Youth Strengths, Characteristics, and Mental Health Needs Post-Residential Treatment

Theoretical Background Approximately 144,000 children in the U.S. were removed from their families in 2013 due to maltreatment. Youth who are placed in residential treatment are at greater risk for poor outcomes post-discharge, including poor mental health, anti-social behaviors, criminal activities, and placement instability. Therefore, understanding factors that can improve their future outcomes is critical. We previously found that youth with a higher number of strengths at residential discharge had better mental health outcomes. Given this, we examined: 1) Which strength(s) is/are most highly associated with outcomes? and 2) What other youth characteristics (i.e., age, race/ethnicity, gender, post-residential living arrangement) are associated with outcomes? This is the first study that demonstrates the longitudinal impact of specific strengths on outcomes of residential treatment youth. Methods Data were collected from the Illinois Department of Children and Family Services (IDCFS) system. The sample includes 799 youth who were discharged from residential treatment between November 1, 2012 and August 31, 2015. Youth strengths and behavioral/emotional needs were measured via the Child and Adolescent Needs and Strengths (CANS) assessment. We conducted descriptive and negative binomial regression analyses. The dependent variable was the number of behavioral and emotional needs of youth post-residential discharge. Independent variables were individual strengths (e.g., coping skills, interpersonal) at residential discharge and the change of these strengths (improved, no change, worsened) between residential discharge and post-discharge. Analyses were stratified by age, gender, race, and post-residential living arrangement. Results Specific youth strengths at discharge were not associated with the number of behavioral/emotional needs post-treatment. However, worsening interpersonal and coping skills post-treatment were consequently associated with worse outcomes. Additionally, outcomes for girls were worse than for boys. Regardless of gender, youth placed in independent living arrangements, transitional living programs, and community integrated living arrangements post-residential discharge had better outcomes than youth placed at less restrictive levels of residential treatment. Discussion We previously found that the number of strengths at discharge affected outcomes while this study found that specific strengths at discharge did not. This indicates that, if youth face difficulties in their lives that any single strength cannot remedy, a combination of other strengths might compensate for the weakness. Additionally, our results suggest that youth need continuous support to maintain strengths, especially interpersonal and coping skills post-residential discharge to achieve better outcomes. Moreover, outcomes of girls and youth placed at less restrictive levels of residential treatment may be improved with extra support post-discharge.