Policy and Supports to Facilitate the Transition to Adulthood Part 2

Findings: DSS Administrative Data A total of 812 youth were identified who turned 18 in 2005 3 . Table 1 provides demographic data about this population. Table 1: Demographic Data N=812 Demographics Gender (% female) Percentage 52% % Latino 23% Race White Black All other, including multiracial Unable to determine 61% 22% 4% 12% Regional Office Boston Central Massachusetts Metro Northeast Southeast Western Other 13% 12% 14% 22% 18% 18% 2% The data also indicated that 87 (11%) of the sample had been adopted at some point. The reported service goal for these youth was most commonly “living independently” (74%). This was followed by: reunify family (8%), long term care with adult service agency (7%), and long term care (6%). “Adoption/guardianship” and “stabilize intact family” were each the listed goal for 1% of the sample. The data file regarding home removal episodes listed up to three episodes. Table 2 provides the reason for home removal for each of the three episodes. These data clearly illustrate the most common reasons members of this population were removed from their homes: child behavior problems, caretaker inability, and neglect. The age of first home removal episode ranged from 0-19 with a mean 12.55 (sd=4.32). 3 While the sample size for the administrative data is 812, the sample size for the retrospective survey is 660. Both components target youth who turned 18 in 2005. The administrative data includes those who were in residential schools, the survey sample does not. 8 Table 2: Reasons for Home Removal (% yes) Episode 1 N=807 5 1 7 25 34 1 1 1 7 4 1 27 9 2 5 4 Abandonment Alcohol abuse -- child Alcohol abuse -- parent Caretaker inability Child behavior problem Child disability Death of parent Drug abuse child Drug abuse parent Inadequate housing Parental incarceration Neglect Physical abuse Risk Sexual abuse Voluntary surrender Episode 2 N=317 3 0 4 22 30 2 0 1 5 5 1 19 4 1 3 4 Episode 3 N=101 3 0 4 24 29 1 2 0 5 6 3 15 4 2 2 6 The legal status for the majority of cases for the first home removal episode was a court order (66%). Next most common were a voluntary placement agreement (19%) and emergency removal (14%). Abandonment and voluntary adoption surrender were each less than 1%. Table 3 lists the reasons that the home removal ended. Table 3: End Reasons for Home Removal Child 18 or older Child returned home Reunification Other Episode 1 N=550 59% 20% 18% 4% Episode 2 N=255 36% 22% 38% 45% Episode 3 N=82 27% 20% 50% 4% The original data files listed up to 41 placements. Our analysis used the data on the first 10 placements only. We also eliminated placements of “0” days in the analysis. Table 4 describes the distribution across different placement settings for the first 10 placement types. Foster care is always the most common but the relative frequency declines as the number of placements increase. Conversely, the percentages of residential and group placements increases as the number of placements increase. The number of adoptive and family-based placements is limited throughout. 9 Table 4: Placement Settings across 10 Placements Placement Type Adoptive Foster care Residential tx Group home Shelter Fam-based tx Kinship 766 placements Other Total 1 2 3 4 5 6 7 8 9 10 <1% 71% 11% 9% 5% <1% 2% 1% <1% <1% 64% 14% 11% 6% <1% 1% <1% <1% 1% 66% 15% 12% 5% 1% 1% <1% <1% <1% 62% 17% 13% 6% 1% 1% <1% <1% 0% 65% 14% 15% 4% 0% 1% 1% 0% <1% 65% 14% 12% 6% <1% <1% <1% <1% 1% 61% 16% 14% 5% <1% 1% <1% 1% 0% 62% 16% 14% 7% 1% 1% 0% 0% <1% 62% 16% 14% 5% 1% 1% <1% <1% 1% 59% 17% 15% 7% 1% 0% 0% <1% 733 692 641 579 540 485 448 393 359 319 Using starting and ending dates for each placement, length of placement was calculated across the first 10 placements. Table 5 provides these data. There is a decrease in the length of placement as the number of placements increases, possibly indicating increased instability of placements. Calculating across the ten placements, we identified 122 of the 812 young people had run from care at least once. Approximately 5% were on the run for each placement episode. Table 5: Length of Time per Placement (in Days) across 10 Placements Mean length Median length Maximum length % on the run 1 236 98 2069 3% 2 236 72 3558 5% 3 217 85 3205 4% 4 199 72 2277 7% 5 230 95 2494 5% 6 210 77 2184 6% 7 231 84 1984 5% 8 193 66 2095 7% 9 153 61 1778 7% 10 198 62 2232 5% Total 789 754 696 640 593 543 490 441 396 350 10 Findings: Retrospective Survey of Youth In this section, we initially present descriptive data for the sample to provide a picture of services, experiences, and outcomes. The findings from the survey are presented in nine main sections: • • • • • • • • demographic characteristics services received pre- and post-18 experience in care feedback about foster care experiences support networks outcomes risk behaviors current goals. We then present a series of bivariate analyses to: 1) compare those who are voluntarily in care post-18 with those who are not; 2) compare demographic groups on services, experiences, and outcomes; and, 3) examine the relationship between services and outcomes. Demographic characteristics This section provides a description of the young people who participated in the survey. Young people who were interviewed were geographically dispersed throughout Massachusetts and four were living outside of the state. We have coded their current location according to region (Table 6). Greater Boston