The Human Face of Vulnerability - youth say Human … · The Pathways to Resilience Project The Human Face of Vulnerability Technical Report 3 Jackie Sanders, Robyn Munford, Linda

The Pathways to Resilience Project

The Human Face of Vulnerability

Technical Report 3

Jackie Sanders, Robyn Munford, Linda Liebenberg, Michael Ungar, Thewaporn Thimarsarn-Anwar, William Johnston,

Youthline New Zealand, Anne-Marie Osborne, Kimberley Dewhurst, Mark Henaghan, Jak Aberdein, Katie Stevens, Yvonne Urry,

Brigit Mirfin-Veitch, Kelly Tikao.

2013

This is a preliminary working paper from the Pathways to Resilience Research Programme funded by the Ministry of Business,

Innovation and Employment

The Pathways to Resilience Research Project (New Zealand):Whāia to huanui kia toa

1 PATHWAYS TO YOUTH RESILIENCE • MASSEY UNIVERSITY • DALHOUSIE UNIVERSITY THE HUMAN FACE

Table of Contents

ACKNOWLEDGEMENTS ............................................................................ 2

INTRODUCTION ........................................................................................ 3

OVERVIEW OF THE STUDY POPULATIONS ............................................... 5

1. DEMOGRAPHIC CHARACTERISTICS ..................................................................... 7

2. LIVING ARRANGEMENTS, HOUSEHOLD SIZE, COMPOSITION, WHĀNAU/FAMILY SIZE

...................................................................................................................................8

3. SOCIAL AND EMOTIONAL RESOURCES ................................................................ 10

MOTHER AND FATHER FIGURES ...................................................................................10

INTIMATE RELATIONSHIPS AND PARENTHOOD ..........................................................13

4. EDUCATION – BELONGING, ACHIEVEMENT AND EXPERIENCES ........................ 13

5. RISKS AND RESILIENCE ......................................................................................... 18

6. SERVICE UTILISATION PATTERNS ......................................................................... 20

EDUCATION SERVICES ..................................................................................................20

CHILD WELFARE SERVICES ...........................................................................................21

JUVENILE JUSTICE SERVICES ........................................................................................22

MENTAL HEALTH SERVICES ..........................................................................................23

HEALTH SERVICES .........................................................................................................24

THE QUALITY OF SERVICE EXPERIENCE .......................................................................25

CONCLUSIONS .......................................................................................... 34

REFERENCES ............................................................................................. 38


ACKNOWLEDGEMENTS We would like to thank all the young people who have participated in this study and taken the time to share their experiences with us. They have been generous in their time and in the effort they have put into answering a complex questionnaire. Many of the youth who participated in this research also nominated an adult who knew a lot about them (PMK) who we could interview. We would like to thank all the PMK who generously gave their time to this study.

The following individuals and organisations have provided intensive support to us at various points in the study. Professor Michael Ungar and Dr Linda Liebenberg at the Resilience Research Centre based at Dalhousie University in Halifax Canada provided the methodologies and research materials and supported us in applying their ground-breaking Canadian study in New Zealand. They have provided enormous amounts of ongoing support to the project. Kāpiti Youth Support (KYS) and particularly Raechel the Manager and Briar the social worker, Presbyterian Support Upper South Island, and in particular Sue Quinn, the Highbury Whānau Centre and particularly Michelle Swain and Anjali Butler, Pete Butler and his team at START, Youth Transitions in Palmerston North. Special thanks to Barbara, Vicki and the team at Otago Youth Wellness Trust who provided assistance and support to the Dunedin research team for the duration of the study. The Ministry of Social Development, and particularly Child Youth and Family, The Families Commission, as well as the Department of Corrections also provided ongoing support at various stages in the research which would like to acknowledge. We also acknowledge the contribution of the Victoria University Research Trust and its staff; The Donald Beasley Institute; Youthline Auckland and Otago University. Finally, we would like to thank and acknowledge the Ministry of Business Innovation and Employment for funding this research.


INTRODUCTION

This is the third in a series of technical reports that outline research procedures and present the results from the New Zealand Pathways to Resilience Research Programme (see Report 2 for a methodological overview of the study). The research was funded by the Ministry of Science and Innovation (now the Ministry of Business, Innovation and Employment) between 2008 and 20141. This report discusses the characteristics of a group of youth who completed a survey administered to 1494 youth during 2009 and 2010. Two populations of youth were surveyed: a group of multiple service users (MSU) recruited from organisations that provide formal support services to youth and a comparison group (CG) of youth who were recruited from schools, community programmes and organisations located in the communities from which the MSU youth were drawn. To be eligible to be included in the MSU category youth needed to have used two or more services within six months prior to completion of the survey. The services included: juvenile justice, child welfare, alternative or special education services, and mental health services. These services could be provided by either a statutory organisation or an NGO providing services under contract to government.

The research programme was approved by the Massey University Human Ethics Committee prior to fieldwork commencing (MUHEC approval 08/33). In addition to this University Ethical approval, ethical approval was secured from any organisation that supported the research in terms of either facilitating access to assist with recruitment or providing access to information such as case file data (see file reviews technical reports). This included Research Access

1 We gratefully thank the Ministry of Business, Innovation and Employment (MBIE) for their ongoing support of our work.


Committee (RAC) approval from the Ministry of Social Development, approval from the Department of Corrections, District Health Boards, as well as approvals from schools and a wide range of NGO organisations that supported the research. The research has several distinct components:

• A survey of MSU and CG youth aged between 12 and 17 years; • A survey of adults nominated by MSU youth as knowing the

most about them (PMK or person most knowledgeable); • Qualitative interviews with MSU youth and the PMK; • Reviews of case files held by a range of organisations that

worked with a subsample of MSU youth.

Taken together these four components constitute the Pathways to Resilience Study. The study builds upon and significantly extends the Canadian Pathways to Resilience study (http://resilienceproject.org/). The goal of the New Zealand study is to identify factors in service provision and youth ecologies that are related to functional outcomes (functional outcomes include; the ability to complete education, capacity to sustain positive peer group relations and to engage in pro-social behaviour for MSU youth). The current report considers the characteristics of the youth involved in the study. It thus focuses on data generated through the completion of the Pathways to Resilience Youth Measure (PRYM) survey instrument; a compilation of scales used in this study to assess risk, resilience, service use patterns and aspects of youth social ecologies.

