Characteristics of children in residential treatment in New York State.

This study addresses three questions about the population of children and families served in the highest level of care in the child welfare system in New York State residential treatment centers (RTCs): (1) How prevalent are emotional and behavioral problems in the youth entering RTCs? (2) Has the proportion of youth with such problems increased compared to 10 years ago? (3) Are there identifiable subgroups of youth entering RTCs? One-fourth of RTC admissions in fiscal year 2001 were randomly selected from a representative sample of 16 RTCs. The study completed a standardized data collection instrument based on a review of agency records, and included information that was known at the time each child was admitted. The results show significant increases compared to t10 years earlier in the proportion of youth with mental health problems and juvenile justice backgrounds. The findings suggest that youth who traditionally have been served by other systems of care are now being served in the child welfare system. The increased treatment needs of these youth and the heterogeneity of the RTC population have important implications for policies, programs, and practice. Since the passage of the Child Welfare Reform Act in 1979 and the Federal Adoption Assistance and Child Welfare Act of 1980, child welfare policy mandates that youth who require out-of-home placements must be placed in the least restrictive level of care possible (Pecora, Whittaker, Maluccio, & Barth, 2000). The system considers an alternative family environment to be the ideal placement setting. Not all youth, however, function in a foster family setting, and require a higher level of care. Within the child welfare system of care, residential treatment is the highest, most restrictive level (Bates, English, & Kouidou-Giles, 1997). Agencies place children in residential treatment centers (RTCs), often after many previous "failed" foster home or group home placements, because they are deemed too emotionally or behaviorally impaired to be served in these lower levels of care. Since the early 1980s, most children and adolescents residing in RTCs have shown some degree of emotional and behavioral problems. The extent and nature of these emotional problems are, however, relatively unknown because no universal guidelines for admission exist (Maluccio & Marlow, 1972) and because little empirical data describe the population of youth served in this setting. Two notable exceptions are studies by Whittaker, Fine, and Grasso (1989) and Baker, Olson, and Mincer (2000). In the first study, the authors used administrative data to describe a sample of boys entering one RTC in 1985. The authors found that the boys entering the agency tended to either come from single-parent families or have no parents at all. Three-fourths of the youth had a prior placement and many had been adjudicated for either a status or criminal offense. Behavioral and emotional problems among the youth included substance abuse, suicidal threats, running away, and sexualized behavior. Baker et al. (2000) also provided descriptive information on a subset of adolescents in one RTC. They too reported high levels of behavioral and emotional problems in their sample. As single point-in-time studies conducted at individual agencies, these data are not necessarily reflective of youth entering agencies today, although the results highlight the use of routinely collected data (DiLeonardi & Yuan, 2000). Descriptive data about the population of youth in RTCs, either nationally or statewide, is still lacking in the field. The current study sought to address this gap by collecting systematic and comparable data from a representative sample of RTCs across the state of New York. These data answer several important policy and practice questions. The first question addressed in this study pertains to the prevalence of youth entering RTCs who exhibit a range of behavioral and emotional problems. …