Metro Northeast Southeast Central Western Out of State Table 6: Geographic Region N=96 n 17 11 21 24 5 14 4 % 18 12 22 25 5 15 4 The demographic description of the sample is provided in Table 7. The majority was female (63%) compared to male (35%), with a few identifying as transgender. The majority were White (53%) with almost a third Black/African-American (29%) and a quarter Latino/Hispanic (24%). Smaller percentages of other race/ethnic groups were identified. In comparison with administrative data of the whole population of youth (Table 1), the survey data over-represents females, slightly over-represents Blacks, and slightly under-represents Whites. All the young people spoke English, with a sizeable percentage also speaking Spanish (28%) and some other languages (15%). The majority had lived in the U.S. since birth (92%). The majority was heterosexual (84%). Most were single (83%). Only 2% were married; an additional 2% had been married but were now separated or divorced. Fifteen percent (15%) had children living with them. 11 Table 7: Demographics N=96 Demographics Gender Male Female Transgender Percentage 35% 63% 2% Race/ethnicity American Indian Southeast Asian/Asian-American Black/African-American Latino/Hispanic Native Hawaiian/Pacific Islander White Other 6% 2% 29% 24% 1% 53% 1% Language English Spanish Other 100% 28% 15% Lived in U.S. since birth 92% 18th birth year 1985 or 1986 1987 1988 or 1989 8% 73% 19% Sexual orientation Heterosexual Gay or lesbian Bisexual Not sure 84% 5% 8% 2% Current marital status Single Married Separated/Divorced Living with partner 83% 2% 2% 13% Has child living with them 15% 12 Services received pre and post age 18 Respondents were asked to identify the services that they received both prior to and after age 18. The following domains of services were asked about: assistance completing high school or GED, reconnecting with family, employment, life skills, health care, and housing. For each of these, respondents were asked whether they received help in this area, what kind of help, how long they received help, and whether they perceived the help as useful. Table 8 provides these data on the frequency of various services received both prior to age 18 and after age 18. Responses do not determine which agency provided the service. Although the majority of assistance was from DSS, these services can be provided by other state agencies as well as contracted agencies. Table 8: Services Received N=96 Completing HS or GED Reconnecting with family Employment services/job training/job search Life skills training/PAYA Accessing health care Housing assistance Other service Before 18 % receiving service 46% 53% 38% After 18 % receiving service 41% 21% 33% 66% 83% 48% 56% 28% 62% 44% 38% For each service category, fewer youth receive services post-18 compared to pre-18. Accessing health care was the most frequently received service at both time periods. Prior to age 18, approximately two-thirds of youth received life skills training (66%); approximately half received: help completing high school or GED, help reconnecting with family, housing assistance, or “other service”. The least commonly received service was assistance with employment (38%). Post-18 the pattern of services received is different. Overall service receipt is less. The only category in which more than half received assistance was “accessing health care”. The least common service categories were reconnecting with family and life skills training. “Other” services received, both pre-18 and post-18 included a variety of responses, most commonly therapy or counseling, but also things such as nutrition programs, college preparation, summer camp, volunteering opportunities, sports activities, driving school, and other such services. Open-ended questioning was used to gather more information about the services received by youth. For each category youth were asked to describe the help received. There was a variety of responses to these questions. High school/GED: Responses were generally positive for this service and relatively brief. Respondents spoke about DSS and program assistance in getting enrolled and getting through, via tutoring, special programs, and encouragement. • DSS helped me find a school. An alternative diploma school. My DSS worker gave me incentives to stay in school -- she would take me out. 13 • In high school and completed high school in DSS care. Continued in same high school after DSS care. Finished school but not really because of DSS help. Would’ve finished high school either way. Reconnecting with family: Responses identified a range of efforts, primarily by DSS, to reconnect the youth with family at different points of time in care. The range of responses included those that were positive, negative, and neutral. The outcome of this service was sometimes not what the young person wanted or had hoped for but, in general, DSS efforts were not blamed for the poor outcome. The range of responses suggests that efforts at reconnection are fraught with challenges. • DSS worker introduced me to my mother. Brought her to visit me where I was staying. Not so helpful because she was a stranger. They kind of pushed her into my life – this druggie. My adoptive mother had died. I felt like I couldn’t say “no”. • Only if I asked. Their motto was: if the family wants to be involved, then they can. Main purpose was to keep me out of trouble. A lot of time they deny your request for a visit. Sometimes the