Youth were recruited into the study from the greater Auckland metropolitan area, Palmerston North, rural Horowhenua and Kāpiti, the greater Wellington metropolitan area, Christchurch and Dunedin areas during 2009 and 2010. The population is composed of two different groups:

1. A group of multiple service using youth (MSU)

http://resilienceproject.org/


– concurrently using two or more services; 2. A comparison group (CG) of youth who were using one or no services.

Of the 1494 youth interviewed, twelve from the CG and four from the MSU were excluded from the dataset because of incomplete data relating to responses on key variables of interest. Analysis indicated that this data was missing completely at random. The resultant data set of 1477 youth forms the base data set for this study. In total then, data from 605 MSU youth and 872 CG is included in this research. Comparison Group youth were matched to MSU youth based on age, gender and ethnicity. This generated a sample of 1210 youth who form the focus for this discussion - 605 MSU youth and 605 Matched Comparison Group youth (MCG). In the following discussion, these 1210 youth are used except where otherwise identified.

Three service delivery systems that most influence access to social and psychological determinants of young people’s well-being2 in six locations3 provided the research team with access to at-risk youth for this research. Young people were identified in each of these commu-nities by the organisations providing services to these young people4.

OVERVIEW OF THE STUDY POPULATIONS

As will be seen from the discussion below, on almost every measure

2 The three systems are the child welfare system, the juvenile justice system and the education system, particularly services for youth who have disengaged from or find it difficult to participate in mainstream classrooms.3 Greater Auckland, Manawatu, Kāpiti/Horowhenua, Greater Wellington, Christchurch, Otago.4 The research team gratefully thank and acknowledge the ongoing support for this research of a wide range of organisations, listed in the Acknowledgement section and also noted on the website www.youthsay.co.nz.

www.youthsay.co.nz


in the PRYM survey, the MSU youth differed in a statistically significant way from the MCG youth5. At times these differences were relatively small, at other times they were very large. The general pattern of difference between MSU and MCG youth was such that the MCG tended to report more moderate stresses and the presence of more protective factors while the MSU youth were more likely to report higher levels of stress, more disadvantage and fewer protective factors overall. Taken as a whole these descriptive statistics suggest a consistent pattern of disadvantage and stress confronted by MSU youth that covered all key domains of their lives.

The remainder of this paper is divided into six sections. The first provides a general overview of the demographic characteristics of the population and details the matching process used to generate two approximately similar populations for analysis purposes; one that includes the multi-service using youth (MSU) who are a particular focus of this research, the other the matched comparison group (MCG). Living arrangements are the focus for the second section and this is followed by consideration of the social and emotional resources available to the youth in the study (the nature of relationships with parent figures and intimate relationships as well as youth’s own experience of parenthood). Attention then turns to experiences in the education system and here consideration is given to engagement in education, achievement of educational credentials as well as personal and emotional experiences in school settings. The following section considers the risk and resilience profiles of MCG and the MSU youth. Finally, section six explores the experiences of youth with social and health services.

5 A significance level of .05 was used for all statistical tests reported in this document.


1 Demographic characteristics

As noted above in total 1494 youth participated in this research by completing an interview. Seventeen youth (1%) were excluded from the dataset after careful examination of responses to key variables of interest because 10% or more of this data was missing. Analysis indicated that data was missing completely at random. The resultant data set of 1477 youth form the base data set for this study. The demographic characteristics of the total sample are provided in Table 1.

Table 1 Demographic characteristics of total sample

Comparison Group youth were matched to the MSU youth based on age, gender and prioritised ethnicity. This process generated 605 matched pairs of MSU and CG youth (this subgroup of CG youth is


labelled MCG or matched comparison group) and this set of 605 pairs of MSU and MCG youth are used for analyses where matching on demographic characteristics is required. The characteristics of the MSU and the MCG appear below:

Table 2 Demographic Characteristics of Multiple service user (MSU) and Matched Comparison Group (MCG) Youth

2 Living arrangements, household size, composition, whānau/ family size

The living arrangements for the MSU and MCG were significantly different (Fisher’s exact test: p < .001; χ2(11, n=1210)=266.08, p < .001). MSU youth lived in a diverse range of situations, while MCG youth tended to be concentrated in households with either both birth


parents or one birth parent (with or without a step parent). Just over half of the respondents from the MCG were living with both birth parents whereas this was the case for only 17% of the MSU participants. It is also of note that MSU youth who were not living with both parents were less likely to spend equal time with the non-custodial parent χ2(1, n = 25) =11.52, p < .001 and more likely to have no contact with the non-resident parent χ2(1, n = 182) =15.04, p < .001 than was the case for the MCG. While 30% of high service using youth had living arrangements that did not contain whānau/family members as caregivers, this was the case for only 4% of MCG youth χ2(1, n = 209)=232.88, p < .001.

Higher percentages of MSU youth were living in either very small (1-2 people =9%, χ2(1, n = 76) = 28.66, p < .001) or very large (7+ people= 23%, χ2(1, n = 239) = 13.39, p < .001) households. Related to this MSU youth were more likely to report fewer numbers of bedrooms (1-2 bedrooms = 12%, χ2(1, n = 119) = 9.68, p = .002) or very many bedrooms (7+bedrooms = 5%, χ2(1, n = 39) = 13.13, p < .001). In the case of 7+ bedrooms many of these youth were living in residential facilities or boarding houses. MSU youth also reported more siblings (6+siblings = 33%, χ2(1, n = 323) = 35.76, p < .001) than did MCG youth (0-1 siblings = 22%, χ2(1, n = 201) = 48.76 p < .001). With the exception of those living in residential facilities, MSU youth were more likely to be living in overcrowded circumstances. Significantly more MSU youth had lived on the streets for 3 or more nights in a row in the last year than was the case for their MCG peers χ2(1, n = 177) = 179.39 p < .001.

