The effects of kinship care on adult mental health outcomes of alumni of foster care ☆ Molly O. Fechter-Leggett ⁎, Kirk O'Brien Casey Family Programs, 1300 Dexter Ave N, Seattle, WA 98109, United States abstract article info Article history: Received 27 June 2009 Received in revised form 26 August 2009 Accepted 26 August 2009 Available online 3 September 2009 Keywords: Alumni Kinship Foster care Casey Mental health outcomes Kinship foster care is emerging into the dominant preferred placement type for out-of-home care, exceeding traditional foster care and group care. The push towards kinship foster care has brought up questions as to whether kinship foster care can better provide for the short- and long-term emotional needs of children in care. This study examined the effects of kinship foster care on adult mental health outcomes of former foster children. Data were drawn from the Casey National Alumni Study and included case record data on 1582 alumni and interviews of 1068 alumni. The adjusted response rate was 73%. Logistic regression was used to compare several patterns of placements in kinship care and their impact on mental health functioning in the year prior to interview. Results indicated that long-term kinship care alone does not result in more positive adult mental health as measured by ten specific mental health outcomes when demographics, risk factors, and foster care experiences were controlled. However, a variety of other in-care factors were identified that were associated to positive mental health functioning. © 2009 Elsevier Ltd. All rights reserved. 1. Introduction 1.1. The current state of foster care in the United States In the United States, there are currently over half a million children living in formal, state sanctioned, foster care (U.S. Department of Health and Human Services, 2008). Many of these children have experienced trauma from child abuse, neglect, witnessing domestic violence, or familial substance abuse. In order to start the recovery process, they need a stable home that can support their needs. Increased pressure on child welfare agencies to expediently develop permanency plans for all children in care, as well as continued fiscal concerns, has led many social workers to look to relatives of these children to take care of them (Child Welfare League of America, 2008; Family Preservation and Support Services Act, 1993). Numerous studies have shown that upwards of 60% of children in foster care exhibit emotional or behavioral problems in the clinical range (Burns et al., 2004; Dubowitz, Zuravin, Starr, Feigelman, & Harrington, 1993; Leslie, Gordon, Ganger, & Gist, 2002; McIntyre & Keesler, 1986; McMillen et al, 2005; Rubin et al., 2004). These issues have also been shown to persist into adulthood with rates of mental health issues, including depression, anxiety, substance use, and trauma-related disorders such as Post-traumatic Stress Disorder (PTSD) being significantly higher than in individuals from similar demographic backgrounds (see also: Courtney, Terao, & Bost, 2004; Benedict, Zuravin, & Stallings, 1996). Researchers of the Northwest Alumni Study found that over 54% of alumni interviewed had diagnosable mental health symptoms within the last 12 months and more than of 25% met the criteria for PTSD, rates much higher than the matched controls who had not had foster care experiences (Pecora, Kessler, Williams, O'Brien, Downs, English, Hiripi, White, Wiggins, & Holmes, 2005). Given the impact of foster care and the growing reliance on kinship placements, it is necessary to look at the differences between the long-term outcomes of children who were cared for in kinship homes versus traditional non-related foster homes. This information will help to determine whether kinship care is adequately supporting children who must be placed outside their homes, as well as whether kinship care acts as a buffer against the negative emotional impact that occurs when a child is removed from home. Furthermore, recognizing the profiles of children at risk for poorer adult outcomes will help child welfare agencies to structure their approach to placing the child and to develop and provide services that are most appropriate in addressing the child and caregivers' needs, including social support and psychological treatment. 1.2. Benefits and liabilities of informal and formal kinship care It has been hypothesized that the traumatic effects of out-of-home placement on children can be minimized through the placement of a child in kinship care (Ehrle & Geen, 2002). There are many benefits to placing a child in a kinship foster home. They include maintaining the child's connection with their cultural and familial identities, Children and Youth Services Review 32 (2010) 206–213 ☆ This article has been derived from data originally used for Molly Fechter-Leggett's doctoral dissertation, it has not been previously published as an article in a scholarly journal. ⁎ Corresponding author. Permanent address: 104 Upland Street, Worcester MA 01607, United States. Tel.: +1 413 221 0930. E-mail addresses: mollyober@gmail.com (M.O. Fechter-Leggett), kobrien@casey.org (K. O'Brien). 0190-7409/$ – see front matter © 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.childyouth.2009.08.017 Contents lists available at ScienceDirect Children and Youth Services Review journal homepage: www.elsevier.com/locate/childyouth