國內接受機構安置少年憂鬱情緒之探究：問題陳顯與解釋因素

Prevalence and Factors Associated with Depressive Mood of Adolescents in Residential Group Care

研究目的：本文試圖瞭解接受機構安置少年的憂鬱情緒狀況，並檢視性別、年齡、自尊心等因素及進入安置機構後的相關經驗對其憂鬱情緒的影響。研究方法：本研究對象為國內接受機構安置至少一個月之12至18歲的少年，共有21家機構同意安置少年參與本研究，以集體填寫問卷方式蒐集資料，共548位符合條件之少年填寫問卷。研究結果：本研究發現：受訪樣本中屬輕度憂鬱者佔12.9%，中度憂鬱者佔16.8%、重度憂鬱則佔了15.7%。多元迴歸分析後發現：女性、年齡越大、自尊心越低、對與家人會面看法越負面、認為工作人員支持與同儕支持越低，以及對機構規範的感受越負向者，其憂鬱情緒的得分越高。研究結論：本研究資料顯示：不少機構安置少年為憂鬱之高危險群，而解釋其憂鬱情緒的因素中又以機構規範的解釋力最強，因此建議機構工作人員應評估並關心安置少年的心理健康，努力建構支持性的機構環境，以求更有效地降低安置少年的憂鬱情緒。

Purpose: Children and youth are growing up in a variety of family constellations today. Foster care provides a substitution for children and youth whose parents are unable to adequately care for them. For youth in Taiwan, those who need foster care are not just maltreated by their parents, but often have behavioral problems. As a result, they usually are not welcomed by foster families; institutional care becomes a major form of their placement. Growing up in dysfunctional families tends to have negative impact for the child, while the placement experiences may devastate the situation. Therefore, it is important to examine their mental health and factors associated with their mental health problems. This study attempts to examine the prevalence of depressive mood among adolescents in residential care, and to study institutional related factors associated with their depressive mood. The study hypothesized that after controlling for gender, age, and self-esteem, meetings with family members while in care, feelings toward such meetings, support received from workers and peers, and feelings toward institutional regulations were associated with their depressive mood. Also, worker and peer support could moderate the effect of negative feelings toward agency regulations on depressive mood. Methods: Adolescents aged 12 to 18 who were placed in residential institutions for at least one month were eligible to participate in the study. Consents were first sent to administrators to obtain institutional approval, 21 out of 76 institutions gave the research team permission to approach the adolescents, and 548 adolescents (out of 641 eligible ones, with an 85.5% participation rate) agreed to participate in the study. There were 67.1% females and 32.9% males, with an average age of 15.7. Their length of stay ranged from one month to 18 years, with an average of 2 years and four months. Data were collected via questionnaires administered in group settings. Research hypotheses were tested by multiple regression models. Results: According to assessment using the Beck Depression Inventory, 54.6% participants did not suffer from depression, 12.9% were considered to be minor, 16.8% were moderate, and 15.7% were considered to be serious. Gender and age differences were found, female and older adolescents were suffered more depressive mood. Those who had lower self-esteem were also had more depressive mood. Multiple regression analyses indicated that after controlling for gender, age, and selfesteem, received less support from workers and peers, perceived more negatively toward family contact and institutional regulations were associated with higher levels of depressive mood. The moderating effects of worker and peer support on perception of institutional regulations were not supported by the data. Conclusions: The results indicated that about one third of adolescents in residential group care were suffered from median or high levels of depressive mood. After controlling for age, gender, and self-esteem, support received from workers and peers, feelings toward family contact while in care, and feelings toward institutional regulations were important factors associated with their depressive mood. The study suggests that related professionals should assess these adolescents’ psychological health, and respond to their mental health needs promptly. Also, we need to develop strategies to increase their self-esteem, especially females. Since peer support plays an important role, we have to reconsider the role of peers in influencing adolescents’ mental health. Most importantly, workers should provide supportive institutional environments and reconsider the reasonableness of institutional regulations, so the well-beings of these vulnerable youths are warranted.