Other studies (AHRG 2002, 2003; Clark et al., 2010) have examined the characteristics of youth in alternative education programmes and the findings from these research programmes offer a point of comparison with the current study. In general, the students in the alternative education studies reported living arrangements that were


between the MCG and MSU youth in the current study. For instance, while around half of the youth in the alternative education studies reported living with both parents (AHRG 2002, p 17; AHRG 2003, p. 11; Clark et al., 2010, p. 13), this was the case for around 40% of MSU youth. Approximately one third of MSU youth (n = 183; 30%) reported living with people other than whānau/family while the al-ternative education studies reported figures ranging between approximately 5% (AHRG 2002, p. 17; AHRG, 2003, p. 11) and 10% (AHRG, 2003, p. 13; Clark et al., 2010, p 13). Living arrangements that did not involve whānau/family for the alternative education studies were therefore more similar to those of the MCG youth in the current study which were 4%. In the current study 27% of youth had reported living rough for three or more nights in a row in the last year. While the alternative education reports do not identify a similar statistic, their 2010 report does identify that approximately half of the young people reported running away from home (Clark, 2010, p.13).

3 Social and emotional resources

Mother and father figuresYouth were asked to identify from a list of people (e.g. biological parent, grandparent, foster parent) who in their life best represented a mother figure and a father figure. This was the person who made day to day decisions about or with them. They were also asked to rate on a four point scale the amount of affection they received from these two people, and, on a three point scale, the closeness of this relationship.

Both MCG and MSU youth chose their biological mother (73% of MSU; 89% MCG) or biological father (56% MSU; 76% MCG) most often as their mother/father figure but the MCG youth were significantly more likely than MSU to identify their biological parent as playing each of these roles in their lives (mother figure: χ2(1, n =


977) = 19.66, p < .001; father figure: χ2(1, n = 797) = 37.35, p < .001). The next most frequently identified parent figure for both MCG and MSU youth was a relative (MSU mother figure: 13%, father figure: 13%; MCG mother figure: 6%, father figure: 7%). Almost twice as many MSU youth identified a relative as a parent figure as did MCG youth and these differences were significant (mother figure χ2(1, n = 112) = 33.02, p < .001; father figure χ2(1, n = 122) = 20.08, p < .001). While more youth from both groups nominated a step-parent as a fa-ther figure than as a mother figure (MSU mother figure: 2%, MCG 2%; MSU father figure: 9%, MCG 7%) the differences in nomination rates of mother and father figures between the MSU and MCG youth was not significant (mother figure: χ2(1, n = 26) = 0.08, p = .782; father figure: χ2(1, n = 98) = 1.65 p = .199).

MSU youth also nominated foster parents and other types of non-familial adults (including social workers) as acting in a parent role in their lives with significantly greater frequency than was the case for MCG youth. While the numbers were small, MSU youth also reported that there was no-one acting in this role in their lives with significantly higher frequency than was the case for MCG youth (mother figure: χ2(1, n = 37) = 26.16, p < .001; father figure: χ2(1, n = 131) = 44.52, p < .001).

As noted above, youth were asked to provide two different assessments of the quality of the relationship they had with their nominated mother and father figures: the amount of affection they received from these key adult figures, and how close they felt to them. In terms of the amount of affection, youth were given four options: a great deal, some, very little and none at all. The amount of affection received from mother and father figures differed depending on whether youth were in the MSU group or in the MCG on all options except receiving some affection from their father figure. Leaving aside the result related to receiving some affection from the


father figure, the general pattern of differences was such that MSU youth reported receiving significantly less affection from both parent figures than did MCG youth. This can be appreciated by considering the extreme ends of each distribution; MCG youth were significantly more likely (mother figure: χ2(1, n = 808) = 20.50, p < .001; father figure: χ2(1, n = 597) = 48.24, p < .001) to report receiving a great deal of affection from both parent figures, while MSU youth were significantly more likely (mother figure: χ2(1, n = 62) = 35.13, p < .001; father figure: χ2(1, n = 187) = 61.78, p < .001) to report receiving no affection from parent figures.

Turning to the question of closeness to parent figures a somewhat different picture emerges; youth were given the options of very close, somewhat close or not close at all. Similar proportions of youth from both groups reported feeling very close to their mother figure, χ2(1, n = 744) = 3.29, p = .069, and feeling somewhat close to their mother figures χ2(1, n = 359) = .35, p = .550. The picture changed however when youth reported on not feeling close at all to their mother figures. Here, significantly more MSU youth reported not feeling close to their mother figures, χ2(1, n = 107) = 36.19, p < .001. In terms of attachment to father figures, significantly more MCG youth reported feeling very close to their father figure than was the case for MSU youth χ2(1, n = 551) = 8.36, p = .004. Significantly more MSU youth reported feeling not close at all to their father figures χ2(1, n = 282) = 48.86, p < .001, than was the case for MCG youth. In the middle, an approximately similar proportion of youth from both groups reported feeling somewhat close to their father figures χ2(1, n = 377) = 6.13, p = .013.

In 2010 similar proportions of youth in the alternative education study reported that their biological parents were acting as their parent figure (Clark et al., 2010 p.14) as did MSU youth in the current study, and similar numbers (p.14) reported that non-familial adults


were acting in a parent role as did the MSU youth (13%). The proportion of MSU youth who felt close to their mother (58%) and father (41%) figures were slightly lower than Clark and colleagues (2010, p. 15) reported (64% overall).

Intimate relationships and parenthoodAlongside a general pattern of less affection and less closeness to the key caregiving figures in the lives of MSU youth was a greater tendency to create intense attachments elsewhere. MSU youth reported higher rates of intimate relationships χ2(1, n = 489) = 26.18, p < .001 than did MCG youth and, even though the numbers were quite small for both groups, MSU youth also reported a higher rate of parenthood χ2(1, n = 22) = 15.36, p < .001. In this connection, it is also noteworthy that while all of the MCG youth who were parents (n=4) were caring for their child at the time of the interview, only half of the MSU youth were doing the same (9 out of 18).

The numbers of youth who were parents at the time of the PRYM interview is substantially lower than for the youth in the 2010 alternative education report (3% in the current study compared to 7%)(Clark et al., 2010, p.28). Interestingly, while a third of youth in the 2010 alternative education cohort reported using contraception inconsistently (Clark et al., 2010, p. 28), over half (58%) of the youth in the current study reported this.

