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The receipt of long-term financial social assistance (FSA) as an indicator of financial difficulties among Finnish youth with prenatal substance exposure (PSE) was investigated in comparison with unexposed youth. Data from national health and social welfare registers were collected for 18–24-year-old exposed (n = 355) and unexposed (n = 1011) youth. The influence of youth and maternal characteristics and out-of-home care (OHC) on the association between PSE and youth's long-term FSA receipt was studied by generalized linear models and mediation analyses. Exposed youth had an increased likelihood of long-term FSA receipt (OR 4.89, 95% CI 3.76, 6.37) but the difference with unexposed was attenuated following adjustments for youth and maternal characteristics and OHC (AOR 1.33, 95% CI 0.89, 1.98). Maternal long-term FSA receipt (0.48, 95% CI 0.35, 0.64) and OHC (0.63, 95% CI 0.47, 0.83) mediated a large proportion of the association between PSE and youth's long-term FSA receipt. Youth's mental or behavioral disorders partly mediated the association (0.21, 95% CI 0.14, 0.30), but the mediating effect of lack of secondary education was minor (0.03, 95% CI 0.01, 0.07). Receipt of long-term FSA among youth with PSE likely reflects maternal substance abuse linked with maternal financial situation and care instability in childhood. [ABSTRACT FROM AUTHOR]

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Comprehensive overviews of the use of psychiatric services among children and adolescents placed in out-of-home care (OHC) by child welfare authorities are scarce. We examine specialized service use for psychiatric and neurodevelopmental disorders among children and adolescents in a total population involving children in OHC. We used the longitudinal administrative data of a complete Finnish birth cohort 1997 (N = 57,174). We estimated risk ratios (RRs) for a range of diagnosed psychiatric and neurodevelopmental disorders among children in OHC. We also estimated RRs for OHC among those with diagnosed disorders. We used descriptive methods to explore the timing of first entry into OHC relative to the first diagnosis. Among children in OHC, 61.9% were diagnosed with any psychiatric or neurodevelopmental disorder, compared with 18.0% among those never in OHC (RR: 3.7; 95% CI 3.6–3.8). The most common diagnosed disorders among children in OHC were depression and anxiety disorders, neurodevelopmental disorders, and oppositional defiant disorder/conduct disorder (ODD/CD). Among all children with any diagnosis, 18.1% experienced OHC, compared with 2.5% among those without a diagnosis (RR: 7.4; 95% CI 6.9–7.9). Of those diagnosed with self-harm and suicidality, ODD/CD, substance-related disorders, and psychotic and bipolar disorders, 43.5–61.2% experienced OHC. Of the children in OHC receiving psychiatric services, half were diagnosed before first placement in OHC. The majority of children with experience in OHC were diagnosed with psychiatric or neurodevelopmental disorders. They comprised a significant proportion of individuals treated for severe and complex psychiatric disorders and self-harm. [ABSTRACT FROM AUTHOR]

