Background and aim

Children who enter or reside in out-of-home care are in greater need of health and dental care services than other children.

This report is one in a series of reports where SBU has examined interventions for children in out-of-home care (foster or residential care). The aim is to evaluate organisational models for securing access to health and dental care for children in out-of-home care.

Conclusions

• An investigation of current Swedish practice in local child welfare shows that less than half of the Swedish local authorities have systematic routines to ensure that children in out-of-home care receive assessment of their physical health, only ten percent provide an oral health assessment and no local author­ity has routines for assessing mental health.
• We did not find any studies of adequate qual­ity, therefore it is not possible to determine the effects of organisational models for providing health and dental care to childrenin out-of-home care. Henceforth, when organisational models are introduced in practice, well-conducted follow-up studies investigating their effects should be performed. There is also a need for studies that assess the prevalence of physical, dental and mental health prob­lems and oral illness among children enter­ing or residing in out-of-home care.
• From an ethical point of view, it is important that children in out-of-home care are provided appropriate health and dental care. The new requirements in the Swedish law (5 kap. 1 d § SoL) regarding mandatory health assessments for children entering out-of-home care should be followed-up and evaluated. There is also a need for estab­lishing organisational models in Swedish practice to ensure that the rights and needs of health and dental care for these individuals are met.
• In an international perspective, promising or­gan­isational models that could secure that these individuals receive health and dental care do exist, but they have not been evaluated with sufficient scientific rigour. A cost calculation performed by SBU suggests that an organ­isational model could be implemented in the Swedish system at a low cost with potential benefits for children in out-of-home care.

What does this report add?

This report shows that children in out-of-home care in Sweden do not receive adequate health and dental care. Furthermore, the report stresses the need for scientific evaluations of organisational models that could secure the access to health and dent­al care for this vulnerable group. An organisa­tional model inspired by the English health care system is described as an example of how a Swedish organisational model could be designed.

Method

The report includes a systematic review of studies investigating the effects of organisational models aimed to secure access to health and dental care for children in out-of-home care.

In addi­tion, the report contains an investigation of cur­r­ent practice in Sweden of routines and structures through electronic surveys that were followed-up via phone interviews with representatives of local child welfare authorities. Ethical, social and legal questions were also analysed by reviewing relevant literature, governmental reports and legal documents. Finally, an economic evaluation was conducted investigating the resources needed for an organisational model that could secure that children in out-of-home care receive health and dental care.

Main results

Discussion

The full report in Swedish

The full report in Swedish /sv/publikationer/SBU-utvarderar/organisatoriska-modeller-for-att-barn-och-unga-i-familjehem-eller-pa-institution-ska--fa-halso--och-sjukvard-och-tandvard/

Flow charts

Project group

Excluded studies

Download PDF (317K)

Search strategies

Download PDF (251K)

References

1.

SBU. Insatser för bättre psykisk och fysisk hälsa hos familjehemsplacerade barn. Stockholm: Statens beredning för medicinsk och social utvärdering (SBU); 2017. SBU-rapport nr 265. ISBN 978-91-88437-07-5.

2.

Vinnerljung B. Hur vanligt är det att ha varit fosterbarn? En deskriptiv epidemiologisk studie. Socialvetenskaplig Tidskrift 1996;3:166-179.

3.

Vinnerljung B, Hjern A, Ringbeck Weitoft G, Franzén E, Estrada F. ­Children and young people at risk. Int J Soc Welf. 2007;16:163–202.

4.

Fallesen P, Emanuel N, Wildeman C. Cumulative risks of foster care placement for Danish children. PloS one 2014;9:e109207. [PMC free article: PMC4192300] [PubMed: 25299657]

5.

Mc Grath-Lone L, Dearden L, Nasim B, Harron K, Gilbert R. Changes in first entry to out-of-home care from 1992 to 2012 among children in England. Child Abuse Negl. 2016;51:163–171. [PMC free article: PMC6205623] [PubMed: 26585214]

6.

Eurochild - Children in alternative care - National Surveys - 2nd Edition January 2010, http://eurochild.org.

7.

Socialstyrelsen. Sociala skillnader i tandhälsa bland barn och unga. Underlagsrapport till Barns och ungas hälsa, vård och omsorg 2013. Artikelnummer: 2013-5-34.

8.

Wettergren B, Blennow M, Hjern A, Söder O, Ludvigsson JF. Child Health Systems in Sweden. J Pediatr 2016;177S:187-202. [PubMed: 27666267]

9.

Schor EL. The foster care system and health status of foster children. Pediatrics. 1982;69:521–528. [PubMed: 7079006]

10.

Bamford FN, Wohlkind SN. The ­physical and mental health of children in care: Research needs (two papers), Swindon: ESRC, 1988.

11.

Chernoff R, Combs-Orme T, ­Risley-Curtiss C, Heisler A. Assessing the health status of children entering foster care. Pediatrics. 1994;93:594–601. [PubMed: 8134214]

12.