4 Education – belonging, achievement and experiences

Significantly more youth from the MCG (92%) were enrolled in an educational programme at the time of completing the questionnaire χ2(1, n = 1029) = 13.07, p < .001. It should be noted that youth did not have to be attending a mainstream school to answer yes to this ques-tion (for example, they could be attending an alternative


education programme or enrolled at Te Aho o Te Kura Pounamu (The Correspondence School) and completing their studies at home). There were also significant differences between the groups in terms of the number of schools they had attended over their lifetimes with MSU attending significantly more schools in total than MCG youth. For instance, a greater proportion of MCG youth (88%) reported attending 5 or fewer schools χ2(1, n = 925) = 43.60, p < .001 while significantly more MSU (16%) youth had attended 8 or more schools χ2(1, n = 119) = 77.71, p < .001.

If youth had stopped attending mainstream school at the time of the interview, they were asked to identify the last full year they had completed at school. If they were still attending a mainstream school, they were asked to identify their current year of enrolment. Youth from the MSU and MCG gave quite different responses to these two questions. For instance, youth from the MSU (80%) were more likely to not be attending a mainstream school at the time of the interview χ2(1, n = 584) = 502.36, p < .001. Linked to this, MCG youth were more likely to be enrolled in or have completed the higher year levels of school than was the case for MSU youth. Further, MCG (97%) youth were more likely than MSU (87%) to be enrolled in school-based qualifications such as NCEA χ2(1, n = 636) = 44.53, p < .0016, while MSU youth were more likely to be enrolled in other types of courses for credentials achieved through avenues such as national certificates and qualifications provided by non-school based educational providers7 χ2(1, n = 52) = 28.04, p < .001. A majority of MSU youth (64%) had stopped attending school prior to year 11 (5th form). Most MCG youth (80%) who were eligible (ie; those who were over 16 years of age) had achieved 8 literacy and 8 numeracy credits at Level 1 of NCEA, while under half (47%) of the eligible MSU youth

6 These figures relate only to those youth from the MSU and the MCG who were older than 15 years and thus eligible to be enrolled for NCEA or related qualifications.7 For example, SPEC, AZDAN, Gateway and Land-based Training.


had achieved this benchmark school qualification. This difference in achievement rates was significant χ2(1, n = 353) = 78.88, p < .001. At the time of the study this was the minimum requirement for progressing through the national NCEA qualification framework; it thus represented the entry point into the national qualifications system. Youth from the MCG also held qualifications at higher levels on average than was the case for MSU youth.

Youth were asked how far they hoped to go in their education. The MSU were more likely to hope to achieve NCEA at Level 1 or 2 χ2(1, n = 140) = 37.16, p < .001, and in terms of post-secondary credentials to achieve certificates and diplomas or trade and technical qualifications, while MCG youth were more likely to hope to finish NCEA Level 3 χ2(1, n = 167) = 12.26, p < .001 and obtain a university degree χ2(1, n = 345) = 126.98, p < .001. Given the profile of the MSU youth and the issues they often confronted in staying engaged in education, it is particularly notable that 82% aspired to achieve educational credentials. In terms of service interventions with these youth, concrete and relevant assistance with staying engaged in education and gaining credentials would appear to be an important area for focus.

The questionnaire also explored the value youth attached to education, the quality of their educational experiences and the sense of belonging they felt to the last mainstream school they had attended (or to their current school if they were still attending a mainstream school). There were significant differences between the two groups on each of these questions. Youth from the MCG were more likely to report feelings of belonging in relation to school χ2(1, n = 638) = 107.29, p < .001, to place a higher importance on education χ2(1, n = 877) = 56.93, p < .001 and to report that teachers intervened


to stop bullying and fighting χ2(1, n = 805) = 10.18, p = .0018.

Youth were also asked for a global assessment of the nature of the last mainstream school they attended (or the school they were currently attending, if still at school). Overall, the two groups were different in their responses to this question. The MCG (71%) youth were more likely to report positively about their school than were MSU (34%) youth and these differences were statistically significant χ2(1, n = 638) = 158.70, p < .0019. Taken overall, these patterns suggest that the quality of the mainstream school experience, the sense of belonging in education and the resultant value youth placed upon education was markedly different for MSU youth than was the case for MCG youth.

Alongside this, youth reported vastly different experiences of exclusion from school, being held back, self-exclusion such as wagging (skipping, bunking or not attending school) and not being able to attend school due to circumstances beyond their control. In general terms MSU youth reported harsher penalties at higher rates than did MCG youth. Seventy one percent of MSU youth had been stood down (18% MCG youth χ2(1, n = 539) = 384.73, p < .001), and 67% of MSU youth had been suspended (14% MCG; χ2(1, n =486) = 418.77, p < .001), while 54% of MSU youth had been expelled or excluded from school (8% MCG; χ2(1, n = 370) = 414.75, p < .001). Reflecting the complex needs they brought to the education system, MSU youth were also more likely to have been held back (17%) compared to MCG (4%) χ2(1, n = 129) = 89.55, p < .001.

The differences in the rates at which youth from the two groups removed themselves from school were also marked, and statistically significant. Just over half (51%) of the youth from the MCG reported not wagging at all or

8 These figures relate to youth who responded positively to the set of questions relating to school belonging.9 These figures relate to the subgroup of MCG and MSU youth who answered positively to the question relating to school being a good place for them to be.


wagging only once in the last year, while just over half (56%) of MSU youth reported wagging a few times a week χ2(1, n = 315) = 158.50, p < .001, or every day in the last year χ2(1, n = 114) = 138.97, p < .001. A similar pattern was observed in youth responses to being unable to attend school due to factors beyond their control; 38% of MCG youth reported this never happening or occurring only once in the last year, while 41% of MSU youth reported this restricting their ability to participate in school either a few times a term χ2(1, n = 211) = 15.17, p < .001, or more than a few times a term χ2(1, n =162) = 81, p < .001.

In order to understand aspirations about the future, youth were asked to choose as many items as were relevant to them from a list of options about what they would hope to be doing when they left school, or in the near future. As with other dimensions of this study, there were notable differences between MSU and MCG youth. For instance, more MSU youth hoped to be balancing working and whānau/family responsibilities χ2(1, n =21) = 18.67, p < .00110 or combining working and training χ2(1, n = 118) = 6.12, p = .013, while more MCG youth hoped to be engaged in training and travelling χ2(1, n =38) = 4.26, p = .039.