family don’t want to have a CORI check because they like to keep things private. • The DSS worker worked with my mother to schedule visits, but going back home was never the plan. Mom never came. • They helped me find my family and get them on my list so I could see them. They helped me see if they were a good environment to go to, that I’d be eligible to live with them and/or visit them. • My parents were abusive. They made us do family therapy because reunification was the goal before 18. Family therapy was the most we did. Even though it wasn’t in my best interest, DSS and worker’s supervisor made me go through the process. I wanted to go into IL. They made a deal with me, if I did eight sessions and after I graduated from high school, then I could find a place. • DSS let me go home on weekends and eventually they placed me back home with her when I was 16. I only stayed for 2-3 months and then she kicked me out again even though I was doing good. I left to go to [another state] but then came back and went to foster care. The efforts at reconnection are different post-18. For example: • They gave me more freedom to call my family and gave me choice of members that I’d like to see and visit and get to know. I was able to call anyone after I turned 18, without DSS approval. They made decisions before but now it’s up to me about where I go although I still have to follow program rules. Employment services: The responses in this section suggested primarily concrete activities by DSS workers as well as program personnel and sometimes mentors or other adults. These concrete activities included help with resumés and completing applications, transportation to interviews, shopping for work clothes, and connecting to employment programs and specific jobs. A particularly successful story is the following: • My adolescent outreach worker told me I should volunteer at [program]. DSS paid me a stipend at the end of the summer. [The program] liked me so much that after the summer they hired me and I work there today. Before she suggested that I volunteer she helped me search for a job on 14 the Internet. We filled out a few applications but then the volunteer opportunity came up and I took it. A less successful story is the following: • Not before 18, trying to keep me out of trouble only. Not allowed to work much because they have to limit your freedom so you don’t get in trouble. Then no work history, it’s difficult to get a job now at 18. This has been frustrating to me. I’ve always wanted to work but was unable to. Life skills training/PAYA: Many respondents listed the type of life skills they learned through the services provided either by a DSS worker, program personnel, or foster parent. These skills are many and varied but include: banking, laundry, grooming, cooking, shopping, cleaning, etc. Most comments on this topic were brief, simply listing the skills. A few additional comments include the following: • I was 17 and they gave me a PAYA worker, [Name]. At first I brushed her off when she said she would work with me, I said “no”. She kept trying though. … To this day I am more independent because of the PAYA. It gave me motivation. It helped me with everything. I accomplished a lot. • I learned a lot of stuff from the book. How to have a household, budget money. How to work. DSS worker didn’t help. They just gave me the book. My older sister went through it so she helped me. Never completed it though. It would have been better if they helped me. Some of it was hard. • Didn’t help much except for the money. • It was kind of fun here and there. I’d take the books when I was bored and complete it for the credits, money. I attended the group discussions. Most of the stuff I already knew. Health care: The responses regarding health care were very straightforward, primarily suggesting the DSS worker, foster parent, or program staff member helped the young person enroll in MassHealth. Occasionally, the respondent also commented on receiving assistance finding a doctor or dentist, getting access to medication, and transportation to appointments. A more unique experience is described below: • DSS found primary care doctors and helped with transportation to appointments. At age 16 I was hospitalized and about to be intubated and my social worker came to be with me which was really nice. Foster parents also helped and took time off to stay with me. Housing assistance: The intent of asking about housing assistance was to determine assistance youth received in securing their own housing post-18. However, respondents primarily talked about receiving assistance with placements into foster homes, group settings, or independent living programs. For example, “All the programs put a roof over my head. DSS did a lot for me in terms of finding a program that meets my needs.” Table 9 describes respondents’ perceptions of the helpfulness of the services received. Respondents who reported receiving the service were asked if they found the services to be very helpful, somewhat helpful, or not helpful. The percentages reported include those reporting the service to be either very helpful or somewhat helpful. 