Mental health-related hospitalisations among adolescents with previous child protection contact from birth to age 11

Abstract

AbstractObjectivesTo examine the burden of mental health-related hospitalisations among adolescents by levels of previous child protection contact.Design, setting and participantsWhole-of-population study of children born in South Australia, 1991-1999 (n=175,115), using de-identified linked administrative data from the Better Evidence Better Outcomes Linked Data (BEBOLD) platform.Main outcome measuresAdolescents: proportion of adolescents aged 12-17 years with mental health hospitalisations; Hospitalisations: proportion of all adolescent mental health hospitalisations according to the level of child protection contact from 0-11 years.ResultsOverall, 15.5% (27,203/175,115 children) of adolescents had a history of child protection contact between ages 0-11 years, and 3.2% (5,646/175,115; 95% CI, 3.1 – 3.3) had a mental health-related hospitalisation between ages 12-17 years. Of the 10,633 mental health-related hospitalisations, 44.9% (95% CI, 44.0 – 45.9) were among adolescents with previous child protection contact even though they comprised only 15.5% of the study population. Of 5,646 adolescents with at least one mental health-related hospitalisation, 40.4% (95% CI, 39.1 – 41.7) had previous child protection contact. Among the population who experienced out-of-home care, 17.5% (209/1,191; 95% CI, 15.5 – 19.8) had experienced a mental health-related hospitalisation during adolescence, compared to 2.3% (3,366/147,912; 95% CI, 2.2 – 2.4) of adolescents with no prior child protection contact.ConclusionAlmost 45% of mental health hospitalisations for 12-17-year-olds occurred among children who had child protection contact, despite that group comprising only 15.5% of the study population. Potential trauma sequelae associated with child protection history is important to consider in the response to adolescents hospitalised due to mental health challenges.Significance of StudyThe knownAdolescent mental health is an important public health issue and those in child protection are at higher risk of experiencing mental health challenges.The newWe have quantified the burden of adolescent mental health hospitalisations attributable to the population with prior child protection system contact. For adolescents aged 12-17 years, those with a child protection history accounted for 44.9% of all adolescent mental health hospitalisations.The implicationsPotential trauma sequelae associated with child protection history are important to consider in the response to adolescents hospitalised due to mental health challenges.