Although the 2002 alternative education (AHRG, 2002) report did not ask youth if getting an education was important to them, it did assess the value they placed on daily attendance, and over 90% of these youth placed importance on attending their educational programmes. In the current study, 79% of MSU youth noted that getting an education was important to them while 86% of the MCG felt this way about their education. In the alternative education studies (AHRC, 2002) youth were asked to rate their sense of belonging at their educational provider, and between 78% (AHRG, 2002, p. 22) and 92%

10 These figures relate to MCG and MSU youth who chose the two options: working and having a family.


(Clarke et al., 2010, p. 19) reported a sense of belonging at the programme. In the current study, youth were asked a different question - to rate their sense of belonging at their last mainstream school. Just over half of MSU youth (56%) reported a sense of belonging at their last mainstream school while 90% of MCG youth reported a sense of belonging. It would appear from this that the alternative education providers in the AHRG study had been able to close the gap in sense of belonging for youth disengaged from education.

5 Risks and Resilience

The focus of this study is upon risk and resilience and the role of services in supporting youth facing risk to harness their own resilience (by, for example, identifying the positive social resources in their social ecologies and networks including family/whānau, community and peers) and achieve positive outcomes. The questionnaire thus included a number of scales that measured different dimensions of risk and resilience, that captured information on the social ecology of participating youth and that also recorded aspects of youth service experience. As was the case with the Canadian Pathways to Resilience study, upon which this study is based, scales were derived from internationally validated measures. Additional questions were added into several of these measures after consultation with local organisations that work with youth11. The following section compares the means obtained for both the MSU and the MCG on these scales.

Youth from the MSU differed in statistically significant ways from MCG youth. The general pattern of variation was such that MSU youth reported significantly lower levels of overall resilience

11 These measures are described in Technical Report 2: Methodological Overview.


t(1193.81) = -8.09, p < .001, and significantly higher levels of risk t(1123.60) = 26.31, p < .001 than their peers in the MCG. The exception to this general pattern was the participation measure where youth from the MSU reported slightly higher (but not significantly so) levels of engagement in community events and activities (see below). The resilience12 means were closer together, although still significantly different (MSU: M = 103.45, SD = 15.85; MCG: M = 110.45, SD = 14.21). However, the difference in means on the risk13 scores (MSU: M = 36.43, SD = 14.43; MCG: M = 16.90, SD = 11.00) were greater and the distribution of scores was also wider for MSU youth than was the case for youth in the MCG. Furthermore, the mean scores for MSU youth on the subscales in the risk measure were often twice or, in the case of the 4H delinquency scale, three times higher than for the MCG youth. MSU youth thus faced significantly more risk, had fewer personal and ecological resources (resilience) to call upon to address this risk and experienced more disadvantage than their MCG peers.

In relation to the participation measure MSU reported higher participation rates in events and activities (M = 13.37, SD = 5.40) than MCG youth (M = 12.80, SD = 5.15). These differences were not significant t(1208) = 1.88, p = .060. Visual inspection of the events and activities from which MSU youth reported involvement revealed that these were predominantly activities into which support services had provided gateways, such as youth groups and community activities, suggesting a potentially powerful role for services in terms of equalising access and opportunities to normative activities for youth with complex needs. Youth in the MSU also reported activity levels associated with community-based sentences that directed them to undertake community work for non-governmental

12 Out of possible 140.13 Out of possible 100.


(NGO) organisations.

6 Service utilisation patterns

Service utilisation was measured by a composite score that counted the number of services youth had contact with over their lifetime up to the point of the interview. When service volume is considered overall, youth from the MSU (M = 15.13, SD = 5.88) reported significantly more lifetime use of each of five service categories (education, child welfare services, juvenile justice services, mental health, physical health14) than was the case for MCG youth (M = 6.23, SD = 3.54; t(990.22) = 31.89, p < .001) and the magnitude of this difference (mean difference = 8.90, 95% CI: 8.35-9.44, η2 = .51) was large. This is to be expected as youth in the MSU group were selected on the basis of current involvement in multiple services. A key task for later analysis is to identify the contribution made by this higher level of lifetime service use to functional outcomes for these more vulnerable youth. At this point, it is sufficient to note that the more vulnerable the youth were the greater their service volume across their life-spans.

Education servicesUtilisation of education services (additional to participation in a mainstream school classroom) varied considerably between the MSU (M = 2.50, SD = 1.56) and the MCG (M = 0.75, SD = 1.02). As can be seen from Figure 1 (below) on most service types the differences between the two groups were large and significant t(1038.12) = 23.08, p < .001, and the magnitude of this difference was large (mean difference =1.75, 95% CI: 1.60-1.90, η2 = .34). The MSU youth were more likely to have used every one of the services ‘once or more’ in

14 Information concerning utilisation of physical health services was collected in the survey in addition to the four main service systems of primary interest in this research.


their lives than the MCG youth. This is a particularly notable finding given the statistically significant differences identified above in terms of educational engagement and completion of educational credentials reported by MSU youth.

At the lower end of the scale (speech therapist and teen parent unit), relatively few youth reported involvement in either of the services (speech therapist: MSU n = 50; MCG n = 28, teen parent unit: MSU n = 28; MCG n = 9) although the difference between the two groups remained high with almost twice as many MSU youth engaging with speech therapists and three times as many MSU youth reporting enrolment in a teen parent unit as MCG youth.

Figure 1 Lifetime mean utilisation of additional educational services

Child welfare servicesAcross all service dimensions listed in this section (see Figure 2) MSU youth reported significantly higher levels of engagement in services


designed to assist youth and their families than did the youth in the MCG t(854.13) = 26.11, p <.001, and the magnitude of this difference was large (mean difference = 2.22, 95% CI: 2.05-2.39, η2

= .44). The significantly higher levels of lifetime engagement in child welfare services reflects the higher level of familial and personal stress and distress noted earlier in this document and suggests an accumulation of stress and distress in and around the youth in the MSU throughout childhood.

