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November 2003Vol. 4, No. 9Adolescents in Residential Care Programs Likely to Have Child Welfare Involvement

Adolescents who live in mental health residential care programs (RCPs) are often "system kids" who have been shuffled between the juvenile justice and child welfare systems, and separated from families and mainstream schools, according to a new report, Latest Findings in Children's Mental Health. These youth are among the most troubled in the mental health system. Approximately one-half of the adolescents in RCPs are victims of abuse or neglect, and about one-fifth experience post-traumatic stress.

When compared to children in all mental health settings, adolescents in RCPs are more likely to:

  • Experience problems with family (72 percent)
  • Experience problems at school (57 percent)
  • Suffer skill deficits (22 percent)

Many of these children also:

  • Are aggressive (66 percent)
  • Are involved in delinquent behavior (34 percent)
  • Have substance use problems (31 percent)

The report also provides demographic information about these youth. Of the youth in RCPs, more are boys (61 percent) than girls, and more are white (65 percent) than black (21 percent) or Hispanic (12 percent). Before entering care, youth in RCPs tend to live outside of traditional families in group homes (17 percent), juvenile detention centers (13 percent), and foster homes (8 percent). They are more often referred for treatment by social service agencies (37 percent) or courts (27 percent) than families (9 percent) or schools (3 percent).

Though their problems are usually complex, the report claims most of these children could be helped to return to their communities with timely, intensive care. Because many of the children in this study were involved with more than one system, the authors suggest policy makers and service providers consider the needs of children in all types of residential facilities--whether in the mental health, juvenile justice, or child welfare system--for services to help them rejoin their communities and lead productive lives.

Latest Findings in Children's Mental Health is a series of nonpartisan bulletins produced by a partnership between Rutgers University, the U.S. Department of Health and Human Services, and the Annie E. Casey Foundation. The data are based on the 1997 Client/Patient Sample Survey conducted by the U.S. Center for Mental Health Services, which is part of the Substance Abuse and Mental Health Services Administration. The findings are available online at

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For another perspective on institutional care, see "Review Finds Little Evidence to Support Institutional Care" in the May 2003 issue of Children's Bureau Express.