背景:收容机构中的儿童青少年和同龄人相比可能存在较差的心身健康水平.稳定的机构照料环境对改善早期童年经历所致破坏性影响是非常重要的,童年经历包括心理创伤、虐待和忽视.目前,澳大利亚或其他国家很少有关收容机构中儿童青少年的安置稳定性高质量研究的数据.目标:首次针对澳大利亚在收容机构生活中的儿童青少年进行系统的背景、照料类型、和安置稳定性特征的调查.方法:2014年收集了墨尔本市区的四家民间儿童青少年社区服务机构的数据.样本包括322名年轻人(女性占52.8%),年龄在12-17岁之间[平均年龄=14.86,(SD=1.63)年].结果:在收容机构中,相对于社区收容照料类型(35.7%),大多数年轻人(64.3%)是基于家庭养育照料模式(即寄养、治疗型寄养照料、青少年照料模式、亲属照料、以及认领照料).然而,与所有收容照料的孩子相比,这个年龄组被社区收容比例是较高的(5%).第一次被社区收容的平均年龄为9岁(SD=4.54).不同的照料类型均无性别差异.其中有248人(76.9%)曾在收容照料系统中有一个以上的安置场所,有117人(36.5%)经历了超过5个安置场所.相对于家庭养育照料者,社区收容的儿童青少年经历了更显著的安置不稳定性(χ2=63.018,p<0.001).结论:安置不稳定性在收容照料机构是常见的现象.需要一个稳定的照料环境来改善被虐待儿童所导致的心理创伤和健康影响.精心设计并以干预为基础的研究能够增加安置稳定性,包括强化对儿童青少年收容照料者的治疗能力.
Background: Young people in out-of-home care are more likely to experience poorer mental and physical health outcomes related to their peers. Stable care environments are essential for ameliorating impacts of disruptive early childhood experiences, including exposure to psychological trauma, abuse and neglect. At present there are very few high quality data regarding the placement stability history of young people in out-of-home care in Australia or other countries. Objectives: To undertake the first systematic census of background, care type and placement stability characteristics of young people living in the out-of-home care sector in Australia. Methods: Data was collected from four non-government child and adolescent community service organisations located across metropolitan Melbourne in 2014. The sample comprised 322 young people (females 52.8%), aged between 12 – 17 years (mean age=14.86 [SD=1.63] years). Results: Most young people (64.3%) were in home-based care seΞngs (i.e., foster care, therapeutic foster care, adolescent care program, kinship care, and lead tenant care), relative to residential care (35.7%). However, the proportion in residential care is very high in this age group when compared with all children in out-of-home care (5%). Mean age of first removal was 9 years (SD=4.54). No gender differences were observed for care type characteristics. Three quarters of the sample (76.9%) had a lifetime history of more than one placement in the out-of-home care system, with more than a third (36.5%) having experienced ≥5 lifetime placements. Relative to home-based care, young people in residential care experienced significantly greater placement instability (χ2=63.018, p<0.001). Conclusions: Placement instability is common in the out-of-home care sector. Given stable care environments are required to ameliorate psychological trauma and health impacts associated with childhood maltreatment, well-designed intervention-based research is required to enable greater placement stability, including strengthening the therapeutic capacities of out-of-home carers of young people.