Figure 2 Lifetime mean utilisation of child welfare services

Juvenile justice servicesOverall the patterns of lifetime justice engagement were markedly different for youth depending on whether they were in the MSU or the MCG groups t(716.26) = 26.29, p <.001 and the magnitude of this difference was large (mean difference =2.69, 95% CI: 2.49-2.89, η2 = .49). As can be seen from Figure 3 (below), with the exception of


being questioned by the police, the mean utilisation levels by MCG youth of juvenile justice services were very low. In relation to the category ‘questioned by police’ there was a clear pattern of significantly higher engagement by MSU youth t(1155.81) = 25.37, p <.001, and the magnitude of this difference was large (mean difference = .51, 95% CI: 1.39-1.62, η2 = .35). The very low mean utilisation levels by MCG youth in itself suggests important differences in service experiences and the wider life experiences of these two populations of youth. What can be observed from this data are the very high levels of involvement of MSU youth in all of the listed juvenile justice service components, while MCG youth had little or no involvement in these services beyond being questioned by the police.

Figure 3 Lifetime mean utilisation of juvenile justice services

Mental health servicesAs was the case with additional educational, child welfare and juvenile justice services, there were significant differences between


the MCG and MSU youth in terms of lifetime volumes of services used on all the mental health questions (see Figure 4). MSU youth were more likely to have used all of the categories of mental health services than was the case for MCG youth t(875.94) = 18.95, p <.001, and the magnitude of this difference was large (mean difference = 1.54, 95% CI: 1.38-1.70, η2 = .29).

Figure 4 Lifetime mean utilisation of mental health services

Health servicesIn terms of utilisation of general health services, there was a less clear split between the two groups than was the case on the other types of services (see Figure 5). Mean utilisation volumes were similar for family doctors (MSU: M = 2.54, SD =.85; MCG: M = 2.50, SD = .86, t(1208) = .88, p =.381) and specialist medical practitioners (MSU:M = 1.06, SD = 1.20; MCG:M =.98, SD = 1.15, t(1205.49) = 1.12, p = .261). While there was an overall pattern of higher volumes of lifetime service use for MSU than for MCG youth the differences between the two groups was much smaller than was the case for the preceding four services (Figures 1 to 4). In the case of dental services,


MCG youth reported significantly higher volumes of use (M = 2.55, SD =.77, t(1185.73) = -3.56, p < .001) compared to the MSU (M = 2.38, SD = .88) but the magnitude of this difference was small (mean difference = -.17, 95% CI: -.26- -.08, η2 = .01). At the other end of the spectrum, MSU youth reported a significantly higher volume of use of specific youth health services such as YOSS (Youth One Stop Shops) (M = 1.08, SD = 1.25, t(1109.20)= 9.85, p <.001 ) than MCG youth (M = .46, SD = .92) and the size of this difference was moderate (mean difference = .62, 95% CI: .50 -.75, η2 = .08). MSU youth also reported higher volumes of use of emergency services and more hospital stays.

Figure 5 Lifetime mean utilisation of general health services

Aside from physical health service use, there is a clear pattern of higher volumes of lifetime utilisation of services by MSU youth that spans the spectrum of specialised and community based programmes for supporting vulnerable youth and youth with complex needs.

The quality of service experienceYouth were asked to provide feedback on the quality of their


experience with up to two services that they had used in the last year. This data was in addition to their answers on the questions relating to the number of times they had used services which is reported in the previous section. The service quality questions were designed to provide further information on the nature and quality of service experience from the perspective of the young person. Because of the markedly different nature and volume of service use reported by youth from the MCG and the MSU, and the focus of this research upon understanding the role played by services in mitigating risk and promoting good outcomes for youth with complex needs, this section considers the responses of MSU youth only. Youth answered questions on services received across the four major care systems that work with vulnerable youth: juvenile justice, alternative or special education (that is, additional to or an alternative to mainstream school programming), child welfare and mental health services. This section considers the answers from youth to questions on the first service they nominated. Later analyses examine the patterns of response across the two services on which youth reported (see for example Technical Report 5 in this series). Quality of service experience was assessed by 13 questions that were ranked on a 5 point scale (converted to a score out of 10 for ease of interpretation of results) that assessed different aspects of service quality. Taken together, the questions gave an overall rating of the quality of the service experience, with a focus on aspects of quality that encouraged active involvement of youth and their whānau/families as well as aspects of quality that emphasised service respect for youth and responsiveness to the realities of their lives. In addition to the overall scoring (overall satisfaction), two subscales assessed the extent to which the service supported the development of individual agency by youth (agency), and service factors relating to empowerment and respect for youth (empowerment). The following discussion considers these three aspects of service quality as they relate to the four service systems (juvenile justice, education, child


welfare, mental health) and the type of organisation (statutory or NGO).

As can be seen from Figure 6, the proportion of answers relating to organisational types (NGO or statutory) differed markedly between the different service systems (juvenile justice, education, welfare, mental health). As would be expected given the nature of the services, responses to questions about juvenile justice and child welfare services primarily came from youth receiving services from statutory providers. The reverse situation applied for responses relating to educational services, with most youth answering on services provided by NGOs, and these were primarily alternative education providers. Located between these two were responses concerning mental health services, where just under two thirds (60%) of youth commented upon a statutory mental health provider, typically a DHB and the remainder commented on services provided by an NGO.

It is important to bear in mind the different pathways by which youth become clients of the different service systems. File review data (see Technical Report 2 in this series for an explanation of this phase of the research) was analysed to identify the reasons why youth became involved in each service system. This analysis revealed that juvenile justice services became involved in the lives of youth as a result of actions directly taken by youth typically relating to behaviours or actions of which the youth were aware. While they may not have welcomed the involvement of the juvenile justice system, they were aware of the reasons for this involvement and of their role in coming to notice. Youth typically became clients of the child welfare system when their caregiving adults had failed to provide for their needs adequately or when the neighbourhoods in which they resided posed serious threats to their safety and wellbeing. In this sense, they often became clients of this system


because of the actions or inactions of others and they may well have had little or no control over the circumstances which brought them to notice, nor over the course which the intervention took. Analysis of file review data indicated that the issues that brought youth into the child welfare system had either been emerging for a number of years, or there was a specific incident of which the youth was often initially unaware that brought their family or whānau to attention. The edu-cation organisations youth commented upon were primarily alterna-tive education providers. Most of the MSU youth (80%) had stopped attending mainstream schools prior to participating in the research yet 59% of them scored over the mean when asked if getting an education was important to them, so many clearly still placed a value on formal education as a developmental pathway. Although most youth should have been attending school at the time of their interview, as many were less than 16 years of age, most of them had not attended for some time. The possibility of returning to education offered by alternative education providers was an active choice made by the youth and this will have influenced both the way in which they engaged with their educational provider and the way in which staff worked with them. Finally, 121 youth (20%) of youth reported on their experiences with mental health services. These services were either alcohol and drug services, mental health services provided through CAFS-type programmes at DHBs or counselling or support services provided by NGOs such as Youth One-Stop Shops. In many cases youth were referred to these services by the other service systems for assessment and possibly ongoing provision of services. File review data clearly illustrated that mental health services would only work with youth who were willing to regularly attend appointments (three missed appointments with a DHB service, for instance, could result in automatic discharge) or who recognised that that they had a mental health or addiction need for which they actively wanted support. Mental health service involvement therefore represents the service system over which youth were able


to exercise the greatest control. Those who reported on their experiences were therefore attending services of their own volition, regardless of whether it was provided by a statutory provider or an NGO.