15 Table 9: Perceived Helpfulness of Services Received Completing HS or GED Reconnecting with family Employment services/job training/job search Life skills training/PAYA Accessing health care Housing assistance Other service Before 18 # receiving % helpful 45 91% 51 86% 36 92% 64 78 46 53 80% 92% 78% 85% After 18 # receiving % helpful 40 93% 20 80% 32 97% 27 60 43 37 85% 97% 84% 89% After addressing the questions regarding services that they received, youth were asked whether any of the listed services that they had not received would have been helpful to them. Sixty-one (61) respondents stated that some of these services would have been helpful to them before age 18; 58 respondents stated that some of these services would have been helpful to them after age 18. Table 10 provides the frequencies of affirmative responses for each type of service. Table 10: Services Not Received That Would Have Been Helpful Completing HS or GED Reconnecting with family Employment services/job training/job search Life skills training/PAYA Accessing health care Housing assistance Other service All of the above Before 18 n=61 23% 5% 20% After 18 n=58 16% 3% 19% 12% 2% 30% 8% 2% 17% 5% 35% 2% 3% The data suggest that housing assistance is the greatest perceived service need for these young people. Also important are educational assistance, especially before age 18, employment assistance at both time periods, and life skills training, especially post-18. 16 Experience in care Descriptive data about the objective experience in foster care are provided in Table 11. Table 11: Experiences with DSS N=96 Indicator Mean (standard deviation) Age at first contact with DSS M=9.43 (5.38) # foster home placements since age 14, at least one month M=3.77 (6.01) # group home placements since age 14, at least one month M=1.75 (2.39) Chose to remain voluntarily in DSS at age 18 91% Currently in voluntary care of DSS 62% Had outreach worker 52% The average age of first contact with DSS was approximately 9 ½ years. The average number of foster home placements since age 14 was almost four and the average number of group home placements was almost two. Of the 96 sample members, 91% chose to remain voluntarily in DSS care at age 18. Furthermore, 62% of the sample was currently in voluntary care at the time of the survey. Fifty-two percent (52%) reported that they had an outreach worker while in care. Those who did not report having a worker were asked why they did not have a worker. Approximately one-third of the respondents reported being unaware of the adolescent outreach program and therefore did not have an adolescent outreach worker. Among this group, the most common responses to whether they had an adolescent outreach worker were: “What is that”? or “Never heard of it”.4 Responses from adolescents who had been involved in the adolescent outreach program were often very positive. These young adults’ positive responses generally fell into two categories: help provided in applying to college and assistance with financial needs. In addition, there were numerous comments about the workers’ ability to be caring, honest, and consistent. For example: • [Outreach worker] is always on time. She seems like she really cares about any minute problem I have. She would email me every day when I was getting into college. She would send me examples highlighted of how to fill things out. One time I wasn’t treated well by DSS – she went right to the office and the problem was straightened out in a few days. • If it wasn’t for her I don’t think I could have … I learned a lot from her, how to be an adult. 4 Outreach services are not currently provided to all youth. Youth in contracted foster care or residential/group care are not the target population for outreach services. Also, not every youth who is eligible for outreach services has access to the service due to funding limitations. 17 Although many respondents were quite positive, others identified areas that needed improvement. Many young adults spoke of having difficulty reaching their outreach worker and noted that workers seemed too busy to respond in a timely manner. In some cases youth reported there was only one worker for a particular area. A few respondents felt outreach workers would benefit from better skills in working collaboratively, noting that some workers did not listen to them. • They should give us a little more space and respect our boundaries too. I have my priorities too. I don’t need to be babied. • If I had a worker that is from [my city] instead of [nearby city]. She doesn’t know much about [my city] resources. • Having more money to have more outreach workers so all kids in the system can have one. Feedback about foster care experience In addition to the feedback reported earlier, regarding perceived helpfulness of services provided, respondents were asked to provide feedback in two, more general, ways. First, a scale was created to measure young peoples’ perceptions of whether a youth development approach was used. The question was asked: “Thinking about all the services you might have received, from DSS and elsewhere, between ages 16-18 could you tell me how you felt about your experiences?” This scale consisted of 8 items. Response categories included: never, sometimes, and usually. Table 12 lists the scale items and the percentages that “usually” felt this way. Table 12: Youths’ Perceptions of Youth Development Approaches Used N=96 Scale Item % usually I was allowed to make decisions about my life. 30% When I was around staff, I was asked to contribute my thoughts. 38% My values, beliefs, and identity were respected. 55% I felt like my opportunities were similar to other young people my age. 33% I had opportunities to learn skills that would help me after I left DSS. 44% My experiences were more negative than positive.