Residential care has become the “third rail” of child welfare, says Andrew Zinn, professor of social work at the University of Kansas. Roughly a quarter of all adolescents placed in substitute care by state or county welfare agencies live in group homes or other kinds of residential care facilities. This number has remained fairly constant for the past 20 years. But group homes or campus-like treatment centers are expensive, and some critics say residential care does more harm than good.
“There are a lot of reasons why we could—and should—find better ways of treating kids,” says Zinn. “But for a long time, you can’t deny it, residential care has been a major part of what we do. We should think about how we can do it better.”
In a paper in the September 2014 Social Service Review, Zinn and his colleague Judy Havlicek, a professor at the University of Illinois at Urbana-Champaign, examine the experiences of 2,542 adolescents in residential care, using data from the Illinois Department of Children and Family Services. The authors found six distinct pathways into residential care, each characterized by different adverse events, including incarceration, hospitalization for mental illness, and instability due to changes in placement, such as running away.
“Pathways to Residential Care: Latent Class and Confirmatory Analyses of Adolescents’ Adverse Placement Event Histories” also reports that adolescents in residential care tend to continue along these pathways after they leave. Young people with a history of running away often run away again; those with a history of hospitalization or incarceration are more likely to leave residential placement to hospitalization or incarceration.
The persistence of these pathways raises questions about the effectiveness of residential care and suggests the difficulty of breaking out of established patterns. Indeed, the longer adolescents followed a particular pathway before entering residential care the more likely they were to continue on it after they left.
A more nuanced understanding of the adverse events that lead to residential placement, the authors argue, can help social workers better diagnose and treat adolescents in residential care. It may also offer a broader lesson for social work. Zinn says that the diversity of issues within the populations they serve presents an ongoing challenge for social workers and needs to be better understood. “Our failure to examine that heterogeneity and to understand its effects is often why we see no impact of intervention,” he says.
Zinn, Andrew, and Judy Havlicek. “Pathways to Residential Care: Latent Class and Confirmatory Analyses of Adolescents’ Adverse Placement Event Histories.” Social ServiceReview 88 (3): 367-406.