Figure 6 Proportion of answers relating to statutory and NGO providers by service system

As Figure 7 (below) indicates, overall the mean service quality scores for all service systems and both service types were above the theoretical mean of 5 out of 10 (overall: M=7.12, SD=1.77; agency M=6.67, SD=2.02; empowerment M=7.85, SD=1.75). Looking at the different service systems; child welfare providers received the lowest overall quality scores (overall: M=6.39, SD=1.89, agency: M=5.96, SD=2.09, empowerment: M=7.15, SD=1.90). While education (agency and overall) and mental health providers (empowerment) received the highest mean scores (education: agency: M=7.71, SD=1.71, overall: M=7.95, SD=1.45; mental health: empowerment: M=8.54, SD=1.53).


Figure 7 Mean scores (out of 10) for aspects of service quality by service system

In a similar vein (see Figure 8), the quality scores by organisational type (statutory or NGO) were all above the theoretical mean (overall (statutory): M=6.77, SD=1.75, (NGO): M=8.03, SD=1.50; agency (statutory): M=6.25, SD=1.97, (NGO): M=7.76, SD=1.74; empowerment (statutory): M=7.61, SD=1.77, (NGO): M=8.46, SD=1.55).


Figure 8 Mean scores (out of 10) for aspects of service quality by type of organisation

A one-way between groups analysis of variance was conducted to explore the impact of service system type on the overall ratings of service quality youth gave to services from the four different service systems. The assumption of homogeneity of variance was not met in this analysis and accordingly, Welch’s adjusted F ratio was used which indicated significant differences in the mean quality scores between the four service systems F (3, 298.61) = 25.8, p < .001. The size of the difference in mean scores calculated (η2 = 0.11) was quite large. Post hoc comparisons using the Games-Howell post hoc test revealed that child welfare (M = 6.39, SD = 1.89) and juvenile justice (M = 6.90, SD = 1.59) means were significantly lower than those for education (M = 7.95, SD = 1.45) and mental health (M = 7.71, SD = 1.71). The mean score for child welfare services overall was also significantly lower than that for juvenile justice (p = .034). Education and mental health provider mean scores were similar to each other (p = .652).


A one-way between groups analysis of variance was conducted to explore the impact of service system type on the agency subscale ratings of service quality youth gave to services from the four different service systems. The assumption of homogeneity of variance was not met in this analysis and accordingly, Welch’s adjusted F ratio was used which indicated significant differences in the mean quality scores assessing the extent of personal agency youth reported between the four service systems F (3, 297.78) = 26.55, p < .001. The size of the difference in mean scores calculated (η2 = .11) was quite large. Post hoc comparisons using the Games-Howell post hoc test revealed that education (M = 7.71, SD = 1.71) and mental health (M = 7.30, SD = 1.96) providers were experienced as of similar and higher quality (p = .316) than juvenile justice providers (M = 6.30, SD = 1.83) which were scored by youth as providing similar opportunities for them to exercise agency in the intervention as child welfare providers (M = 5.96, SD = 2.09, p = .339).

A one-way between groups analysis of variance was conducted to explore the impact of service system type on the empowerment subscale ratings of service quality youth gave to services from the four different service systems. There was a statistically significant difference at the p <.05 level in the extent to which youth experienced services as empowering between the four service systems F(3,601) = 18.41, p < .001). The size of the difference in mean scores (η2 = .08) was in the moderate to large range. Post hoc comparisons using Tukey’s HSD test indicated that education (M = 8.26, SD = 1.49) and mental health (M = 8.54, SD = 1.53) providers received similarly high mean scores (p= .588). Juvenile justice providers (M=7.76, SD=1.68) received similar empowerment scores to education providers (p = .053). On this aspect of service delivery, child welfare providers (M = 7.15, SD = 1.90) were significantly different to providers in the other three service systems and received the lowest mean scores on this subscale.


An independent-samples t-test was conducted to compare service quality scores on the three measures (overall, agency and empowerment) for statutory and NGO providers. There were significant differences in all three mean quality scores depending on provider type. NGO providers were consistently ranked more highly on this quality measure than were statutory providers on each of the three measures. The overall mean quality scores given by youth to services provided by NGOs (M = 8.02, SD = 1.50) was significantly higher than that given for services provided by statutory providers (M = 6.77, SD = 1.75, t(350.57) = -8.82, p <.001). In a similar way, the mean scores youth gave to the agency subscale was significantly higher for NGO providers (M = 7.76, SD = 1.74) compared to statutory providers (M = 6.25, SD = 1.97, t(339.68)= -9.18, p < .001) and the same general pattern also applied to the rankings youth gave the different provider types on the empowerment subscale (NGO: M = 8.46, SD = 1.55, statutory: M = 7.61, SD = 1.77, t(603)=-5.45, p <.001). The magnitude of the differences between each of these means (mean difference for overall scores = -1.26, 95% CI: -1.54- -.98; mean difference for agency = -1.51, 95% CI: -1.83- -1.18; mean dif-ference for empowerment = -0.85, 95% CI: -1.15- -.54) were large for the overall (η2 = .18) and agency (η2 = .20) and moderate for the empowerment scores (η2 = .05). As noted above there were marked differences in the proportion of statutory and NGO providers from each of the four systems (juvenile justice, child welfare, education and mental health) and furthermore, youth came into each of these systems in different ways and these differences will at least in part have influenced the differences seen in these analyses. However, that notwithstanding, there are significant and large differences in the ways in which youth report their experiences of services delivered by statutory and NGO providers across the four service systems.