* 26% I did not feel connected to my community.* 34% My experiences helped build on my strengths. 79% * These two items were purposefully constructed to be “negatively” phrased and were reversed scored in averaging the total scale score. Second, a standardized scale, the Consumer Satisfaction Index (CSI; McMurtry & Hudson, 2000), was used to measure overall satisfaction with experience in DSS care. The CSI included nine items; responses were on a 7-point scale from: “none of the time” to “all of the time.” Higher scores indicate greater satisfaction. The average score across all items was 4.08 (sd=1.65). Table 13 lists the items and the percentage responding “a good part of the time”, “most of the time”, or “all of the time.” 18 Table 13: Satisfaction N=96 Scale Item People at DSS really seem to care about me. I would come back to DSS if I need help again. I would recommend DSS to people I care about. People at DSS really know what they are doing. I get the kind of help at DSS that I really need. People at DSS accept me for who I am. People at DSS seem to understand how I feel. I feel I can really talk to people at DSS. The help I get at DSS is better than I expected. % positive response 47% 46% 37% 37% 48% 65% 33% 37% 43% Support networks The survey gathered information about several different types of potential supports: birth family members, mentors, other supportive adults and supportive organizations. Birth family members: Of the 96 sample members, 86 (90%) reported contact with their birth families. Table 14 reports the percentages of youth in contact with various birth family members. Siblings and mother were most common (69%) followed by “other” relatives (67%). Less frequent was contact with fathers and grandparents. Table 14: Respondents’ Contacts with Birth Family Members N=86 Birth Family Member % in contact Mother 69% Father 38% Grandparent(s) 34% Sibling(s) 69% Other relatives 67% Table 15 displays the results of the types of contact respondents report with the first birth family member they listed. Letters and email are not commonly used, but are noticeably more frequent with siblings than with other family members. Although the percentage of fathers in contact with youth was less than other categories (n=8), when there was contact, 100% had in-person contact. Table 15: Types of Contacts with Birth Family Members N=84 Phone In-person Mother (n=47) 72% 68% Father (n=8) 38% 100% Grandparent(s) (n=5) 60% 80% Sibling(s) (n=21) 76% 71% Other relatives (n=5) 80% 80% 19 Letter/email 2% 0% 0% 14% 0% Mentors: Youth were asked, “Other than a parent or guardian, is there an important adult in your life who is older than you, has taken a special interest in you, that you can count on to be there for you, and who inspires you to do your best?” This type of question is used in a variety of studies to describe mentoring relationships. Sixty-six sample members (69%) reported that they did have such a person. They were then asked to describe in their own words the nature of this relationship. These responses were then coded and are summarized below. Table 16 provides a count of responses for the type of mentor. Table 16: Mentor Type N=66 Type of Mentor Count Program staff/therapist Foster mother Mother of friend Aunt/uncle Coach/teacher Friend Outreach worker/DSS worker Older sibling Family friend Church member/minister Other community person Grandmother Stepmother Parent Cousin 9 8 8 7 5 5 4 4 4 3 2 2 2 1 1 The most common mentors were a program staff member or therapist (n=9), foster mother (n=8), mother of friend (n=8), and aunt/uncle (n=7). Examples of mentor relationships with program personnel/foster parents/DSS workers include the following: • PAYA worker through DSS. Known for 1 year. Meet once a week but talk on the phone every day. Became important at age 18. She has made me more mature and has helped me be more independent. She listens to me and gives me advice. I think the DSS social worker should be more like a PAYA worker. They should start at age 16 to help us prepare more. • Foster mother – known for 4 years. She became important at age 17-18. She is motherly, supportive, cares. She is the only mother-figure in my life. She made me have confidence and believe in myself. I lived with her for a total of 3 ½ - 4 years, off and on. She was always there when things got rough. When I was 17, I came to realize the importance of commitment, trust, honesty, all of which she provided for me. She and her husband were great examples of the kind of relationship that I would like to have with a significant other – respect. • My social worker through DSS. We met when I was 13. See him once a month. He became important to me when I was 15 or 16. Over the years he has come to understand me. I tell him there are things he can’t change about me and he respects that. • Foster mom is definitely the biggest. She became important at age 16. We come from different backgrounds. She was raised in an old fashioned way – you don’t talk back to adults. I was 20 raised to respect adults for who they were. Even when I was upset and despite our differences and decisions she made, she never disregarded my feelings. She took me into her home and treats me like a daughter. She was always interested in how I was feeling and finding a compromise. The adults in the youths’ lives, who are not program personnel, foster parents, or DSS workers tend to have been in their lives for many years. Not surprisingly, the