Haflon N, Mendonca A, Berkowitz G. Health status of children in foster care. The experience of the Center for the vulnerable child. Arch Pediatr Adolesc Med. 1995;149:386–392. [PubMed: 7704166]

13.

Bundle A. Health of teenagers in residential care: comparison of data held by care staff with data in community child health records. Arch Dis Child. 2001;84:10–14. [PMC free article: PMC1718628] [PubMed: 11124775]

14.

Hill C, Thompson M. Mental and physical health co-morbidity in looked-after children. Clin Child ­Psychol Psychiatry. 2003;8:315–321.

15.

Hill C, Watkins J. Statutory health assessments for looked-after children: what do they achieve. Child Care Health Dev. 2003;29:3–13. [PubMed: 12534562]

16.

Anderson L, Vostanis P, Spencer N. The health needs of children aged 6-12 years in foster care. Adoption &­Fostering. 2004;28:31–40.

17.

Hansen RL, Mawjee FL, Barton K, Metcalf MB, Joye NR. Comparing the health status of low-income children in and out of foster care. Child Welfare. 2004;83:367–380. [PubMed: 15310062]

18.

Kristoffersen L. Barnevernbarnas helse. Uførhet og dødelighet i perioden 1990–2002 NIBR-rapport 2005:12. ISBN: 82-7071-564-6.

19.

Jee SH, Barth RP, Szilagyi MA, Szilagyi PG, Aida M, Davis MM. Factors associated with chronic conditions among children in foster care. J Health Care Poor Underserved. 2006;17:328–341. [PubMed: 16702718]

20.

Leslie LK, Gordon JN, Meneken L, Premji K, Michelmore KL, Ganger W. The physical, developmental, and mental health needs of young ­children in child welfare by initial placement type. J Dev Behav Pediatr. 2005;26:177–185. [PMC free article: PMC1550710] [PubMed: 15956866]

21.

Miller LC, Chan W, Litvinova A, Rubin A, Tirella L, Cermak S. Medical diagnoses and growth of children residing in Russian orphanages. Acta Paediatr. 2007;96:1765–1769. [PubMed: 17971188]

22.

Nathanson D, Tzioumi D. Health needs of Australian children living in out-of-home care. J Paediatr Child Health. 2007;43:695–699. [PubMed: 17854456]

23.

Zewdu AM. Health-related benefits among children in the child welfare system: Prevalence and determinants of basic and/or attendance benefits. Norsk Epidemiologi. 2010;20:77–84.

24.

Kaltner M, Rissel K. Health of Australian children in out-of-home care: needs and carer recognition. J Paediatr Child Health. 2011;47:122–126. [PubMed: 21091584]

25.

Lightfoot E, Hill K, LaLiberte T. Prevalence of children with disabilities in the child welfare system and out of home placement: An examination of administrative records. Child Youth Serv Rev. 2011;33:2069–2075.

26.

Schneiderman JU, Leslie LK, Arnold-Clark JS, McDaniel D, Xie B. Pediatric health assessments of young children in child welfare by placement type. Child Abuse Negl. 2011;35:28–39. [PubMed: 21316106]

27.

Simkiss D. Outcomes for looked after children and young people. Paediatrics and Child Health. 2012;22:388–392.

28.

Stein R, Hurlburt M, Heneghan A, Zhang J, Rolls-Reutz J, Silver E, et al. Chronic conditions among children investigated by child welfare: A national sample. Pediatrics. 2013;131:455–462. [PMC free article: PMC4074665] [PubMed: 23420907]

29.

Jaudes P, Bilaver L, Champange V. Do children in foster care receive appropriate treatment for asthma. Child Youth Serv Rev. 2015;52:103–109.

30.

Jaudes P, Weil L, Prior J, Sharp D, Holzberg M, McClelland G. Wellbeing of children and adolescents with special health care needs in the child welfare system. Child Youth Serv Rev. 2016;70:276–283.

31.

Köhler M, Emmelin M, Hjern A, Rosvall M. Children in family foster care have greater health risks and less involvement in Child Health Services. Acta Paediatr. 2015;104:508–513. [PubMed: 25619631]

32.

Szilagyi M, Rosen D, Rubin D, Zlotnik S. Health care issues for children and adolescents in foster care and kinship care. Pediatrics. 2015;136:1142–1166. [PubMed: 26416934]

33.

Tanguy M, Rousseau D, Duverger P, Nguyen S, Fanello S. Parcours et devenir de 128 enfants admis avant l’age de quatre ans en pouponniere sociale [Course and progression of children admitted before 4 years of age in a French welfare center] Archives de Pediatrie. 2015;22:1129–1139. [PubMed: 26454760]

34.

Kling S, Vinnerljung B, Hjern A. Somatic assessments of 120 Swedish children taken into care reveal large unmet health and dental care needs. Acta Paediatr. 2016;105:416–420. [PubMed: 26684221]

35.

