Entry into Restrictive Care Settings: Placements of Last Resort?

Abstract

This study examines the relative risk of first entry into restrictive care settings (RCSs) such as group homes, residential treatment, or inpatient psychiatric care for a cohort of children (N = 570) in out-of-home care, and determines reasons and determinants related to the risk of entering such settings. Findings indicate the cumulative hazard of entering restrictive settings is highest during the first 2 to 3 months following entry into care. Behavior-related placement disruptions, behavior problems, and older age are the primary determinants of this finding. Although the majority of children entered an RCS for behavior-related reasons, close to one third entered an RCS because of reasons unrelated to behavior. Implications for service delivery to children in out-of-home care are discussed.