Give Youth a Voice in Discussions about their Mental Health Care and Child Welfare Services

“Just treating people with respect is the biggest thing, like treating kids with respect, because I mean they do understand a lot… they do know what’s going on, and they pick up on a lot of things that I think a lot of adults don’t really think they do.” –Young adult reflecting on his experiences being diagnosed with depression and attention deficit hyperactivity disorder in childhood.

Children are often viewed as in need of protection and incapable of participating in decisions about their care. They are seldom brought to the table in discussions surrounding the services they receive. Research aimed at improving children’s services, including mental health and child welfare services, is often uninformed by the very children and youth served by these systems. Capturing youth voice in policy research would greatly help to inform and improve these systems of care.

Youth Voice and Children’s Mental Health Services:

As one example, youth perspectives could inform the field of children’s mental health. Researchers, advocates, and clinicians alike agree that, in order to improve systems of care for youth, we need to hear directly from the youth themselves. Youth can provide “relevant, considered views” on the mental health services they have received and inform improvements to the services that they themselves have experienced.^[i]

A key finding was that professionals and parents often withhold information from children about their mental health diagnoses. Interviews suggest that this can exacerbate the stigma children experience. Those whose diagnoses were withheld from them recalled feeling the stigma of having something “wrong” with them, even though they could not identify its source. As one participant, who was sent out of the room when her parents were informed of her diagnosis, recalled:

[I remember] feeling like there was something wrong with me because my parents never talked to me about it. I just remember the silence in the car ride home after that doctor’s appointment […] my whole life changed in that moment.

These findings suggest that practitioners and parents, as well as other adults in children’s lives, can help minimize the stigma children experience by sharing information as openly as possible, albeit in developmentally appropriate ways. More research is needed to provide guidelines on how to best share and discuss this information with children at different stages of development.

When asked how to improve mental health services for children, many participants emphasized the importance of being open with children throughout the process. A participant suggested:

I don’t know if I just had bad therapists or what, but I feel like that would be one of the biggest things is just treating kids with respect and sitting down and really talking to them.

Researchers could offer the same respect by listening to youth’s experiences and capturing their perspectives.

Youth Voice and Child Welfare Services:

Youth voice is also lacking in child welfare research[ii], despite calls for clients’ perspectives that can provide insight to improve child welfare services.[iii]

Through Child Trends’ new study, The Wendy’s Wonderful Kids Post-Adoption Study, we will soon be hearing directly from youth adopted from foster care. This study, funded by the Dave Thomas Foundation for Adoption (DTFA), aims to include interviews with several hundred youth (ages 19-20) across more than a dozen states who have entered foster care at older ages and were adopted through DTFA’s signature adoption recruitment program, Wendy’s Wonderful Kids. The goal of this study is to learn how youth who were adopted from foster care fare in young adulthood.

One exciting area of this study involves examining youth perspectives on the adoption process, including the information and services they or their family members received before, during, and after the adoption.

It is our hope that findings from this study will inform foster care adoption practice and policy, as well as permanency planning efforts more generally. Stay tuned, as we listen to their stories!

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[i] Laws, S. (1998). Hear me! Consulting with young people on mental health issues. The Mental Health Foundation.

[ii] Hyde, J., & Kammerer, N. (2009). Adolescents’ perspectives on placement moves and congregate settings: Complex and cumulative instabilities in out-of-home care. Children and Youth Services Review, 31, 265-273; Kools, S. M. (1997). Adolescent identity development in foster care. Family Relations, 46(3), 263-271;Rauktis, M. E., Fusco, R. A., Cahalane, H., Bennett, I. K., & Reinhart, S. M. (2011). ‘Try to make it seem like we’re regular kids’: Youth perceptions of restrictiveness in out-of-home care. Children and Youth Services Review, 33, 1124-1233.

[iii] Drake, B. (1996). Consumer and worker perceptions of key child welfare competencies. Children and Youth Services Review, 18(3), 261-279; Dumbrill, G. C. (2006). Parental experience of child protection intervention: A qualitative study. Child Abuse and Neglect, 30, 27-37.