Pediatric to Adult Mental Health Service Use of Young People Leaving the Foster Care System

J. Curtis McMillen, Ramesh Raghavan

Research output: Contribution to journalArticlepeer-review


Purpose: To assess and predict changes in mental health service use as older youth leave the foster care system. Methods: Participants were 325 19-year-olds participating in a longitudinal study of older youth leaving the foster care system in Missouri. All were in the foster care system at age 17. Participants were interviewed nine times between their 17th and 19th birthdays using the Service Assessment for Children and Adolescents and a history calendar to improve recall of service history. Analyses included Cox proportional hazards regression to predict time to service stoppage and McNemar's test to assess difference in rates of service use between age 17 and 19. Results: Mental health service use dropped dramatically across the study period for all services. Service rates dropped most steeply for youth who left the foster care system. Service use rates declined by roughly 60% from the month prior to leaving the foster care system to the month after leaving the system. Most young adults who stopped pharmacotherapy following discharge from foster care reported they did so of their own volition. Conclusions: Practitioners should be aware of the possibility of patient-initiated mental health service discontinuation following exit from the foster care system and plan accordingly.

Original languageEnglish (US)
Pages (from-to)7-13
Number of pages7
JournalJournal of Adolescent Health
Issue number1
StatePublished - Jan 2009


  • Adolescent-to-adult transition
  • Medications
  • Mental health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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