Title : Using linked administrative data to examine mental health outcomes among young people transitioning from out-of-home care in Australia.
Abstract:
Background: There is overwhelming evidence that young people who have been in out-of-home care (OHC) have poor long-term outcomes in many areas, including mental health. The study is invaluable in developing strategies and policies for young people with a history of trauma and abuse.
Aims: This study aimed to describe the most prevalent mental disorders of young people in Western Australia transitioning from OHC compared to young people with child protection contact (CP contact) and those in the general population with no child protection contact (No CP contact). In addition, factors associated with any mental health diagnosis were assessed for the whole population.
Methods: The study utilised linked health, child protection, education, and justice datasets from WA’s Social Investment Data Resource (SIDR). The SIDR is a population-level database of linked administrative records provided by various WA government agencies. The linked datasets were from a birth cohort of young people between 1993-2008. Three groups were identified within the birth cohort for the analysis: OHC (n = 6,526), CP Contact (n = 78,095), and No CP contact (n = 329,645). Descriptive statistics of each cohort are presented for the mental health variables. Univariate and multivariate Cox regression analyses were conducted, and hazard ratios (HR) were calculated for each cohort to investigate the risk of children and young people having mental health contact, accounting for different follow-up periods.
Results: Young people in OHC had a period prevalence of 32% of any mental health disorder compared to a period prevalence of 21% for those with CP contact and 7% with No CP Contact. The most prevalent mental health disorders among OHC were stress-related disorders (21%), psychological development (16%), self-harm (9%), and mood disorders (5%). Young people in OHC had more than three times increased risk (HR:3.95 [3.62–4.30]) of a mental health diagnosis compared to those with No CP, while those with a CP Contact had over two times increased risk (HR: 2.41 [2.30–2.53]) of a mental health diagnosis compared to those with No CP. A higher risk of mental health diagnosis was determined among females, Indigenous young people in remote areas, young people with higher levels of disadvantage, those with substance misuse disorders, maternal/ paternal mental health, and previous experience of housing instability.
Conclusion: Our findings were consistent with previous studies; however, our study determined the prevalence, variability, and risk factors of mental health disorders among young people transitioning from OHC. Further research is required to determine the mental health trajectories for these three population groups. Understanding the experiences of young people in these three heterogenous groups is crucial to inform policies and practices that support young people going through different developmental stages.