closeness of feeling stems from this longevity, and the person’s constant presence, and ongoing encouragement. • My grandmother. Known my whole life, see once a week. Has been important since I was little and could first remember. She is there to talk to. She does favors. Always has a present for [my daughter]. If I need a place to stay I could go there. She sticks up for me. She won’t be nice to my parents because she knows what they do. • My aunt. Known her my whole life. See her daily. Became important at age 16. Puts me in my place, helps me clean and cook and take care of myself. She is always there and won’t give up on me. Teachers, coaches, and other adult community members are examples of the type of natural mentors that youth may connect to. For example: • He was my teacher/basketball coach who I met when I was 13. He was very important because the school I went to, there weren’t a lot of minorities. It was a small town. I was disrespected. There weren’t a lot of my kind (minorities). When I met him he looked past that. He knew the position I was in and that I was in foster care. He made me feel comfortable. He was outgoing. Told jokes but also took his job seriously and the kids know this too. He made the whole class feel close to each other. Since I left [that town] I haven’t seen him but I contacted him – for a reference for an apartment. He called me back and asked for an update. I told him how things had been and I was in college. I still have his cell phone number. Siblings also may have an important role, particularly serving as role models: • Brother, since the day I was born. Took care of me in [another country and another U.S. city] and here in Massachusetts. He’s a role model, never gotten in trouble and got it made in the military and wanted the best for me even though he’s strict. • My older sister who is 24. She is important to me because she is older than me. She has gone through a lot and finished college. When I was 14 we started talking a lot more and I learned more about her. She gives me advice. If I need anything, she is willing to give it to me. She’s always there. If I need her I can call her. I speak to her every day. Friends and parents’ of friends were identified by some youth but appear to have less longevity and might be more transient in their lives: • Friend. Known him five months. See him daily. Became important at age 19. They always know the right thing to tell me. If I am ever in a jam they are always there for me. • My friend’s mother. She has a great sense of humor. I have known her about four months. She has been here for me with whatever trouble I’ve had. She’s like a mother figure and she gives me advice. I don’t take advice from many people but I do from her. 21 In summary, the key characteristics of these important people appear to be acceptance of the young person, constant encouragement, and ability to provide assistance when needed (i.e., “always there”). Other than these characteristics they appear to have a wide range of interpersonal styles. Other adult supports: In addition to these identified mentors, young people were asked a series of closed-ended survey questions about their support networks. Respondents could name up to six people and for each identified person, data were collected about who the person was (e.g., relative, co-worker, etc.), the type of help this person provides, how often they have contact, and how long this person has been a support. A total of 81 respondents were able to identify at least one adult in their support network. Multiple responses were given by some youth. The most frequently listed relationship was friend (n=68), followed by relative (n=47), “other” (n=36), significant other (n=32), professional (n=13), outreach worker (n=2), minister (n=1), and coworker (n=1). Further analysis examined the nature of the relationship in term of type of assistance, frequency of contact and length of the support. These relationships were examined for the first supportive person mentioned. Table 17 identifies the types of support perceived to be provided by the various types of individual. Emotional support was most commonly provided across all categories of relationship. Friends appear less able to provide concrete types of assistance than the other categories of support but, along with significant others, provide the most amount of fun. Table 17: Types of Support Provided N=83 Relative (n=20) Significant Other (n=20) Professional (n=7) Friend (n=22) Other (n=14) Concrete 90% 80% 86% 36% 57% Emotional 95% 100% 100% 86% 100% Fun 75% 85% 71% 82% 57% There is no significant association between type of relationship and length of support. All but three of the reported individuals had been supports at least six months. Relatives and “other” tended to have a longer relationship with the young person. Supportive organizations: In a separate question youth were asked whether any programs, groups, organizations, religious organizations, or other settings provided them with support or assistance. Religious organizations were most frequently mentioned (n=12), followed by therapeutic programs (n=11), support programs (n=9), a high school or college (n=4), and DSS outreach. Church and church program can provide both the spiritual assistance of church as well as concrete assistance. Support programs include food pantries, Alcoholics Anonymous, Boston Alliance of Gay and Lesbian Youth, and the DSS Outreach program. These programs provide assistance that can include concrete assistance as well as emotional support. For example, “Entire staff at [program], a youth run teen center – financial support, transportation, and moral, emotional support provided.” Therapeutic programs include programs where youth are living, substance abuse treatment programs, and therapy or counseling. High school and college includes help with financial aid, sports teams, and access to disability services. 