Previous research suggests that young adults from out‐of‐home care (OHC) are at high risk of low education and unemployment. However, there are no studies on their risk of long‐term NEET (Not in Employment, Education or Training). This study compared the risk of NEET at age 21–23 among OHC youth across Denmark, Finland and Sweden, using register data for an entire birth cohort born in 1987. The Nordic countries share many features, but there are differences in the provision of after‐care support and in the linkage between the educational system and the labour market. The results show that about a fourth in Denmark and Sweden and a third in Finland were NEET, suggesting that the welfare systems were not able to compensate for the OHC youth's childhood disadvantages. To a significant extent, the excess risk of NEET was attributed to poor school performance. Implications for research, policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Young people taken into custody and lacking the support of their families suffer from social and health problems more often than their peers, and the likelihood of their marginalization in later life can be significantly higher. The aim of this study is to discover how the different factors documented at the time of the custody decision or the placement in out-of-home care are associated with the coping abilities of young adults once aftercare services come to an end. The original dataset consisted of 428 measured variables taken from 600 young Finnish adults who have participated in aftercare services. The data were collected at the end of the aftercare period in 2015 from electronic customer/patient record systems. Original free-text documents were read and data extracted and collected on a structured electronic worksheet. All of the factors that had influenced the custody decisions were included in the dataset. Thus, the data consisted both of the baseline and follow-up data. The data were analyzed with BayesiaLab 7.0 tool. Altogether, 18.5% of examined persons had no remarkable coping problems, 74.5% had some challenges and 7% experienced serious difficulties. A child's own problems, such as substance use, running away from home or truancy, were associated with a poorer prognosis compared to children whose custody decisions stemmed from their parents´ urgent life situations, e.g. substance use, violence or serious mental health issues. Children and adolescents who may be in need of child protection services require effective preventive care activities. If a child does enter out-of-home care, s/he will need more influential social support and personal follow-up to enhance his or her long-term wellbeing as early as possible. • BayesiaLab tool was used first time to estimate coping after aftercare. • The biggest group of care leavers was the Survivors. • Youngsters' heavy drinking behavior increased the likelihood of poor coping. • Parental problems are associated with better coping than the adolescents' problems. • Services should include personalized and interdisciplinary care. [ABSTRACT FROM AUTHOR]

International evidence indicates that child poverty increases the risk of child welfare intervention needs but Finland, paradoxically, has low child poverty rates and high child welfare intervention rates. We investigate the extent to which the rate of social assistance use in families with children, as a proxy for child poverty, can be associated with the rate of children in out-of-home care in Finnish municipalities. Data on the annual rate of social assistance use and out-of-home care were drawn from national registers for 216 Finnish municipalities from 1992 to 2021. Linear regression models were utilised to investigate the extent to which the social assistance use rate explained child out-of-home care rates, both spatially and temporally, across municipalities and years while adjusting for the unemployment rate. The rate of out-of-home care increased from some 700 to 1600 per 100,000 children over the period 1992–2021. A percentage point higher rate of the social assistance use was associated with 44–72 more children placed in out-of-home care per 100,000 children, net of the unemployment rate. This association was stronger in more recent time periods. A smaller association was observed within municipalities over time: a percentage point increase in social assistant use was linked to some 4–25 more children placed in out-of-home care per 100,000 children. Out-of-home care is increasingly concentrated in Finnish municipalities with high rates of families receiving social assistance. Preventative child welfare interventions are therefore required in areas with higher rates of economic difficulties among families. [ABSTRACT FROM AUTHOR]

Abstract Previous studies have reported that children and adolescents who have been placed in out-of-home care for the protection of their safety and welfare face considerably high risks for early school leaving. Our study adds to the literature by comparing the association between children's exposure to placement in care and lack of secondary education (i.e. post-compulsory education after age 16) across three Nordic countries: Denmark, Finland, and Sweden. We use data from national registers for children born in 1987, following them until age 23. The datasets for Denmark (N = 55,995, of whom 3056 are in care), Finland (N = 58,855, of whom 1884 are in care), and Sweden (N = 100,152, of whom 3209 are in care) cover the entire birth cohort. To estimate and compare country-specific risks, we calculate average marginal effects from binary logistic regression and adjust the effects for birth mother's socio-economic and health-related background. As expected, the results show that in each country, children placed in care had a significantly higher risk for early school leaving. After adjusting for maternal background, young adults who experienced out-of-home care were 24 to 39 percentage points more likely than their peers never in care to have not completed secondary education. Those placed in care for the first time at teenage were the most likely to have low attainment. In Finland and Sweden, children in care had a similar excess risk for early school leaving, whereas in Denmark the risk was higher. We discuss these results and recommend developing effective interventions to improve the educational attainment of children in care. The difference between Denmark and the other two requires further investigation. Highlights • We compare how many children in out-of-home care leave school early in Denmark, Finland, and Sweden. • Those placed for the first time at teenage were the most likely to have low education in all countries. • In those placed before teenage, attainment was less poor and associated with length of time in care. • In Denmark, the risk for early school leaving was higher than in Finland and Sweden. [ABSTRACT FROM AUTHOR]