Kling S, Vinnerljung B, Hjern A. Hälsokontroll för SiS-ungdomar. En studie av hälsoproblem och vårdbehov hos ungdomar på fyra särskilda ungdomshem. Institutionsvård i Fokus. Rapportnummer: 4, 2016. ISBN: 978-91-87053-40-5.

36.

Turney K, Wildeman C. Mental and physical health of children in foster care. Pediatrics 2016;138:e20161118. [PubMed: 27940775]

37.

Dunnigan A, Thompson T, Jonson-Reid M, Drake B. Chronic health conditions and children in foster care: Determining demographic and placement-related correlates. J Public Child Welfare. 2017;11:586–598.

38.

Randsalu LS, Laurell L. Children in out-of-home care are at high risk of somatic, dental and mental ill health. Acta ­Paediatr. 2018;107:301–306. [PubMed: 28986993]

39.

Aguilia A, Gonzalez-Garcia C, Bravo A, Lazaro-Visa S, del valle J (submitted). Children and young people with intellectual disabilities in residential care. Prevalence of mental health disorders and therapeutic interventions.

40.

Viner R, Taylor B. Adult health and social outcomes of children who have been in public care: Population-based study. Pediatrics. 2005;115:894–899. [PubMed: 15805361]

41.

Vinnerljung B, Brännström L, Hjern A. Disability pension among adult former child welfare clients: A Swedish national cohort study. Child Youth Serv Rev. 2015;56:169–176.

42.

Kessler R, Pecora P, Williams J, Hiripi E, O’Brian K, English D, et al. Effects of enhanced foster care on the long-term physical and mental of foster care alumni. Arch Gen Psychiatry. 2008;65:625–633. [PubMed: 18519820]

43.

Vinnerljung B, Sallnäs M. Into adulthood: a follow-up study of 718 young people who were placed in out-of-home care during their teens. J Child Fam Soc Work. 2008;13:144–155.

44.

Schneider R, Baumrid N, Pavao J, Stockdale G, Castelli P. What happens to youth removed from parental care? Health and economic outcomes for women with a history of out-of-home placement. Child Youth Serv Rev. 2009;31:440–444.

45.

Berlin M, Vinnerljung B, Hjern A. School performance in primary school and psychosocial problems in young adulthood among care leavers from long term foster care. Child Youth Serv Rev. 2011;33:2489–2497.

46.

Villegas S, Rosenthal J, O’Brien K, Pecora P. Health outcomes for adults in family foster care as children: An analysis by ethnicity. Child Youth Serv Rev. 2011;33:110–117.

47.

Zlotnick C, Tam TW, Soman LA. Life course outcomes on mental and physical health: the impact of foster care on adulthood. Am J Public Health. 2012;102:534–540. [PMC free article: PMC3487656] [PubMed: 22390519]

48.

von Borczykowski A, Vinnerljung B, Hjern A. Alcohol and drug abuse among young adults who grew up in substitute care – findings from a ­Swedish national cohort study. Child Youth Serv Rev. 2013;35:1954–1961.

49.

Bruskas D, Tessin DH. Adverse childhood experiences and psycho­social well-being of women who were in foster care as children. Perm J 2013;17:e131-41. [PMC free article: PMC3783064] [PubMed: 24355905]

50.

Ahrens KR, Garrison MM, ­Courtney ME. Health outcomes in;young adults from foster care and economically diverse backgrounds. Pediatrics. 2014;134:1067–1074. [PMC free article: PMC4243069] [PubMed: 25367543]

51.

Vinnerljung B, Hjern A. Consumption of psychotropic drugs among adults who were in societal care during their childhood-A Swedish national cohort study. Nord J Psychiatry. 2014;68:611–619. [PubMed: 24754468]

52.

Socialstyrelsen. Tandhälsa bland unga vuxna som varit placerade. Barns och ungas hälsa, vård och omsorg 2013. Artikelnummer: 2013-3-15. ISBN: 978-91-7555-042-8.

53.

Socialstyrelsen. Vård och omsorg om placerade barn. Öppna jämförelser och utvärdering. Rekommendationer till kommuner och landsting om hälsa och utsatthet. Artikelnummer: 2013-3-7.

54.

Berlin M, Mensah T, Lundgren F, Klingberg G, Hjern A, Vinnerljung B, Cederlund A. Dental health care utilization among young adults who were in societal out-of-home care as children: A Swedish national cohort study. Int J Soc Welf (In press).

55.

Vinnerljung B. Mortalitet bland fosterbarn som placerats före tonåren [Mortality among foster children placed before their teens] Socialvetenskaplig Tidskrift. 1995;2:60–72.

56.

Barth R, Blackwell Blackwell, D D. Death rates among California’s foster care and former foster care populations. Child Youth Serv Rev. 1998;20:577–604.

57.

Christoffersen MN. Risikofaktorer i barndommen [Childhood risk factors]. Copenhagen: Socialforskningsinstituttet, Rapport 99:18 1999.

58.

