of young people living in the out-of-home care sector in Australia.

METHODS

Data was collected from four non-government child and adolescent community service organisations located across metropolitan Melbourne in 2014. The sample comprised 322 young people (females 52.8%), aged between 12 - 17 years (mean age=14.86 =1.63] years).

RESULTS

Most young people (64.3%) were in home-based care settings (i.e., foster care, therapeutic foster care, adolescent care program, kinship care, and lead tenant care), relative to residential care (35.7%). However, the proportion in residential care is very high in this age group when compared with all children in out-of-home care (5%). Mean age of first removal was 9 years =4.54). No gender differences were observed for care type characteristics. Three quarters of the sample (76.9%) had a lifetime history of more than one placement in the out-of-home care system, with more than a third (36.5%) having experienced ≥5 lifetime placements. Relative to home-based care, young people in residential care experienced significantly greater placement instability (χ=63.018, <0.001).

CONCLUSIONS

Placement instability is common in the out-of-home care sector. Given stable care environments are required to ameliorate psychological trauma and health impacts associated with childhood maltreatment, well-designed intervention-based research is required to enable greater placement stability, including strengthening the therapeutic capacities of out-of-home carers of young people.

摘要

背景

与同龄人相比,接受家庭外照料的年轻人更有可能出现较差的身心健康状况。稳定的照料环境对于减轻早期童年不良经历(包括接触心理创伤、虐待和忽视)的影响至关重要。目前,关于澳大利亚或其他国家接受家庭外照料的年轻人的安置稳定性历史的高质量数据非常少。

目的

对澳大利亚接受家庭外照料的年轻人的背景、照料类型和安置稳定性特征进行首次系统普查。

方法

2014年从墨尔本大都市地区的四个非政府儿童和青少年社区服务组织收集数据。样本包括322名年轻人(女性占52.8%),年龄在12至17岁之间(平均年龄=14.86±1.63岁)。

结果

与寄宿照料(35.7%)相比,大多数年轻人(64.3%)处于家庭式照料环境(即寄养、治疗性寄养、青少年照料项目、亲属照料和主要租户照料)。然而,与所有接受家庭外照料的儿童(5%)相比,这个年龄组中寄宿照料的比例非常高。首次被安置的平均年龄为9岁(±4.54)。在照料类型特征方面未观察到性别差异。四分之三的样本(76.9%)在家庭外照料系统中有过不止一次安置的经历,超过三分之一(36.5%)经历过≥5次终身安置。与家庭式照料相比,寄宿照料中的年轻人经历的安置不稳定程度明显更高(χ²=63.018,P<0.001)。

结论

安置不稳定在家庭外照料部门很常见。鉴于需要稳定的照料环境来减轻与童年虐待相关的心理创伤和健康影响,需要开展精心设计的基于干预的研究,以实现更高的安置稳定性,包括加强对年轻人的家庭外照料者的治疗能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8271/5518265/4a2a31f0c14d/sap-29-85-g001.jpg

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