Older Youth Leaving Foster Care: Old Dilemmas, New Insights, Fresh Ideas

1. Older Youth Leaving Foster Care: Old Dilemmas, New Insights, Fresh Ideas Curtis McMillen, Ph.D.Louise and Abraham Makofsky Lecture UMB SSW, April 13, 2007 The Center for Mental Health Services Research

2. Outline • 7 old dilemmas • 7 “new” insights • 7 “fresh” ideas

3. Some new data sources • VOYAGES Study in Missouri followed 404 youth 17-19 with 9 interviews • Midwest Foster Care Study (Illinois, Wisconsin, Iowa), interviewing 736 older youth at ages 17, 19 and 21 • Intersections Study in Missouri, qualitative interview study about mental health services in child welfare

4. Persistent Dilemma 1 THE BIG QUESTION: How to help older youth and young adults, with very difficult backgrounds, move productively forward with their lives as they leave the foster care system.

5. Persistent Dilemma 2 TROUBLING NUMBERS employment school completion early pregnancy

6. High school Grad at 19

7. HS Grad or GED at 19

8. In college at 19

9. Employed at 19

10. Past year earnings at 19

11. Females Given Birth by 19

12. Persistent Dilemma 3What services to offer? Most/all states offer: Life skills assessments Skills classes Youth advisory boards Teen conferences and retreats

13. Persistent Dilemma 3What services to offer? Many states offer: Tutoring Mentoring programs Payment for normalizing experiences Financial support for crises (aftercare) Room and board at TLPs (aftercare)

14. Persistent Dilemma 4The Dose of Service Skills classes 36 weeks (MO) 10 weeks (L.A.) Tutoring 30 hours at Sylvan (NC) 50 hours (L.A. C.C.) Youth empowerment Advisory board versus California Youth Connection

15. Biggest hurdle No evidence to date that any of these services work.

16. Persistent Dilemma 5Opportunity vs. structure

17. Persistent Dilemma 6Getting adults to stop being so controlling

18. Persistent Dilemma 7Getting states to do the right thing When older youth must leave care (18, 21) Participating in Medicaid option to cover older youth from foster care from 18-21.

19. Persistent Dilemmas • What services to offer • At what dose • To move problematic outcomes • How to get: • States to do the right thing • Adults to do the right thing • Adults to give up some control • Older youth to do the right things

20. New Insight 1: Where Youth Live Old assumptions Youth who leave care live independently Youth who stay in care stay in foster homes

21. Where Older Youth Live Who have left the system - percentages

22. Where Older Youth Live (who stayed in the the system - percentages)

23. New Insight 2: How and Why Older Youth Leave the Foster Care System

24. 58% exited by age 19

25. Percentage Who Reported This As Part of Their “How I Left Care” Story

26. How: Youth initiated • “I left my foster home and never came back.” • “I ran away from placement after placement so they released me when I was 18.”

27. How: D/C no notice • “They just sent me a letter telling me I was out of custody.” • “My caseworker quit, but before she left she got me out of custody, but no one ever told me, so I called and they told me I was out.”

28. How: System initiated • “I’m not really sure. It is just what they recommended when I went to court.” • “I went to court and it just happened.” • “It just happened. My case manager went to court and come home and said I had been [released].”

29. Wanting to Leave 90% of those who left the foster care system said that they wanted to leave the foster care system at the time of their exit.

30. Percentage Who Reported as Part of Their “Why I Left Care” Story

31. New Insight 3: Academic Preparation

32. Educational plans at age 17

33. Problems with Reading:Percentage with certain reading levels at age 17

34. New Insight 4: Mental Health Services Lifetime Service Use

35. Psychotropic Medication Use By When Youth Leave Foster Care

36. New Insight 5: Depression Anderson & Simonitch (1981) “Reactive depression appears to be a common reaction to emancipation” (p. 385) Barth (1990) 55 older youth from the Bay Area (CA) an “accidental sample” The average score on the CESD was above the clinical cutoff for depression –

37. 3 Classes of Depression Trajectories from Growth Mixture Modeling

38. New Insight 6: If you build it, they may not come.

39. New Insight 7: Staying in Care Helps

40. Basic Idea: To 21 for all 50 states • Care options for youth in the FCS to age 21 in all 50 states. • Federal dollars to pay for foster care boarding to age 21. • Full participation in Medicaid options

41. Idea 1: Making Life in Care Tolerable POLICY CHANGES • Clarified legal status for youth in system who are 18-21 years of age. • Fewer decision makers.

42. Idea 2: Making Life in Care Tolerable PROGRAMMATIC CHANGES • High expectations without ultimatums • Fewer contingencies • Second chances

43. Idea 3: Get Older Youth Out of Residential Treatment

44. Idea 4: Powerful Programs Programs that can change lives in many ways Young adult owned businesses auto detailing business

45. Idea 5: True Youth Empowerment Programs

46. Idea 6: Quality Outreach/Quality Assurance • Informed about options (emergency funds, tuition remission). • Can’t trust workers to inform youth. • Structured information shared at review hearings. • Basic QA

47. Idea 7: Fresh Look at Permanency • New look at birth families. • Child specific recruiting

48. Your ideas may be better • Lots of room for innovation. • Lots of potential for new research that can really make a difference.

49. Contact information Curtis McMillen Campus Box 1196 Washington University St. Louis MO 63130 314.935.7517 cmcmille@wustl.edu