Kalland M, Pensola TH, Merilainen J, Sinkkonen J. Mortality in children registered in the Finnish child welfare registry: population based study. BMJ. 2001;323:207–208. [PMC free article: PMC35273] [PubMed: 11473912]

59.

Vinnerljung B, Ribe M. Mortality after care among young adult foster children in Sweden. Int J Soc Welf. 2001;10:164–173.

60.

Vinnerljung B, Berlin M, Hjern A. Skolbetyg, utbildning och risker för ogynn­sam utveckling hos barn. Social Rapport 2010. Stockholm: Socialstyrelsen: 227-266, 2010.

61.

Björkenstam C, Björkenstam E, Ljung R, Vinnerljung B, Tuvblad C. ­Suicidal behavior among delinquent former child welfare clients. Eur Child Adolesc Psychiatry 2013a;22:349-55. [PubMed: 23296473]

62.

Hjern A, Vinnerljung B, Lindblad F. Avoidable mortality among child welfare recipients and intercountry adoptees: a national cohort study. J Epidemiol ­Community Health. 2004;58:412–417. [PMC free article: PMC1732760] [PubMed: 15082742]

63.

Gao M, Brännstrom L, Almquist YB. Exposure to out-of-home care in child­hood and adult all-cause ­mortality: a cohort study. Int J Epidemiol. 2017;46:1010–1017. [PMC free article: PMC5837321] [PubMed: 28031308]

64.

Brännström L, Vinnerljung B, Hjern A. Child welfare clients have higher risks for teenage childbirths: which are the major confounders. Eur J Public Health. 2016;26:592–597. [PMC free article: PMC4946411] [PubMed: 27085195]

65.

Brännström L, Vinnerljung B, Hjern A. Risk Factors for Teenage Childbirths among Child Welfare Clients: Findings from Sweden. Child Youth Serv Rev. 2015;53:44–51.

66.

Vinnerljung B, Franzén E, ­Danielsson M. Teenage parenthood among child welfare clients: A Swedish national cohort study of prevalence and odds. J Adolesc. 2007;30:97–116. [PubMed: 16455132]

67.

Williams J, Jackson S, Maddocks A, Cheung W-Y Cheung W-Y, Love A, Hutchings H. Case-control study of the health of those looked after by local authorities. Arch Dis Child. 2001;85:280–285. [PMC free article: PMC1718952] [PubMed: 11567933]

68.

Ashton-Key M, Jorge E. Does providing social services with information and advice on immunisation status of “looked after children” improve uptake. Arch Dis Child. 2003;88:299–301. [PMC free article: PMC1719515] [PubMed: 12651751]

69.

Morritt J. The health needs of children in public care: the results of an audit of immunizations of children in care. Public Health. 2003;117:412–416. [PubMed: 14522156]

70.

Rodrigues VC. Health of children looked after by the local authorities. Public Health. 2004;118:370–376. [PubMed: 15178145]

71.

Barnes P, Price L, Maddocks A, Cheung WY, Williams J, Jackson S, Mason B. Immunisation status in the public care system: a comparative study. Vaccine. 2005;23:2820–2823. [PubMed: 15780730]

72.

Hill C, Mather M, Goddard J. Cross sectional survey of meningococcal. C immunisation in children looked after by local authorities and those living at home. BMJ. 2003;326:364–365. [PMC free article: PMC148892] [PubMed: 12586668]

73.

Walton SB, Bedford H. Immunization of looked-after children and young people: a review of the literature. Child Care Health Dev. 2017;43:463–480. [PubMed: 28317146]

74.

McIntyre A, Keesler T. Psychological disorders among foster children. J Clin Child Psychol. 1986;15:297–303.

75.

McCann JB, James A, Wilson S, Dunn G. Prevalence of psychiatric dis­orders in young people in the care system. BMJ. 1996;313:1529–1530. [PMC free article: PMC2353045] [PubMed: 8978231]

76.

Stein E, Evans B, Mazumdar R, Rae-Grant N. The mental health of ­children in foster care: A comparison with community and clinical samples. Can J Psychiatry. 1996;41:385–391. [PubMed: 8862858]

77.

Dimigen G, Del Priore C, Butler S, Evans S, Ferguson L, Swan M. Psychiatric disorder among children at time of entering local authority care: questionnaire survey. BMJ. 1999;319:675. [PMC free article: PMC28219] [PubMed: 10480823]

78.

Kjelsberg E, Nygren P. The prevalence of emotional and behavioural problems in institutionalized childcare clients. Nord J Psychiatry. 2004;58:319–325. [PubMed: 15370782]

79.

Minnis H, Everett K, Pelosi AJ, Dunn J, Knapp M. Children in foster care: mental health, service use and costs. Eur Child Adolesc Psychiatry. 2006;15:63–70. [PubMed: 16523249]

80.

Ford T, Vostanis P, Meltzer H, ­Goodman R. Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J ­Psychiatry. 2007;190:319–325. [PubMed: 17401038]

81.

