Service support and quality of life for youth in foster care

Studies have consistently shown that children and youth in out-of-home care have substantially more health problems and greater health care needs than children and youth in general populations. Therefore, researchers and national decision makers agree that youth in foster care need extra service support. Hence, the question is whether youth in foster care receive services according to need and how the families experience the quality of the help received. Furthermore, we need more knowledge about positive outcomes for youth in foster care. The overall aim of the current thesis was to examine service use among foster families, foster parents’ experiences of quality of care, quality of life (QoL) among youth in foster care, and whether different characteristics were related to these outcomes. To reach this aim we utilized data from the prospective follow up study “Young in foster care” concerning foster families in Norway. Carers of children in foster care aged 6-12 years (n = 236) and child welfare caseworkers (n = 220) answered survey questionnaires in 2011/2012 (T1). Carers reported on the child's mental health, and caseworkers reported on pre-placement maltreatment and service contact. The follow-up study (T2) was conducted in 2016/2017 when the youths were aged 11-18 years. Youths (n = 303) and carers (n = 330) completed questionnaires regarding mental health and service use. In addition, youths reported their QoL, and foster parents reported their service experiences and perceived outcomes following contact with their main service provider. The foster families had a high service use, with 31.2% of carers reporting contact with child and adolescent mental health services and 61.2% with primary health care services during the last two years (Paper I). Furthermore, a substantial number of families reported contact with several service providers, and there was a positive association between youth mental health problems and service use. However, less than half of the youth with indications of mental health problems had received services from child and adolescent mental health services. Moreover, youth in kinship care had a lower use of the primary health care services compared to youth in nonkinship care, even when controlling for mental health problems. Foster parents reported overall positive service experiences, especially regarding the clinician’s communication and professional skills (Paper II). However, they were less satisfied with the information pro