Summary Finnish child welfare divides care orders into voluntary and involuntary care orders, based on the consent or objection of different parties. When giving consent to a care order, the parties allow their rights to family life and self-determination to be restricted. This article examines how the voluntary care order differs in practice from the involuntary one and how voluntarism and involuntarism are represented in these two types of care order. Findings The analysis of 37 care orders highlights different shades of voluntarism and involuntarism as well as formal and informal spheres of consent and objection. The binary distinction between voluntarism and involuntarism becomes problematic. Instead, new forms and arenas for consent and objection, e.g., resistance, become topical in child welfare. Applications The spectrum of voluntarism and involuntarism should be recognised in every type of child welfare. The study points out several critical points in the dual decision-making system in Finland, in particular informed consent. [ABSTRACT FROM AUTHOR]

Temporal dynamics during the early adulthood transition among children in out-of-home care is a neglected research area, leaving the possibility of coping with childhood adversity over time a poorly understood topic. To explore early adulthood education and employment trajectories among young adults who experienced out-of-home care during childhood and to examine how various care history factors predict these trajectories. We use longitudinal birth cohort data comprising individual-level information from national registers of all children born in Finland in 1987 (N = 59,476, of whom 1893 were in care). We use trajectory clustering from a previous study on the 1987 birth cohort to compare trajectories between children in care and a propensity score–matched group of peers never in care. We investigated the association between care history factors and trajectories with multinomial logistic regression modeling. Compared with the matched peer group, children in care were less likely to enter trajectories characterized by education and employment (38%) and more likely to enter trajectories involving early parenthood (14%) or long periods of fragmented social assistance benefit receipt and unemployment (21%). Those on early parenthood trajectories were almost exclusively women, whereas those receiving social assistance benefits and experiencing unemployment for lengthy periods were mostly men. Entering disadvantaged trajectories was associated with, inter alia, placement as an adolescent, residential care, and aging out of care. The study demonstrates the relevance of examining longitudinal trajectories in children in care's early adulthood. Many young adults with care experience need support in education and employment beyond young adult age. [ABSTRACT FROM AUTHOR]

Introduction: The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out-of-home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring., Methods: This is a longitudinal register-based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18-23 years., Results: The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out-of-home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45-0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23-0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18-0.48) showed an independent negative effect on secondary education completion., Conclusions: Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction and Aims: To study (i) whether the children of substance-abusing mothers are hospitalised because of injury or illness more often than other children; (ii) how often these children are placed out of home; and (iii) how the type of substance used by the mother affects her children., Design and Methods: This was a retrospective population-based cohort study based on Finnish health care and social welfare registers. The participants were all children born in Finland in 2002 (n = 55,369) and their biological mothers (n = 54,519). Mothers with register entries related to substance abuse in the period 1998-2009 were defined as having a substance abuse problem. Children were followed up for their first seven years of life for hospitalisations because of injuries and infectious diseases and out-of-home placements. The associations between hospitalisation and out-of-home care and mothers' type of substance abuse were estimated using logistic regression. The child's gender and the mother's psychiatric disorders and socio-demographic characteristics obtained from the registers were standardised in the final models., Results: Based on the register data, 2% of mothers had a substance abuse problem. Alcohol problems were more common than drug problems. Children with substance-abusing mothers were more often hospitalised because of injuries and infectious diseases than other children. They had also been placed out of home more often. Mothers' abuse of both alcohol and drugs was a bigger risk for the child than solely alcohol or solely drug abuse., Discussion and Conclusions: The mother's substance abuse has negative outcomes on the child's immediate environment, which affects the health and safety of the child., (© 2014 Australasian Professional Society on Alcohol and other Drugs.)