Sawyer M, Carbone J, Serle A, ­Robinson P. The mental health and wellbeing of children and adolescents in home-based foster care. Med J Aust. 2007;186:181–184. [PubMed: 17309418]

82.

Schmid M, Goldbeck L, Nuetzel J, Fegert JM. Prevalence of mental disorders among adolescents in German youth welfare institutions. Child Adolesc Psychiatry Ment Health. 2008;2:1–8. [PMC free article: PMC2262059] [PubMed: 18226213]

83.

McAuley C, Davis T. Emotional well-being and mental health of looked after children in England. Child Fam Soc Work. 2009;14:147–155.

84.

Egelund T, Lausten M. Prevalence of mental health problems among childrenplaced in out-of-home care in Denmark. Child Fam Soc Work. 2009;14:156–165.

85.

Pecora P, White C, Jackson L, ­Wiggins T. Mental health of current and former recipients of foster care: a review of recent studies in the USA. Child Fam Soc Work. 2009;14:132–146.

86.

Damnjanovic M, Lakic A, Stevanovic D, Johanovic A. Effects of mental health on quality of life in children and adolescents living in residential and foster care: a cross-sectional study. Epidemiol ­Psychiatr Sci. 2011;20:257–262. [PubMed: 21922968]

87.

Lehmann S, Havik OE, Havik T, ­Heiervang ER. Mental disorders in foster children: a study of prevalence, comorbidity and risk factors. Child Adolesc Psychiatry Ment Health. 2013;7:39. [PMC free article: PMC3922948] [PubMed: 24256809]

88.

Havnen K, Breivik K, Jakobsen R. Stability and change – a 7- to 8-year follow-up study of mental health problems in Norwegian children in long-term out-of-home care. Child Fam Soc Work. 2014;19:292–303.

89.

Maaskant A, van Rooij F, Hermanns J. Mental health and associated risk factors of Dutch school aged foster children placed in long-term foster care. Child Youth Serv Rev. 2014;44:207–216.

90.

Sainero A, Bravo A, del Valle J. Examining needs and refferals to mental health services for children in residential care in Spain: An empirical study in an autonomous community. J Emot Behav Disord. 2014;22:16–26.

91.

Cohn A-M Cohn A-M, Szilagyi M, Jee S, ­Blumkin A, Szilagyi P. Mental health outcomes among child welfare investigated children: In-home versus out-of-home care. Child Youth Serv Rev. 2015;57:106–111.

92.

Greger HK, Myhre AK, Lydersen S, Jozefiak T. Previous maltreatment and present mental health in a high-risk adolescent population. Child Abuse Negl. 2015;45:122–134. [PubMed: 26003821]

93.

Bronsard G, Alessandrini M, Fond G, Loundou A, Auquier P, Tordjman S, Boyer L. The Prevalence of Mental Disorders Among Children and Adolescents in the Child Welfare System: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016;95:e2622. [PMC free article: PMC4998603] [PubMed: 26886603]

94.

Jozefiak T, Kayed NS, Rimehaug T, Wormdal AK, Brubakk AM, ­Wichstrom L. Prevalence and comorbidity of mental disorders among adolescents living in residential youth care. Eur Child Adolesc Psychiatry. 2016;25:33–47. [PMC free article: PMC4698296] [PubMed: 25749933]

95.

Gonzalez-Garcia C, Bravo A, ­Arruabarrena I, Martin E, Santos I, Del Valle J. Emotional and behavioral problems of children in residential care: Screening detection and referrals to mental health services. Child Youth Serv Rev. 2017;73:100–106.

96.

Vasileva M, Petermann F. Mental health needs and therapeutic utilization of young children in foster care in Germany. Child Youth Serv Rev. 2017;75:69–76.

97.

Zito JM, Safer DJ, Sai D, Gardner JF, Thomas D, Coombes P, Dubowski M, Mendez-Lewis M. Psychotropic medication patterns among youth in foster care. Pediatrics 2008;121:e157–e63. [PubMed: 18166534]

98.

Socialstyrelsen. Förskrivning av psyko­farmaka till placerade barn och ungdomar. Artikelnummer: 2014-11-3. ISBN: 978-91-7555-235-4.

99.

Tai M-H Tai M-H, Shaw T, dosReis S. Antipsychotic use and foster care placement stability among youth with attention-deficit hyperactivity/disruptive ­behavior disorders. J Public Child Welf. 2016;10:376–390.

100.

Haysom L, Indig D, Byun R, Moore E, van den Dolder P. Oral health and risk factors for dental disease of Australian young people in custody. J Paediatr Child Health. 2015;51:545–551. [PubMed: 25363249]

101.

Melbye ML, Chi DL, Milgrom P, Huebner CE, Grembowski D. Washington state foster care: dental utilization and expenditures. J Public Health Dent. 2014;74:93–101. [PubMed: 23889590]

102.

Swire MR, Kavaler F. The health status of foster children. Child Welfare. 1977;56:635–653. [PubMed: 590042]

103.

