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Paper

Outcomes assessment in residential care: a long term evaluation

abstract

Purpose. In the present work we report the results of a follow-up study of young people in two Autonomous Communities of Spain who had spent at least nine months in residential care and who had left between 1991 and 1999.

Method. Participants were required to be at least 16 years old at the time of the follow-up. A sample of 260 people (the average period spent in residential care was 7.1 years) were located and interviewed covering the following aspects: where they had gone on leaving the children's home, current living arrangements and type of dwelling, employment status/studies, health problems, problems of drug-dependence, delinquency or marginalization and relations with family.

Key findings. With respect to the place they went on leaving residential care, the vast majority (70.4%) returned to the family home; of the remainder, 11% went to the homes of relatives (uncles/aunts or grandparents) and 14% went to live elsewhere (11.5% in flats with other young people and 2.7% with a partner). At the time of locating them (3 years later on average) almost half the sample continue to live in the family home, though by now nearly a third were living with a partner or in a shared flat (just a few cases).
As far as their main occupation is concerned, 48.8% were working at the time of the interview, while the figure for "unemployment" (defined as those who are between jobs) is 17.7%, so that we can say that 67% are immersed in the fluctuations of the young persons' labour market, though the jobs in question are almost always unskilled, and in many cases temporary.
In only five cases was the respondent working and studying at the same time, and indeed only 6% were studying at all. We should add that 10% of the women described themselves as housewives.
Some young people (7.4 % of men, y 15.2 % of women) indicated that they were doing nothing at all in particular, and typically were living in the family home or with a partner without making a contribution to it.
There were several cases of prostitution among the women, and the "others" section includes a range of activities, nearly all of a marginal type (drug-dealing, crime, etc.). As for the indicators of social maladjustment, we compiled specific information on substance-dependence and problems with the law.
A total of 9.4% have severe dependence on substances, and 7.8% are sporadic users, while 4.3% have received treatment for drug-dependence and overcome the problem.
Given that nearly all the indicators produce a highly partial and segmented view of the follow-up situation, and with the aim of obtaining a more comprehensive picture, we constructed a measure of general social integration.
The procedure consisted of drawing up a summary of each case in relation to the current situation that included the principal aspects, such as: reason for leaving the institution, where they went, changes of dwelling and/or type of household, main occupation, type of job, relations with the family, problems with the law or drugs, and state of health.
Afterwards, two independent assessors read these case histories and gave each of them a level of 'social integration' using the following five categories:

  • social marginalization: presence of serious problems of drug-addiction, prostitution or delinquency;
  • social welfare recipient: absence of serious problems, but largely dependent for maintaining this situation on help from social services;
  • intermediate adjustment: cases in which the participant has passed from a situation of dependence on social welfare to a more independent one, but with some instability;
  • good adjustment: cases where there is financial independence and good social integration in general, but minor problems in some of the indicators (health, family relationships, etc.);
  • excellent adjustment: Full independence and stability in employment and residence and a positive situation in all the selected indicators.


Results show that the most numerous groups are those of 'intermediate adjustment' (24%) and 'dependence on social welfare' (24%), so that the role of social service support is a prominent one. On the negative side, it is noteworthy that 14.6% have serious problems of social marginalization, and there were more women than men in this category, a finding largely accounted for by prostitution.
The "good" and "excellent" levels account for 36.5% of the sample. What we have found is that in spite of long years spent in children's homes, the majority of our sample were making their way to independence as adults.
The results serve to warn against simplistic analysis and radical judgements in relation to residential care, without taking into account the complexities concerning the purpose of such placements, their stability and the conditions in which they are implemented.

Contacts: Jorge F. del Valle, Child and Family Research Group. University of Oviedo, Facultad de Psicología. Plaza Feijoo s/n, 33003 Oviedo. Spain, E-mail: jvalle@uniovi.es, Phone +34 985 103246, +985 104141.

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