Lived Mental Health Experiences of African American Adolescents in Foster Care
Ella M. Scott PhD, RN, CNS-BC
Assistant Professor
Kent State University, College of Nursing
Kent, Ohio
August 6, 2008
Purpose of Research
To explore the lived mental health (MH) experiences of African American adolescents in foster care (FC)
Gain knowledge and understanding of the MH experiences of AAA in FC
Problem Statement
Crisis in MH in US w/children/adol >problem in FC
( National Action Agenda /Children’s Mental Health, 2001)
>MH problem AA children in FC
Problem Statement
Foster Care – Welfare service for children who must live
apart from their parents for a period of time for various reasons (Child Welfare League of America, 2004)
– >500,000 children in foster care (Sedlak & Boadhurst, 1996)
Disproportional AA children in FC– 15% of U.S. child population– 49% of foster care population
(Child Welfare League of America, 2003
Overview of Literature
Adolescence– Vulnerability
inappropriate behavior (e.g. drug use), insecurity, emotional crises, mental health disorders, and other problems (Egan, 1997).
– Identitytime for searching, determining identity
(ethnicity)defining oneself as person (Papalia et al., 2004)
– 30% children in FC adolescents 11-15 yr(Child Welfare League of
America, 2003)
Overview of Literature
Children/AA – System of child welfare in U.S. maintained hx of racial
discrimination for AA children/White dominance/control (Billingsley & Giovannoni, 1972).
Misguided view– Black children can/should function separated from
Black families– Permeated most concepts on child welfare (Billingsley &
Giovannoni, 1972).
Overview of Literature
Child welfare services institutionalized in U.S. – Surrogate parental care is focus of care of children
separated from parents – Services to promote welfare of children living w/own
families sparsely developed/minute portion of child welfare efforts (Billingsley & Giovannoni, 1972).
By 1900 orphanages and foster homes became independent of organizations that had worked directly with families and children in their homes.
Overview of Literature
Bureaucratization and professionalization of social work infused means of caring for children (Billingsley & Giovannoni, 1972).
Child welfare services priority remains placing children away from their parents.
Bureaucratization is organized system of agencies w/specialized functions/elaborate governing rules.
Bureaucracies funded based on functions they performed. Services organized by functions, but functions not necessarily promote
best interests of children and families. The result was that child welfare services and services to children in
their own homes became separate endeavors. Black children or children of color have generally not fared well under
policies and practices that stem from bureaucratic arrangements (Billingsley & Giovannoni, 1972).
Overview of Literature
Results to AA children1. insufficient or no services for Black children2. inequality of services3. inadequate efforts to change system
(Billingsley & Giovannoni, 1972).
Majority of reports to child protective services involves cases of neglect (USDHHS Children of Color, 2003)
Methods
Study Design Phenomenological approach: geared to qualities of
humans (Giorgi, 2005)
– Descriptions of raw everyday lived-through experiences
– Philosophy: How do we know or what constitutes the nature of a phenomenon (Ray, 1994; Annells,1996)
Hermeneutic approach– Implies understanding – Means uncovering a phenomenon’s concealed
meanings (Omery, 1983)
Methods
Setting Midwestern state, population 400,000 25% <18yrs Only 8% AA 33% of FC placements AA children/adoles
Sample Target AAA, 15-17 yrs Of Color/Black, Mixed black Nine (n=9)
Methods
Procedure Recruitment
– Children Services of Child Welfare Data Collection
– Face-to-face interviews – Audiotaped– 172 pages of transcribed data
Methods
Summary of participants’ characteristics – 1 to 7 siblings. – Multi-placements - mean 6.8. – Highest number of placements -12, next highest 10. – Lowest number of placements - 3. Number of years in FC 4 to 14
years. – 4 of participants stated they were in FC because drug use by their
mothers. – 2 participants did not know why they were in FC. – 2 male participants experienced the deaths of their mothers.
One of the 2 participants was 5 when placed in FC shortly after his mother’s death.
The other participant was 11 when his mother died, in FC for 8 years.
Methods
Summary of participants’ characteristics – All but 1 had diagnosed mental disorder e.g. separation
anxiety disorder, ADHD, oppositional defiant disorder, obsessive-compulsive personality disorder, depression, PTSD.
– All w/diagnosed condition treated w/medication/therapy. – One female sexual/abuse/witness abuse of siblings. – All separated from siblings . – Data reported by adolescents, not chart review. – Identifying data eliminated/names replaced by
pseudonyms to protect confidentiality/privacy.
Methods
Analysis
Giorgi’s 4 Step1. Listen to interview tape, read transcript, get sense of
overall substance of data2. Identify units for meaning of the experience 3. Develop description of major themes 4. Determine whole meaning of experience
(Giorgi, 1985)
Results
3 Themes Emerged from Data
1. Antecedents r/t separation from biological families to FC
2. Consequences r/t separation from biological families to FC
3. Adverse perceptions of MH diagnoses & tx
Recommendations
More research needed to:– Create policies/practices < MH problems for adols– Explore better ways of preventing situations that may result in separations
from birth families – Focus on MH problems r/t separating from families– Identify better interventions/support for adolescents when separation occurs– Determine alternate means of dealing w/child abuse and neglect– Eliminate poverty
Recommendations
Immediate – Allow children/adolescents separated from their
families to have regular contact w/their birth families especially siblings (Minnesota Model)
– Communicate better w/children/adols r/t reasons for separations
– Provide anger management