Olivan G. Untreated dental caries is common among 6 to 12-year-old physically abused/neglected children in Spain. Eur J Public Health. 2003;13:91–92. [PubMed: 12678324]

104.

Socialstyrelsen. Tandhälsa bland unga vuxna som varit placerade. Registerstudie av tandhälsa och tandvårdskonsumtion bland 20–29-åringar som varit placerade i heldygnsvård under uppväxten. Artikelnummer: 2016-2-28.

105.

Sveriges Kommuner och Landsting (2017). Nationell kartläggning om hälsoundersökning av barn och unga vid placering. ISBN 978-91-7585-483-0.

106.

Phillips J. Meeting the psychiatric needs of children in foster care: Social workers’ view. Psychiatric Bullentin. 1997;21:609–611.

107.

Mount J, Lister A, Bennun I. Identifying the mental health needs of looked after young people. Clin Child Psychol Psychiatry. 2004;9:363–382.

108.

Butterworth S, Singh S, Birchwood M, Islam Z, Munro E, Vostanis P, Paul M, Khan A, Simkiss D. Transitioning care-leavers with mental health needs: ‘They set you up to fail’ Child Adolesc Ment Health. 2017;22:138–147. [PubMed: 32680381]

109.

Vinnerljung B, Hjern A (2018). Health care in Europe for children in societal out-of-home care. Rapport till EU-­kommissionen från MOCHA – Models of Child Health Appraised. London: MOCHA/Imperial College. http://www.childhealthservicemodels.eu/wp-content/uploads/Mocha-report-Children-in-OHC-May-2018.pdf.

110.

Vinnerljung B, Kling S, Hjern A. Health problems and health care needs among youth in Swedish secure residential care. Int J Soc Welf (In press).

111.

Department of Education & Department of Health. Promoting the health and well-being of looked-after children. Statutory guidance for local authorities, clinical commissioning groups and NHS England. London: Department of Education/Department of Health 2015.

112.

Simkiss D, Jainer R. The English system for ensuring health care and health monitoring of looked-after children. Int J Soc Welf 2018 (In press).

113.

Royal College of Nursing, Royal ­College of Paediatrics and Child Health, Royal College of General Practitioners. Looked after children: Knowledge, skills and competences of health care staff. ­London: Royal College of Paediatrics and Child Health 2015.

114.

Mather M, Batty D. Doctors for ­children in public care. London. BAAF (British Agencies for Adoption & ­Fostering) 2000.

115.

Goodman A, Goodman R. Strengths and Difficulties Questionnaire scores and mental health in looked after children. Br J Psychiatry. 2012;200:426–427. [PubMed: 22550331]

116.

Barne-, ungdoms- og familiedirektoratet & Helsedirektoratet. Samarbeid mellom barnevernstjenster och psykiske helse­tjenster till barnets bästa. Oslo: Barne-, ungdoms- og familiedirektoratet/Helse­direktoratet 2015.

117.

Helsedirektoratet. Barne-, ungdoms- og familiedirektoratet. Oppsummering og anbefalninger fra arbeidet med helse­hjelp till barn i barnevernet. Oslo, 2017.

118.

Helsedirektoratet. Prioriteringsveileder – psykisk helsevern för barn og unge. Oslo, 2015.

119.

NOU 2016:16. Ny barnevernslov. Barne- og likestillingsdepartementet. Oslo: Norge Offentlige utredninger.

120.

Lehmann S. Kayed N. Mental health care for children in alternate care by the child protection services: Experiences from Norway. Int J Soc Welf (under tryckning).

121.

Zlotnik S, Wilson L, Scribano P, Wood JN, Noonan K. Mandates for Collaboration: Health care and child welfare policy and practice reforms create the platform for improved health for children in foster care. Curr Probl Pediatr Adolesc Health Care. 2015;45:316–322. [PubMed: 26403650]

122.

Jaudes PK, Bilaver LA, Goerge RM, Masterson J, Catania C. Improving access to health care for foster children: the Illinois model. Child Welfare. 2004;83:215–238. [PubMed: 15202800]

123.

Simms MD. The foster care clinic: A community program to identify treatment needs of children in foster care. J Dev Behav Pediatr. 1989;10:121–128. [PubMed: 2473095]

124.

Jee S, Szilagyi M, Blatt S, Meguid V, Auinger P, Szilagyi P. Timely identification of mental health problems in two foster care medical homes. Child Youth Serv Rev. 2010;32:685–690.

125.

Jaudes KP, Champagne V, Harden A, Masterson J, Bilaver LA. Expanded medical home model works for ­children in foster care. Child Welfare. 2012;91:9–33. [PubMed: 22894013]

126.

Regionförbundet Uppsala Län. Rutin och riktlinjer rörande barn och unga som utreds för samhällsvård. Uppsala: Regionförbundet Uppsala Län. 2016.

127.

Halldin J. Socialläkarna – ­mellan hälsovård och socialtjänst. ­Läkartidningen. 2011;108:551–552. [PubMed: 21744560]

128.

