The association between treated psychiatric and neurodevelopmental disorders and out-of-home care among Finnish children born in 1997

Kääriälä, Antti; Gyllenberg, David; Sund, Reijo; Pekkarinen, Elina; Keski‐Säntti, Markus; Ristikari, Tiina; Heino, Tarja; Sourander, André

doi:10.1007/s00787-021-01819-1

Cited by 6 publications

(5 citation statements)

References 37 publications

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“…Being placed in out-of-home care by child protection authorities by the age of 16, in 2003 and 2013 respectively, was used as a marker of mental ill-health and adversity. This was a secondary predictor [25].…”

Section: Predictorsmentioning

confidence: 93%

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Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early

Ringbom

Suvisaari

Sourander

et al. 2023

Eur Child Adolesc Psychiatry

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Psychiatric problems are risk markers for poor educational attainment. The number of adolescents receiving treatment has increased. We investigated whether the association between psychiatric problems in early adolescence and dropping out of school had changed. We used the register-based 1987 and 1997 Finnish Birth Cohort studies, which include all live births in Finland. Hospital districts with incomplete records were excluded, leaving 25,421 participants born in 1987 and 32,025 born in 1997. The main outcome was not having applied for secondary education by the year the cohort members turned 18. Our main predictors were psychiatric and neurodevelopmental disorders diagnosed by specialized services during 1998–2003 and 2008–2013, when the cohort members were 10–16 years old. We found that 511 (2.0) of subjects born in 1987 and 499 (1.6%) born in 1997 dropped out of school. Having any diagnosis at 10–16 of age was associated with dropping out of school early in both cohorts: 3.9% in 1987 and 4.8% in 1997. The highest proportions were in the subgroup with autism spectrum disorders (ASD), 19.4% in 1987 and 16.2% in 1997. Dropping out early increased among adolescents diagnosed with any psychiatric or neurodevelopmental disorder, from 3.9 to 4.8%, with the clearest increase for learning disabilities, from 3.4 to 9.0%. Dropping out decreased for those with depression, from 4.5 to 2.1%. Adolescents with psychiatric and especially neurodevelopmental disorders, need effective interventions to prevent them dropping out of school early. Increased detection of psychopathology did not result in decreased dropout rates.

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Section: Predictorsmentioning

confidence: 93%

“…To ensure that changes in service use were not biased by incomplete reporting we excluded individuals who resided in any of the hospital districts with incomplete data. The final cohort comprised 25,421 participants born in 1987 and 32,025 born in 1997. They represented 42.7% and 54.5% of the respective live births.…”

Section: Methodsmentioning

confidence: 99%

Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early

Ringbom

Suvisaari

Sourander

et al. 2023

Eur Child Adolesc Psychiatry

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“…This ranges from instances where children have been referred for suspected maltreatment, to being placed in foster or residential care away from their biological parents. Despite this variability in the populations being studied, there is a concordance among the international literature to find that these children have a higher prevalence of mental health disorders than the general population [1,14,27,28]. Greater involvement (i.e.…”

Section: How Does It Compare With Other Work?mentioning

confidence: 99%

“…Version 1 13 Despite this variability in the populations being studied, there is a concordance among the international literature to find that these children have a higher prevalence of mental health disorders than the general population [1,14,27,28]. Greater involvement (i.e.…”

Section: Ball Et Al 2023mentioning

confidence: 99%

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

Ball,

Anderson,

Black

et al. 2023

Preprint

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PurposeChildren with experience of maltreatment, abuse or neglect are known to have a higher prevalence of poor mental health. Child Protection Services identify children most at risk of harm and in need of intervention. Mental healthcare usage in this population is not well understood as registration data is not routinely linked to health records.MethodsWe undertook data linkage to describe the population on the register, their mental healthcare usage and to calculate age- and sex-specific incidence rates of mental health outcomes. We analysed records from the Aberdeen City Council Child Protection Register and for mental health prescribing and referrals to child and adolescent mental health services (CAMHS) for the NHS Grampian region between 1stJanuary 2012 and 31stDecember 2022.ResultsWe identified 1,498 individuals with a Child Protection Register registration, of which 70% were successfully matched to health records. 20% of registrations occurred before birth and the median age of registration was 3 years. 10.1% of children with a registration ever received a mental health prescription, 5.1% for treatment of attention deficit hyperactivity disorder and 1.7% for treatment of depression. 18.9% received a referral to specialist outpatient Child and Adolescent Mental Health Services. Age- and sex- standardised incidence rates for mental health prescribing and referrals are higher for children with a child protection registration compared to the general population.ConclusionChildren identified as being at significant risk of harm and involved with child protection services are at greater risk of seeking or receiving professional mental health support than their peers. Clinical services should investigate additional ways to support this population’s mental well-being as a priority. Efforts to reduce the exposure of children to potentially harmful environments at a societal level should also be pursued.

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“…The high-risk behavior of children and adolescents who have been in out-of-home care may impair the transition to independent life because these individuals already suffer from more health and well-being problems than their peers. For example, over 60% of adolescents in out-of-home care were diagnosed with a psychiatric or neurodevelopmental disorder, most commonly depression and anxiety disorders, and oppositional defiant disorder or conduct disorder (Kääriälä et al, 2021). The transition to independent life of a care leaver who has engaged in high-risk behavior is also impaired by a lack of informal and formal support, which increases the risk of social exclusion, problems with social interaction, homelessness, unemployment, low educational levels, and financial difficulties (Häggman-Laitila et al, 2018;Nho et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of High-Risk Behavior Among Adolescents in Aftercare Services and Transitioning from Out-of-home Care: A Systematic Review

et al. 2022

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Adolescents in aftercare services who are transitioning from out-of-home care, also called care leavers, face more challenges in their lives, and engage in more risk behaviors, than their peers. However, no previous reviews have comprehensively addressed this issue to identify future research needs. The aim of this systematic review was to gather, assess, and synthesize previous studies concerning care leavers’ high-risk behavior. The search was conducted in six databases, with sixteen articles included in the final review. The selected research highlighted five forms of high-risk behavior: substance abuse, delinquency, sexual behavior, irresponsible use of money, and self-destructive behavior. The incidence of high-risk behavior among care leavers varied noticeably between the studies. Some of the studies reported significant connections between high-risk behavior and gender, race, reason(s) for placement, and the form and number of placements. The synthesized findings revealed a fragmented, limited view of care leavers’ high-risk behavior that highlighted substance abuse and delinquency. The development of adolescents, particularly care leavers, includes multiple factors that have either a conducive or protecting effect for high-risk behavior. Comprehensive research regarding care leavers’ high-risk behavior, including the associated factors, is needed to better support healthy development and success in transitioning to independent living.

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The association between treated psychiatric and neurodevelopmental disorders and out-of-home care among Finnish children born in 1997

Cited by 6 publications

References 37 publications

Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early

Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early

Serious mental health diagnoses in children on the Child Protection Register: a record linkage study

The Prevalence of High-Risk Behavior Among Adolescents in Aftercare Services and Transitioning from Out-of-home Care: A Systematic Review

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