Abstract
ObjectiveMultiple psycho-social risk factors are common in children and adolescents in youth welfare, especially in residential care. In this survey study we assessed the prevalence of behavioral, emotional symptoms and mental disorders in a German residential care population.Methods20 residential care institutions including 689 children and adolescents (age 4 – 18 years; mean 14.4; SD = 2.9) participated. A two-step design was performed. First, the children and adolescents and their residential caregivers answered a standard symptom checklist (CBCL/YSR). For those participants scoring more than one standard deviation above the mean of their German population reference group, a standardized clinical examination was performed to specify an ICD-10 diagnosis.ResultsThe study population reached high average scores in almost all scales and subscales of the CBCL and YSR (mean CBCL total score T = 64.3, SD = 9.7, Median = 66.0). The prevalence of mental disorders according to the diagnostic criteria of ICD-10 was 59.9%, with a predominance of externalizing and disruptive disorders. High rates of co-morbidity were observed.ConclusionChildren and adolescents in youth welfare and residential care are a neglected high risk population. Providing adequate psychiatric diagnosis and multimodal treatment for this group is necessary.
Highlights
Multiple risk factors such as poverty, broken homes, neglect, sexual and physical abuse, discontinuous relationships, and genetic factors have an impact on the mental health of children and adolescents in residential or foster care [1,2,3,4,5]
Screening questionnaires The analysis of the Child Behavior Checklist (CBCL)-scores of 132 children without informed consent showed that they did not differ in their global scores from those 557 participating with informed consent
In accordance with the results of survey studies of comparable populations from Great Britain or the United States [24,25,26,1], our study demonstrates a high amount of severely mentally disturbed children and adolescents. 59.9% of all children and adolescents fulfilled the criteria for an ICD-10 diag
Summary
Multiple risk factors such as poverty, broken homes, neglect, sexual and physical abuse, discontinuous relationships, and genetic factors have an impact on the mental health of children and adolescents in residential or foster care [1,2,3,4,5]. These children and adolescents have a very high risk for the development of a chronic mental disorder with subsequent impairment of their psychosocial functioning, for example school failure, unemployment or a criminal career [6,7]. Survey studies on children in group homes are scarce, and the results on the prevalence of mental disorders in this population differ within a wide range
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