SBU. Utvärdering av metoder i hälso- och sjukvården. En handbok, 2 uppl. Stockholm 2014. https://www.sbu.se/metodbok.

129.

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, ­Alonso-Coello P, et al. GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–926. [PMC free article: PMC2335261] [PubMed: 18436948]

130.

Jones R, Everson-Hock E, ­Guillaume L, Clapton J, Goyder E, ­Chilcott J, et al. The effectiveness of interventions aimed at improving access to health and mental health services for looked-after children and young people: a systematic review. Families, Relationships and Societies. 2012;1:71–85.

131.

Richards L, Wood N, Ruiz-Calzada L. The mental health needs of loooked after children in a local authority permanent placement team and the value of the Goodman SDQ. Adoption & Fostering. 2006;30:43–52.

132.

Janssens A, Deboutte D. Screening for psychopathology in child welfare: the Strengths and Difficulties Questionnaire (SDQ) compared with the Achenbach System of Empirically Based Assessment (ASEBA). Eur Child Adolesc Psychiatry. 2009;18:691–700. [PubMed: 19462154]

133.

Jee SH, Halterman JS, Szilagyi M, Conn AM, Alpert-Gillis L, ­Szilagyi PG. Use of a brief standardized screening instrument in a primary care setting to enhance detection of social-emotional problems among youth in foster care. Acad Pediatr. 2011;11:409–413. [PubMed: 21683668]

134.

Jee SH, Szilagyi M, Conn AM, Nilsen W, Toth S, Baldwin CD, Szilagyi PG. Validating office-based screening for psychosocial strengths and difficulties among youths in foster care. Pediatrics. 2011;127:904–910. [PubMed: 21502256]

135.

Lehmann S, Heiervang ER, Havik T, Havik OE. Screening foster children for mental disorders: properties of the strengths and difficulties questionnaire. PLoS One 2014;9:e102134. [PMC free article: PMC4090209] [PubMed: 25006669]

136.

Ronsalbalm K SE, Lawrence N, ­Coleman K, Frey J, van der Ende J, Dodge K. Child wellbeing assessment in child welfare. A review of four measures. Child Youth Serv Rev. 2016;68:1–16.

137.

Jee SH, Szilagyi M, Ovenshire C, ­Norton A, Conn AM, Blumkin A, ­Szilagyi PG. Improved detection of developmental delays among young children in foster care. Pediatrics. 2010;125:282–289. [PubMed: 20064864]

138.

Jee SH, Conn AM, Szilagyi PG, ­Blumkin A, Baldwin CD, ­Szilagyi MA. Identification of social-emotional problems among young children in foster care. J Child Psychol Psychiatry. 2010;51:1351–1358. [PubMed: 20840498]

139.

Jee SH, Halterman JS, Szilagyi M, Conn AM, Alpert-Gillis L, ­Szilagyi PG. Use of a brief standardized screening instrument in a primary care setting to enhance detection of social-emotional problems among youth in foster care. Acad Pediatr. 2011;11:409–413. [PubMed: 21683668]

140.

Gallagher CA, Dobrin A. Can juvenile justice detention facilities meet the call of the American Academy of ­Pediatrics and National Commission on Correctional Health Care? A national analysis of current practices. Pediatrics 2007;119:e991-1001. [PubMed: 17403835]

141.

Undheim AM, Lydersen S, Kayed NS. Do school teachers and primary contacts in residential youth care institutions recognize mental health problems in adolescents. Child Adolesc ­Psychiatry Ment Health. 2016;10:19. [PMC free article: PMC4928249] [PubMed: 27366205]

142.

Bellonci C, Huefner JC, Griffith AK, Vogel-Rosen G, Smith GL, Preston S. Cocurrent reductions in ­psychotropic medication, assault, and physical restraint in two residential treatment programs for youths. Child Youth Serv Rev. 2013;35:1773–1779.

143.

Huefner JC, Griffith AK, Smith GL, Vollmer DG, Leslie LK. Reducing psychotropic medications in an intensive residential treatment center. J Child Fam Stud. 2014;23:675–685.

144.

Lee TG, Walker SC, Bishop AS. The impact of psychiatric practice guidelines on medication costs and youth aggression in a juvenile justice residential treatment program. Psychiatr Serv. 2016;67:214–220. [PubMed: 26423102]

145.

Poynor M, Welbury J. The dental health of looked after children. Adoption & Fostering. 2004;28:86–88.

146.

Hunter D, McCartney G, Fleming S, Guy F. Improving the health of looked after children in Scotland. Using a specialist nursing service to improve the health care of children in residen­tial accommodation. Adoption & Fostering. 2008;32:51–56.

147.

Williams A, Mackintosh J, Bateman B, Holland S, Rushworth A, Brooks A, Geddes J. The development of a designated dental pathway for looked after children. Br Dent J 2014;216:E6. [PubMed: 24504318]

148.

