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Infants in Out-of-Home Care in NSW, Australia. Marilyn Chilvers Albert Zhou Economics, Statistics & Research Directorate NSW Department of Community Services ISCI Conference June 26-28 2007 Chicago, Illinois. marilyn.chilvers@community.nsw.gov.au. Introduction.
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Infants in Out-of-Home Care in NSW, Australia Marilyn Chilvers Albert Zhou Economics, Statistics & Research Directorate NSW Department of Community Services ISCI Conference June 26-28 2007 Chicago, Illinois marilyn.chilvers@community.nsw.gov.au
Introduction • Analysis focuses on vulnerable group of children (infants) admitted to Out-of-Home Care (OOHC) before their first birthday • Based on administrative data (from 1996 to 2006), collected by the NSW Department of Community Services (DoCS) • Examines: • Child protection history prior to care • Rate of entry to care • Duration of first spell / care period • Re-entry to care / moves in care
Overall trend • Infants have a high rate of child protection reports and a high rate of entry into OOHC. • Infants represent around 5% of the NSW 0-17 year population. • 9% of all children aged 0-17 years reported to DoCS in 2005/06 were infants. • 21% of all children aged 0-17 years admitted to care for the first time in 2005/06 were also infants.
Child protection experiences of infants • Prior to entry into OOHC - early adverse experiences with child protection risks. • The majority of infants in the system (73%) were reported by police and health professionals (both mandatory reporters). • The children come from vulnerable families where parents were in difficult relationships resulting in domestic violence, and/or with drug & alcohol, or mental health problems. • For infants reported, administrative data show: • 50% of reports with associated carer DV issues, • 23% with carer D&A, and • 21% with carer mental health problems. • Comparative percentages for all age groups are 37%, 15% and 12% respectively. • Case files show much higher rates.
Table 1: Selected reported issue for infants reported in 2004/05, by age at first report in 2004/05 Note: a The total refers to the total number of children reported in 2004/05. A child can have up to three issues reported in any one report. So the number of issues reported is greater than the number of children.
Children reported before birth and admitted into care • In 2004/05, 5.3% of infants reported to DoCS were admitted to care later within the same reporting period, twice the proportion for all children (2.7%). • The proportion of entry into care for children who were first reported before birth was even higher (9.2%). • Of the 131 children who were reported to DoCS before birth and subsequently admitted into care when born in 2004/05, 95% were reported more than once before birth and 86% three times or more. • Drug and/or alcohol abuse appears to be the most prevalent issue amongst mothers of these unborn children (47.3%).
Entry to OOHC (1) • Between 1996 and 2005, about one out of every five children entering OOHC for the first time was an infant. Figure 1: Age at first entry to care, by year of entry, percentage distribution 1996-2005
Entry to OOHC (2) • Infants (indigenous infants in particular) had a notably high entry rate per 10,000 population, compared to all children aged 0-17 years • 10-fold difference between indigenous and others in 2005 Table 2: Incidence rates of first entry to care, by age at first entry and year Rate per 10,000 children
Entry to OOHC (3) • Infants in regional areas were at higher risk of entering care than their metropolitan counterparts. Table 3: Incidence rates of first entry to care, by age at first entry and region in 2005, Rate per 10,000 children
Entry to OOHC (4) • Foster care was the most common type of placement for the first care period in which an infant was placed. Table 4: Placement type of first care period by age at entry, counts and percentage, 1996-2005 a ‘Others’ include supported accommodation, residential care and independent living.
Duration of stay in care (1) • On average, infants stayed in care twice as long as all children aged 0-17 years. • Median for infants = 5 months vs 2-3 months for others Table 5: Duration quartiles (in days) of first care period for infants by year of entry cohort
Duration of stay in care (2) • Indigenous infants stayed much longer in care than non-indigenous infants, and the median duration was extremely high for infants placed in relative and kinship care. Table 6: Median duration (in days) of first care period for infants by year of entry, indigenous status and selected placement type, 1996-2005
Duration of stay in care (3) • The results from a proportional hazards model show that infants experienced the longest duration for their first care period compared to children of other ages (while year of entry, gender, indigenous status and placement type were controlled). Table 7: Hazard rates of duration for age Notes: * p < 0.05. a <1 is the referent category.
Re-entry to OOHC • The majority of infants (75%) experienced only one care period (spell) in OOHC • Infants were less likely than other children to be discharged from care • If discharged, they were more likely to return • A significant group of children move in and out of care many times
Re-entry to OOHC (1) • A small proportion of children accounted for a disproportionate number of movements in and out of care (10% of children accounted for 40% of moves). Figure 2: Cumulative percentage of movements in and out of care and cumulative percentage of infants with at least one re-entry, 1996-2005
Re-entry to OOHC (2) • There is a negative relationship between the likelihood of re-entry to care and the duration of prior care period. Table 8: Out-of-Home Care Re-entry, by age at first entry and duration of prior care period, 1996-2005 cohorts, as at 31/08/2006
Re-entry to OOHC (3) • Indigenous infants had a higher re-entry rate than non-indigenous infants (57.9% re-enter vs 34.7%) Table 9: Re-entry of infants to OOHC, by indigenous status, 1996-2005 cohorts, as at 31/08/2006
Re-entry to OOHC (4) • Compared to those in foster care, infants who were first placed in relative and kinship care experienced a lower discharge level, a lower re-entry level given discharge and a lower overall re-entry level. Table 10: Re-entry of infants to OOHC, by selected placement type, 1996-2005 cohorts, as at 31/08/2006
Placements stability and moves in care (1) • There was a positive association between the number of placements in the first care period and the length of time a child spent in care. Figure 3: Number of placements by infants in first care period by length of first care period, 1996-2006
Placement stability and moves in care (2) • There was a negative relationship between the likelihood of re-entry to care and number of placements in the first care period. Figure 4: OOHC re-entry by number of placements in first care period, 1996-2006 cohorts, as at 31/08/2006
Conclusions and implications • Implications for the development of policy and early intervention programs – safety, stability & permanency. • High reporting rate and high rate of entry to OOHC by infants, and by indigenous infants in particular. • Tendency for infants to stay in care longer than other children, coupled with high entry rate to OOHC. • Focus resources and service delivery on young children to prevent escalation in the child welfare system and to improve outcomes • Opportunity for improvement through the longitudinal study of children and young people in OOHC.
Safety • Significant investment in ‘Brighter Futures’ Early Intervention Program. • Expansion of the Aboriginal Maternal and Infant Health Strategy across NSW with linkages to Brighter Futures to improve health and well-being for indigenous children. • Focus on infants affected by: domestic violence, parental substance abuse and mental ill health. • Co-operation, coordination and integration of community, police, health and family support services. • Pre-natal reporting policy addresses the issues of timely and appropriate interventions for at-risk infants and their families.
Placement stability and permanency planning • Effective permanency planning required for infants who enter care: More reliable assessment of restoration viability, development of realistic case plans to support restoration. • Permanency Planning project focused on 0-2 year age group • Research and funding of family preservation services • ‘Research to Practice’ and professional development for caseworkers