Mental Health Problems in Teens Investigated by U.S. Child Welfare Agencies

• Published in: Journal of adolescent health 2013-05, Vol.52 (5), p.634-640
• Main Authors: Heneghan, Amy, M.D, Stein, Ruth E.K., M.D, Hurlburt, Michael S., Ph.D, Zhang, Jinjin, M.Sc., M.A, Rolls-Reutz, Jennifer, M.P.H, Fisher, Emily, M.S.W, Landsverk, John, Ph.D, Horwitz, Sarah McCue, Ph.D
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult and adolescent clinical studies; Anxiety; Anxiety - epidemiology; Anxiety-Depression; Attention Deficit Disorder; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Biological and medical sciences; Child; Child Welfare; Child welfare investigation; Child Welfare Services; Depression (Psychology); Depression - epidemiology; Female; Foster care; Government Agencies; Health Problems; Health Surveys; Humans; Logistic Models; Male; Medical sciences; Mental health; Methodology (Data Collection); Miscellaneous; National Survey of Child and Adolescent Well-Being; Pediatrics; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Destructive Behavior; Substance Abuse; Substance-Related Disorders - epidemiology; Suicidal behaviour; Suicidal Ideation; Teens; United States - epidemiology
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2012.10.269

Abstract Purpose To examine prevalence and correlates of five mental health (MH) problems among 12–17.5 year olds investigated by child welfare. Methods Data from the National Survey on Child and Adolescent Well-being (NSCAW II) were analyzed to examine depression, anxiety, substance use/abuse, suicidality, and attention deficit hyperactivity disorder (ADHD) as reported by teens and their caregivers. In a sample of 815 adolescents, prevalence for each MH problem and correlates (e.g., age, placement location) were identified using bivariate and multivariable logistic analyses. Results After investigation for maltreatment, 42.7% of teens reported at least one MH problem, regardless of placement. Nine percent reported depression, 13.9% reported suicidality, 23% had substance use/abuse, 13.5% reported anxiety, and 18.6% had ADHD. Of 332 teens with any MH problem, 52.1% reported only one problem, 28.3% had two problems, and 19.6% had ≥ three problems. Teens with prior out-of-home placement had odds 2.29 times higher of reporting a MH problem and odds 2.12 times higher of reporting substance use/abuse. Males were significantly less likely to report depression. Older teens were more likely to report substance use/abuse. Black teens were significantly less likely to report suicidality and ADHD and almost half as likely to report anxiety. Teens with a chronic health condition and teens whose caregiver reported depression had more than twice the odds of reporting anxiety. Conclusions This study highlights high rates of MH problems in teens of all ages and placement locations and suggests that all teens involved with child welfare should be screened for MH problems, regardless of initial placement status.