Mental Health and Service Use of Older Adolescents as
They Leave Foster Care (a.k.a. VOYAGES)

Principal Investigator: Curtis McMillen, PhD.
Funder:                National Institute on Mental Health(NIMH - RO1 MH 61404-A1)
Timeframe:          Funded 4/01-3/06
Affiliation:          Center for Mental Health Services Research (CMHSR)
                             Comorbidity and Addictions Center

Project Staff:       Wendy Auslander, Ph.D., Investigator
                             Lionel Scott, Ph.D. Investigator
                             Edward Spitzanagel, Ph.D., Statistician
                             John Landsverk, Ph.D., Consultant
                             Bonnie Zima, M.D., Consultant
                             Michelle Munson, Doctoral Student
                             Marcia Ollie, Doctoral Student
                             Ramona Moore, B.A., R1
                             Trisha Wallis, B.A., R1
                             Jennifer Steffen, B.A., Project Coordinator
Participating Organizations: Missouri Division of Family Services-Foster Care
Project Contact:    Jennifer Steffen
                               (314) 935-7971
                               E-Mail: JSteffen@gwbmail.wustl.edu

Project Update as of 01/25/2008
Stage: Completed

Description
What happens to adolescents who are heavy mental health service users once they are no longer eligible for child service systems?  The mental health service system changes considerably as youth move from adolescence to adulthood.  There are fewer service options for adults, eligibility narrows, and affordability changes.  These service system changes occur at a time of considerable stress as young people often change residences, jobs and learn to live more independently during this same time period.  This is particularly true for youth leaving the foster care system. This study examines service use, mental disorder and functional early adult outcomes among older youth as they leave the foster care system.  Youth in the foster care system are an ideal study population in which to study this transition because they tend to be extremely heavy mental health service users, and experience a particularly sudden and harsh transition out of foster care.  This study examines 1) changes in service use among older teens as they leave the foster care system; 2) the correlates of service continuity and discontinuity as they leave the foster care system; 3) gateways to mental health service use for youth who have left the foster care system; and 4) the relationship between continued mental health service use and episodes of homelessness, unemployment, incarceration, psychiatric hospitalizations and traumatic events.

Three hundred eighty youth in the foster care system in Missouri will be interviewed in person just prior to their 17th birthday, tracked with informed quarterly telephone interviews for two years and then re-interviewed in person two years subsequent to the first interview.  The project will use the Diagnostic Interview Schedule to assess mental health and the Service Assessment for Children and Adolescents (SACA) to measure mental health service and psychotropic medication use.

The study addressed several needs for mental health services research identified in the Bridging Science and Service report by characterizing the service use of an important population (young people who have left the child service system), by examining what happened to service users over time, and determining who is providing mental health services for a vulnerable population.  This research helps public and private policymakers decide how to target their clinical resources, especially the federal dollars earmarked for preventing negative outcomes for youth leaving the foster care system.
 
 
  Publications

Jonson-Reid, M., Scott, L., McMillen, C. & Edmonds, T. (2007).  Dating Violence Among Emancipating Foster Youth. Children and Youth Services Review, 29(5), 557-571.

Scott, L.D., Munson, M.R., McMillen, J.C., Snowden, L.R.  (2007).  Predisposition to seek mental health care among Black males transitioning from foster care.  Children & Youth Services Review, 29, 870-882.

Vaughn, M.G., Ollie, M.T., McMillen, J.C., Scott, L., Munson, M. (2007).  Substance use and abuse among older youth in foster care.  Addictive Behaviors, 32, 1929-1935.

Wei, H., Jonson-Reid, M., & Tsao, H. (2007). Bullying and Victimization among Taiwanese 7th Graders: A Multi-method Assessment. School Psychology International, 28, 479-500.

Lee, B.R., Munson, M.R., Ware, N.C., Ollie, M.T., Scott, L.D., McMillen, J.C. (2006).  Experiences of and attitudes toward mental health services among older youths in foster care. Psychiatric Services, 57, 487-492.

Munson, M.R. (2006).  Non-kin natural mentors in the lives of older youth exiting foster care.  Dissertation Abstracts International Section A: Humanities and Social Sciences, 66, 3811.

Scott, L.D., Munson, M.R., McMillen, J.C., Ollie, M.T. (2006).  Religious Involvement and Its Association to Risk Behaviors among Older Youth in Foster Care.  The American Journal of Community Psychology, 38, 223-236.

McMillen, J.C., Zima, B.T., Scott, L.D., Auslander, W.F., Munson, M.R., Ollie, M.T. & Spitznagel, E.L.  (2005).  The Prevalence of Psychiatric Disorders Among Older Youths in the Foster Care System.  Journal of the American Academy of Child & Adolescent Psychiatry, 44, 88-95.

McMillen, J.C., Scott, L.D., Zima, B.T., Ollie, M.T., Munson, M.R. & Spitznagel, E.L.  (2004).  Use of Mental Health Services Among Older Youths in Foster Care.  Psychiatric Services, 55, 811-817.