Mental Health of Children and Adolescents in Foster Care Residential Institutions in Northern Taiwan

Mental Health of Children and Adolescents in Foster Care Residential Institutions in Northern Taiwan

Objectives: Studies reposted that children and adolescents entering foster care systems are at risk of mental health conditions. In this study, we intended to describe the prevalence of mental illnesses as well as the characteristics of emotional and behavioral problems of children and adolescents in foster care residential institutions in Northern Taiwan. Methods: From July 2011 to January 2014, we recruited 97 children and adolescents from four foster care residential institutions due to child maltreatment or loss of dependency. They were assigned through the social welfare bureau (three group homes, n = 76) or the judiciary department due to delinquent or conduct behaviors (one youth home, n = 21). Psychiatric illnesses were diagnosed through semi-structured interviews using the Kiddie Schedule for Affective Disorder and Schizophrenia, Epidemiological Version. Emotional and behavioral problems were assessed by main caregivers in foster care residential institutions and the youths themselves. Results: We found higher rates of lifetime (54.6% in total, 44.7% in group home, and 90.5% in youth home) and current (28.9% in total, 31.6% in group home, and 19.0% in youth home) for any psychiatric disorders among the children and adolescents in the foster care residential institutions compared to those in the general population in Taiwan (31.6% in lifetime and 25% current). The rates of lifetime psychiatric diagnoses in total entire cohort, group home, and youth home were as follows: attention deficit/hyperactivity disorder (15.5%, 15.8%, and 14.3%), oppositional defiant disorder (13.4%, 2.6%, and 52.4%), conduct disorder (22.7%, 6.6%, and 81.0%), posttraumatic stress disorder (4.1%, 5.3%, and 0%), adjustment disorder (11.3%, 9.2%, and 19.0%), and nicotine use disorder (12.4%, 2.6%, and 47.6%), respectively. Self-reported depression rates were 9.0% among youths aged between 8 and 16 years, and 17.2% among those aged between 8 and 12 years. Conclusion: The results underscore the importance of receiving a comprehensive mental health assessment in the beginning and periodically for those children and adolescents in foster care residential institutions for them to receive appropriate mental health care.