Relationship between placement change during foster care and utilization of emergency mental health services

The present study aimed to confirm a relationship between placement change during a foster care episode and use of emergency mental health care, specifically crisis services and psychiatric hospitalization. Additionally, the study sought to differentiate between placement change's impact on emergency mental health care and emergency mental health care's impact on placement change. We examined placement change during the first 90 days in foster care among 19,351 Californian children and youth who started a new foster care episode between October 1998 and March 2001. Sample selection procedures differentiated between use of crisis and inpatient services prior to and following a placement change. Multivariate analysis revealed that while placement change is a significant predictor of subsequent psychiatric hospitalization, use of crisis services and psychiatric hospitalization are predictors of subsequent placement change. This bidirectional relationship suggests that children in foster care could benefit from both interventions that promote placement stability and improved mental health treatment following psychiatric crises. (C) 2011 Elsevier Ltd. All rights reserved.