238983 Lost in Transition: Illicit Substance Use and Services Receipt Among At-Risk Youth in the Child Welfare System

Monday, October 31, 2011

Cecilia Casanueva, PhD , Children and Families Program, RTI International, Research Triangle Park, NC
Leyla Stambaugh, PhD , Children and Families Program, RTI International, Raleigh, NC
Matthew Urato, MS , Sphere, RTI International, Research Triangle Park, NC
Jenifer Goldman Fraser, PhD, MPH , Children and Families Program, RTI International, Harvard, MA
Jason Williams, PhD , Behavioral Health Research Division, RTI International, Research Triangle Park, NC
This study examined the use of mental health and substance abuse services among adolescents followed from 1999 to 2007 as part of the National Survey of Child and Adolescent Well-Being (NSCAW). NSCAW is a nationally representative, longitudinal study of the well-being of children who have had contact with the child welfare system (CWS). 1,004 adolescents age 11-15 years at baseline were followed for 5-7 years, over five waves of data collection. After the investigation for maltreatment (baseline), 69.1% of youths using illicit substances received mental health and/or substance abuse outpatient s services. By the last follow-up, during the transition to adulthood, only 21.5% of young adults using illicit substances received outpatient specialty services. Youth who used illicit substances were more likely to receive outpatient and inpatient specialty services than non-users at the time of contact with the CWS (mostly baseline), but this difference faded over the follow-up period. By 5-7 years follow-up, there was no significant difference in specialty services receipt for illicit substances users versus non-users. Predictors of outpatient service use were having Medicaid, mental health needs, and having recently seen a school counselor or primary care physician. Among illicit substance users transitioning to adulthood, African American youths were less likely to receive outpatient services than White youths. These findings reveal a need for more attention to illicit substances use among youth in the CWS, better cross agency integration, and special attention to the needs of transition-age youth to better connect them with services.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Describe levels of illicit substance use and specialty services receipt among adolescents in the child welfare system (CWS) based on nationally representative data collected from 1999 to 2007. Identify prevalence estimates across time for a variety of illicit substance use (marihuana, inhalants, hard drugs, prescriptions) among adolescents reported for maltreatment to child protective services. Compare receipt of specialty outpatient and inpatient services by type of illicit substance use from adolescence to the transition to young adulthood. Examine predictors of specialty outpatient and inpatient services across time among adolescents in the child welfare system.

Keywords: Adolescents, Drug Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have presented before at APHA and multiple other conferences on issues related to research on child maltreatment. My work at RTI is as one the lead analysts for NSCAW, I have worked with the NSCAW data set doing analysis since 2003.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.