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A new study published in the Journal of Child Abuse and Neglect looked at the prevalence, disparities, and mental health of youth at the intersection of parental incarceration and foster care.

“Our study was about adolescent health in the context of parental incarceration and foster care,” study author, Luke Muentner told us. “Really, we were hoping to get a deeper understanding of how exposure to both the criminal legal and the child welfare system differentially impacts youth mental health compared to peers who were exposed to only one system as well as those who were never systems-impacted.”

Researchers wanted to be able to paint a better picture of the well-being of youth at this systems intersection, given the numerous ways in which parental incarceration and foster care can be linked, in order to better inform policies and practices that bolster adolescent health and improve family functioning.

“Based off of prior research that studies children with incarcerated parents as well as that which studies foster youth, we expected that systems-impacted youth would report the most concerning mental health symptoms,” Muentner told us. “But prior to our study, there really hadn’t been much evidence of how youth at the crossroads of both systems are faring.”

In other words, most studies that examine the mental health of systems-impacted youth have focused only on parental incarceration or exclusively on foster care with limited attention to those ever in both situations.

“We hypothesized that our findings would be consistent with allostatic load theory,” Muentner told us, “which means that we expected the additive effect of having an incarcerated parent and being in foster care would result in the greatest adverse consequences for youth’s problematic health conditions – evidenced here in their concerning states of mental health.”

The research team has years of practice and advocacy experiences working with children and families impacted by both parental incarceration and foster care. In the research space, topics of parental incarceration and foster tends to be discussed in silos, or analyzed as isolated events.

“Part of this is due to data limitations, such that the Venn diagram which overlaps circles of foster youth and those with incarcerated parents creates a relatively small proportion of children who experience both situations, at least relative to those who have experienced one – or even none – of these adversities,” Muentner told us. “But here in Minnesota, there is a really interesting state-wide, population-based survey of 8th, 9th, and 11th grade students in Minnesota public schools. This survey yields a sample of more than 112,000 adolescents and makes it possible to look at outcomes for subsamples of youth (like those at these systems crossroads) that can otherwise be more difficult to study.”

Researchers had three primary objectives in this study. First, they wanted to understand just how prevalent it was for Minnesota adolescents to experience both parental incarceration and foster care. Next, they wanted to examine racial, socioeconomic, and regional disparities in these rates of system exposure. Finally, they wanted to see how experiences of none, one, or both systems was associated with youth mental health (specifically anxiety, depression, self-harm, suicide ideation, suicide attempt, mental health diagnosis, and mental health treatment).

To test this, they analyzed descriptive statistics and used bivariate tests to understand whether parental incarceration and/or foster care was significantly more common for certain racial, socioeconomic, or regional groups. Then, they used logistic regression models with interactions between parental incarceration and foster care to examine associations with adolescent mental health. This allowed them to calculate the likelihoods of youth reporting adverse mental health symptoms dependent upon their experiences of none, one, or both systems.

“We found a lot of really interesting information,” Muentner told us. “First, our results showed that approximately two per cent of the whole sample reported experiences of both parental incarceration and foster care.”

Of all the youth who had ever experienced parental incarceration, about 27% were also ever in foster care. Of those who were ever in foster care, about 65% also ever had an incarcerated parent.

“However, we found that there were significant disparities for students that intersected with the one or both of the criminal legal or child welfare systems,” Muentner told us. “Pointedly, we saw that systems-exposure was more common for Black, Latino/a/x, and Native youth, with disparities that were most pronounced for youth who navigate both systems.”

Researchers also found that those who met criteria for having experienced poverty and those who resided in rural communities were disproportionately likely to experience parental incarceration and foster care separately, with rates that were again even more pronounced for those involved in both systems.

“Lastly, we found that, even after adjusting for differences by race, poverty, and region, as well as accounting for youth navigating only one system,” Muentner told us, “being at the intersection of parental incarceration and foster care was significantly associated with the highest odds of anxiety, depression, self-harm behaviors, suicide ideation and attempt, as well as being diagnosed with a mental health problem and receiving treatment.”

They also found that those who had the most proximal experiences of these systems exposure (meaning, currently having an incarcerated parent and recently being in foster care) was associated with the most adverse mental health outcomes. This was followed by youth who had any history of dual-systems exposure (meaning that youth may have experienced one or both of these systems in the past, even if they were not currently).

Foster care only seemed to be more potent for adverse mental health indicators than parental incarceration only, though involvement in either one of these systems alone was still associated with worse outcomes relative to their peers who never experienced the incarceration of a parent of were in foster care.

“While the findings were cutting-edge, they unfortunately were not necessarily that surprising,” Muentner told us. “We expected systems-impacted youth to report the most adverse outcomes and hypothesized that multiplicative (and concurrent) exposure would be linked with the most concerning reports of mental health.”

Even though this was largely in line with what researchers had expected, it reaffirms the need to examine adolescent health and well-being in a more holistic context of everything that they may be going through. For instance, watering down systems-exposure to only one of these systems may miss some nuance behind how youth are actually faring. It also continues to shed light on the historically inequitable distribution of the criminal legal and child welfare systems for families of color, those experiencing poverty, and those who live in more rural and potentially under-resourced communities.

“I think that the results mean a number of things moving forward,” Muentner told us. “First, it calls for future research to consider an even broader set of health-outcomes for youth at these crossroads. This includes things like substance use as well as physical and behavioral health. It also warrants an examination of protective factors that can mitigate some of these health-related concerns, such as school connectedness or strong family ties.”

Second, Muentner explained the results call for swift clinical intervention that screens for and treats conditions like anxiety and depression for systems-impacted youth. Additionally, it warrants the expansion of evidence-based therapeutic programs that reduce risk for self-harm as well as suicidal ideation and attempt.

“Next, it calls for a smooth continuum of care as youth navigate one or both of these services,” Muentner told us. “For instance, ensuring that providers and treatment regimens transfer with children as they navigate care placements. Lastly, these ‘downstream’ implications must come in tandem with ‘upstream’ approaches that reduce the number of children made systemically vulnerable to these precarious and compromising situations.”

This includes attending to issues of family policing and separation in a way that hands agency, autonomy, and rights back to parents and families while still promoting child safety and family well-being.