22 Outcomes Data were collected in several core outcome domains, including: housing, education, employment, income, health, and risk behaviors. In this section, all tables reflect the 96 respondents, unless otherwise indicated (some questions were addressed to a subset of respondents). Housing. Table 18 provides data on key variables measuring housing outcomes. Respondents identified a wide variety of current living situations. Most frequently they were living on their own (32%), but many were living with relatives including their birth parents. A fairly large percentage of young people (12%) were living in a group home or residential setting. Outcome Current living situation On own Two birth parents One birth parent Adoptive parent Unrelated foster parent Relative Group home/residential Friend’s family Shelter Spouse/partner Other Table 18: Housing Outcomes N=96 Percentage 32% 3% 6% 1% 7% 9% 12% 5% 4% 8% 12% Years at current living situation 1 year or less 1-2 years 3-4 years 73% 17% 10% Ever homeless since age 18 37% The percent reporting ever having been homeless since age 18 appears substantial (37%) 5 . Respondents were asked to describe the circumstances leading to their homelessness. Review of these data suggest several were “kicked out” or asked to leave by a program, DSS, or foster home (n=10). • DSS kicking me out of the program just because I wouldn’t go to summer school even though I have gone since I was 12 years old. I wanted a break so I could get a job and money so I wouldn’t have to rely on DSS. Others were “kicked out” by a landlord or the family or friends they had been living with (n=7). 5 The question on the survey asked: Have you been homeless at any time since turning 18? Although a large percentage report “yes”, the qualitative comments indicate a wide range of circumstances that suggest in some cases youth experience housing instability or not having a place of one’s own, rather than being on the street. 23 • I was living in [city]. A friend invited me to [different city] to move in. I saw it as an opportunity to get out from DSS rules. I signed out from DSS. I lived with my friend for two weeks. Her boyfriend didn’t like me. He said he wanted me out and I moved to a shelter. Another category of respondents included those who chose to be on their own (n=4): • I wasn’t liking my situation, wanted to be my own person and get out on my own and realized I needed more help than what I could get on the streets. I’m still in DSS care, but was considered on the run for that time. Other respondents’ explanations provide insight into the challenges of finding a home for former foster youth: • Once I leave housing at school for holidays, summer breaks, etc. I don’t have any place solid to go. • I’ve never actually lived on the street but I’ve never had anyplace to call home. I’ve bounced from house to house. • I wanted to get into housing so I went to a shelter. DSS didn’t help with any housing. It was the shelter that helped me find a place. Education and training. Data on educational outcomes identified that prior to turning 18 youth in the sample attained the following educational achievements: completed GED program (9%), completed high school (21%), completed college course(s) (6%), and completed “other” education (3%). Many continue on an educational path post-18 and are able to enroll in, and complete, educational activities. Table 19 presents data on educational achievements after age 18. Only 9% of the sample reported no educational or job training activities after age 18. Of those enrolled in various educational activities, the completion rates are 62% for high school, 28% for GED, and 38% for a job training program. Because completion of college was not expected given the age group, we instead inquired of those who reported enrolling in college, whether they were still enrolled. Sixty-four percent (64%) were still enrolled. Education and training appear to be activities that are important to this population – 92% reported plans to engage in further education and training in the next six months. Table 19: Educational Outcomes Post-Age 18 Type of Education/Training Enrolled n (%) 51 (53%) 17 (18%) 28 (29%) 41 (43%) High School GED program Job training program College Percent of those enrolled who completed 62% 28% 38% --- Employment. Table 20 provides data related to employment and financial well-being. Less than half of respondents were currently employed. Of those employed, slightly over half were working more than 20 hours per week (55%) and less than half were making more than $8.00 per hour. Only 12% received health benefits through employment. 