CONCLUSIONS

Taken together, the results demonstrate that the MSU youth in this study experience quite different lives than their peers in the MCG. In terms of living arrangements they were less likely to live in households with one or both biological parents and they tended to live in dwellings occupied by larger numbers of people, they also spent more time living rough than MCG youth. While biological parents were the most common parent figures nominated by both groups, the rates between the groups were markedly different. MSU youth identified much higher rates of non-parents and non-familial adults playing key caregiving roles in their lives. The data suggests a relative absence of enduring, positive caregiver presence in the lives of MSU youth and patterns of whānau/family life characterised by disruptions to emotional attachment along with a lack of certainty around whom the key decision maker was. Perhaps compensating for the absence of a consistent emotional presence from caregiving adults, youth in the MSU reported higher rates of involvement in intimate relationships with their peers and they also had higher rates of teen parenthood (although the numbers for both MCG and MSU were quite small). MSU youth also reported higher rates of unsafe sexual practices which in itself brought large health and wellbeing risks. Further they reported higher levels on all the risk measures.

The youth recruited into the study were aged between 12 and 17; all of them should have been able to expect to be attending school and accumulating educational qualifications commensurate with their abilities. MSU youth reported higher levels of both emotional and physical disengagement from mainstream schools. Given that their family/whānau experiences were characterised by lower rates of emotional attachment to primary caregiving figures this pattern of educational experiences is of concern. It appears that rather than


providing a safe place away from the challenges they confronted in their daily lives and opportunities to build a strong base for themselves through the accumulation of educational credentials and engagement with positive role models, the education system reinforced this pattern of adult rejection for these youth. If home was not able to provide a safe nurturing space for them, neither were their schools. Many youth in the MSU group had stopped attending school before high school, and a substantial number of them became disengaged during years 9 and 10. Very few MSU youth managed to sustain themselves through to year 13 and achieve what were effectively their normative educational milestones of NCEA 1 and NCEA 2. Yet these youth retained a desire to achieve educationally and recognised the value of education to their futures, what they lacked appeared to be the support to learn how to survive at mainstream schools given the pressures they faced in their daily lives, and the resources required to ensure that they had a sense of belonging while at school. It was not surprising then that they reported significantly higher rates of self-exclusion from school.

Reflecting the above patterns, the risk and resilience profiles of the youth in the MSU and the MCG were markedly different. While the mean resilience scores for the two groups were significantly different, it was the risk profiles that really separated the two groups of youth. No doubt these were the factors that played a significant role in the challenges MSU youth faced in sustaining themselves at school and that also brought them into contact with the four service systems. Interestingly, the measure on which the MSU and MCG youth returned broadly similar scores was the participation and community involvement measure. As noted above, it appeared that support services played a role in facilitating MSU youth involvement in community programmes and activities and in this way the gap between MSU and MCG youth on this measure was reduced. Through this, MSU youth were able to become involved in normative activities


and experiences. The similarity on the measure of participation notwithstanding, the data presented here suggests an enduring accumulation of disadvantage, stress and distress that then translates into reduced life chances and poorer outcomes for these youth. Alongside this, youth also reported the accumulation of skills that enabled them to manage these demanding lives.

Like the Alternative Education study youth reported by Clark at al. (2010), the youth in the current study were still children when they participated in the research and so their ability to mitigate the stresses and to take definitive steps to manage or overcome the disadvantages they confronted was limited. They adapted to their circumstances as best they could and brought to bear the resources available to them in order to manage these complex challenges, and they often did this on their own.

As expected given the sampling process, youth in the MSU group reported more intense service engagement right across the service spectrum than their peers in the MCG. As compensatory resources for those that were missing in their families and in mainstream schools; welfare, justice, mental health and additional educational services were all features of MSU youth lives and provided one important avenue for the mitigation of the risks they faced and the redressing of the imbalance in opportunities open to them. Other papers (see for example, Technical Reports 4 and 5 in this series) consider the impact that this higher level of service involvement has for MSU youth in terms of the extent to which it might close the gap in outcomes between the two groups. Here the focus is upon exploring differences in quality of experience of MSU youth between the four different service systems. In general terms, services received higher quality scores when youth were able to choose whether or not they became clients. This meant that mental health and alternative education providers tended to score more highly on the service


quality measures than juvenile justice and child welfare services. Alongside this, NGO providers tended to score more highly on the quality measure than statutory providers.

Overall this preliminary descriptive data suggests a pattern of accumulating disadvantage confronted by MSU youth that simply does not have a parallel in the MCG group. With the exception of community participation, MSU youth faced greater challenges in achieving what might be argued to be normative milestones, relationships and experiences that could to be considered typical features of childhood. While they reported numerous resources within their own social worlds and these together generated resilience profiles that were close to those of the MCG, the differences between the MSU and the MCG on the resilience mea-sure were still significant. MSU youth faced very significant risks, many of which they navigated either alone or with their peers and the resilience resources available to them were not sufficient to compensate for the risks. Of particular concern was the absence of an enduring adult presence either in their families/whānau or in the mainstream schools they attended any one of whom might have provided the support needed to create a meaningful alternative pathway for these youth. The equalising effects of universally available public education were not apparent for this group of youth. In the absence of an enduring adult presence in their daily lives, MSU youth needed to navigate competently through the four major service systems that provided support for youth facing challenges. As this data shows, these risks cast long shadows forward making it difficult for MSU youth to achieve educationally and to create safe lives for themselves.


REFERENCES

Clark, T.C., Smith, J.M., Raphael, D., Jackson, C., Fleming, T., Denny,S., Ameratunga, S., & Robinson, E. (2010). Youth’09: The health and wellbeing of young people in Alternative Education. A report on the needs of Alternative Education students in Auckland and Northland. Auckland: The University of Auckland.

Adolescent Health Research Group (AHRG). (2002). Alternative education students’ health: From Northland and Auckland Regions. Report Commissioned by AIMHI consortium. Adolescent Health Research Group, The University of Auckland.

Adolescent Health Research Group (AHRG). (2003). Alternative education students’ health: Northland and Auckland Region. Adolescent Health Research Group, The University of Auckland.

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