24 A series of questions was asked about the young person’s level of satisfaction with different characteristics of their job. Young people were asked to rate these characteristics on a three-point scale (1=bad, 2=OK, and 3=good). There appears to be relatively low levels of satisfaction regarding wages and amount of hours, but moderate levels of satisfaction on criteria such as: interesting work, level of responsibility, supervisor, and co-workers. Despite these job characteristics, employment was the chief source of income for most of the sample. The second most common source of income was a stipend from DSS. Following this, family (31%) and friends (23%) were the most frequent sources of income. Additionally, 22% were receiving TANF assistance and 18% were receiving SSI payments. Total monthly income, regardless of source, was $621. Forty-three percent (43%) of the sample reported that they had been able to save some money. Among these savers, the average amount saved was $900. Table 20: Employment and Financial Outcomes Outcome Employment Currently employed Working >20 hours per week (n=43) Wage >$8.00 per hour (n=41) With health benefits (n=42) Percentage 46% 55% 43% 12% Satisfaction with current job (% rating “good”) Wages Amount of hours Interesting work Level of responsibility Supervisor Co-workers 35% 41% 67% 72% 70% 63% Sources of Income Employment DSS stipend TANF SSI Child support Family Foster family (non-relative) Foster family (relative) Friends Other 70% 51% 22% 18% 4% 31% 10% 4% 23% 24% Total monthly income Able to save money Amount of savings (n=37) M=$621 (sd=$500) 43% M=$900 (sd=$1,248) 25 Health. Table 21 provides data about respondents’ health outcomes. Although 70% perceived themselves to be in excellent or good physical health, less than half (49%) rate their emotional health at this level. Yet, most were able to see health care providers or counselors when needed (95% were able to see a health care provider, 87% were able to see a counselor, 63% had seen a dentist). Ninety percent (90%) reported currently having health insurance, almost always MassHealth 6 . Table 21: Health Outcomes Outcome Perceived excellent or good physical health Perceived excellent or good emotional health Has physical disability/chronic health problem Currently have health insurance Had physical in past year Able to see health care provider, if needed, in past year Able to see counselor/therapist, if needed, in past year Seen dentist in last six months 2 or more days of heavy exercise in last 7 days 5 or more hours of community service in last month 1 or more times participated in organized activities in last 7 days Percentage 70% 49% 39% 90% 80% 95% 87% 63% 58% 19% 28% Risks. Table 22 provides data on several potential risks for this population. These items were selected from the Massachusetts Youth Risk Behavior Survey 7 . Unlike other questions, youth responded to these items on a self-administered survey in order to afford more privacy. The data suggest that a considerable percentage (34%) is not using a birth control method. Moreover, 43% had been pregnant or gotten someone pregnant. In terms of exposure to violence, 30% have been threatened or injured with a weapon in the past year. The data suggest that sexual and physical abuse are not uncommon: a third of respondents (33%) reported having been hurt physically or sexually by a date or someone they were going out with. A similar percentage (34%) reported a history of sexual contact against their will, although some of the contact prior to 12 months ago may have been among the reasons for bringing them into care. A very high percentage (59%) responded affirmatively to an indicator of depression (i.e., during the past 12 months feeling sad or hopeless almost every day for two weeks or more in a row and that led to stopping some usual activities). The majority of youth are not drinking heavily or using illegal drugs. Approximately 17% however, reported heavy drinking (five or more drinks on three or more days in the past month) and 21% have used illegal drugs three or more days in the past month. Similarly, the majority of young people have not been arrested (74%) or incarcerated (92%) in the past 12 months. 6 All these youth are eligible for MassHealth coverage, but some may not recognize they are covered by it. The Youth Risk Behavior Survey (YRBS) is conducted by the Massachusetts Department of Education in collaboration with the Centers for Disease Control and Prevention. The YRBS is conducted in randomly selected high schools every odd-numbered year and focuses on the major risk behaviors that threaten the health and safety of young people. See www.doe.mass.edu/cnp/hprograms/yrbs for more information. 7 26 Table 22: Risks N=96 Risk Percentage Birth control method Never had sexual intercourse No method used Method used How many times have you been pregnant or gotten someone pregnant? None 1 time 2+ times In past 12 months, how many times threatened or injured with weapon? None 1 time 2+ times Ever been hurt physically or sexually by a date or someone you were going out with? Physically Sexually Physically and sexually Has anyone ever had sexual contact with you against your will? Yes, within the past 12 months Yes, more than 12 months ago Yes, within 12 months and more than 12 months ago Past 12 months, ever felt so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities -- % yes In past 30 days, how many days have you had more that 5 or more drinks in a row? None 1-2 days 3+ days In past 30 days, how many times have you used any illegal drugs? None 1-2 days 3+ days In the past 12 months, how many times have you been arrested? None 1 time 2+ times In the past 12 months, how many times have you been incarcerated? None 1 time 2+ times 27 8% 34% 49% 57% 32% 11% 71% 14% 16% 16% 7% 10% 4% 23% 7% 59% 69% 15% 17% 67% 13% 21% 74% 16% 10% 92% 6% 2%