Hill C, Wright V, Sampeys C, et al. The emerging role of the specialist nurse: promoting the health of looked after children. Adoption & Fostering. 2002;26:35–43.

149.

Jaudes PK, Bilaver LA, Goerge RM, Masterson J, Catania C. Improving access to health care for foster ­children: the Illinois model. Child Welfare. 2004;83:215–238. [PubMed: 15202800]

150.

Horwitz SM, Owens P, Simms MD. Specialized assessments for children in foster care. Pediatrics. 2000;106:59–66. [PubMed: 10878150]

151.

Williams ME, Park S, Anaya A, ­Perugini SM, Rao S, Neece C, Rafeedie J. Linking infants and ­toddlers in foster care to early childhood mental health services. Child Youth Serv Rev. 2012;34:838–844.

152.

Risley-Curtiss C, Stites B. Improving healthcare for children entering foster care. Child Welfare. 2007;86:123–144. [PubMed: 17953330]

153.

Green M, Mattsson T. Health, Rights and the State, Scandinavian Studies in Law. 2017;62:177-97.

154.

Barnombudsmannen. Våga fråga – röster från barn i familjehem 2014.

155.

Care Quality Commission (CQC). Not seen, not heard: a review of the arrangements for child safeguarding and health care for looked after children in England. Newcastle upon Thyne: Care Quality Commission 2016.

156.

Kling S, Nilsson I. Familjehems­placerade skolbarns hälsa och hälso­vård - uppfölj­ning av 105 barn, 2015. Tillgänglig 2018-02-25 på http://www.allmannabarnhuset.se/wp-content/uploads/2015/04/Familjehemsplacerade-skolbarns-h%C3%A4lsa-och-h%C3%A4lsov%C3%A5rd.pdf.

157.

Vinnerljung B, Forsman H, Jacobsen H, Kling S, Kornør H, Lehman S. Barn kan inte vänta. Översikt av kunskapsläget och exempel på genomförbara förbättringar. Stockholm: Nordens Välfärdscenter, Projekt: Nordens barn – fokus på barn i fosterhem, 2015.

158.

SBU. Behandlingsfamiljer för ungdomar med beteendeproblem – Treatment Foster Care Oregon. En systematisk översikt och utvärdering inklusive ekonomiska och etiska aspekter. Stockholm: ­Statens beredning för medicinsk och social utvärdering (SBU); 2018. SBU-rapport nr 279. ISBN 978-91-88437-21-1.

159.

Socialstyrelsen. Individ- och familje­omsorg – Lägesrapport 2017. Artikelnummer 2017-2-14. ISBN: 978-91-7555-413-6. http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/20491/2017-2-14.pdf.

160.

Department of Health. Promoting the health of looked after children. Tillgänglig 2018-03-06 på http://web­archive.nationalarchives.gov.uk/+/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4060424.pdf 2002.

161.

Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med 2012;9:e1001349. [PMC free article: PMC3507962] [PubMed: 23209385]

162.

Fryers T, Brugha T. Childhood determinants of adult psychiatric disorder. Clin Pract Epidemiol Ment Health. 2013;9:1–50. [PMC free article: PMC3606947] [PubMed: 23539489]

163.

Dean K, Stevens H, Mortensen PB, Murray RM, Walsh E, Pedersen CB. Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry. 2010;67:822–829. [PubMed: 20679590]

164.

Simkiss DE, Stallard N, Thorogood M. A systematic literature review of the risk factors associated with children entering public care. Child Care Health Dev. 2013;39:628–642. [PubMed: 23210455]

165.

Blair C, Raver CC, Granger D, Mills-Koonce R, Hibel L, Family Life ­Project Key Investigators Family Life ­Project Key Investigators. Allostasis and allostatic load in the context of poverty in early childhood. Dev Psychopathol. 2011;23:845–857. [PMC free article: PMC4167021] [PubMed: 21756436]

166.

Gard AM, Waller R, Shaw DS, Forbes EE, Hariri AR, Hyde LW. The long reach of early adversity: Parenting, stress, and neural pathways to antisocial behavior in adulthood. Biol ­Psychiatry Cogn Neurosci ­Neuroimaging. 2017;2:582–590. [PMC free article: PMC5695704] [PubMed: 29170760]

167.

Turney KW, Wildeman C. Adverse childhood experiences among ­children placed in and adopted from ­foster care: Evidence from a nationally ­representative study. Child Abuse Negl. 2017;64:117–129. [PubMed: 28086178]

168.

Ferraro KF, Schafer MH, Wilkinson LR. Childhood disadvantage and health problems in middle and later life: Early imprints on physical health. Am Sociol Rev. 2016;81:107–133. [PMC free article: PMC4950981] [PubMed: 27445413]

169.

Kvist T, Annerbäck E-M Annerbäck E-M, Dahlöf G. Oral health in children investigated by Social services on suspicion of child abuse and neglect. Child Abuse Negl. 2018;76:515–523. [PubMed: 29294446]

170.

Farrington D. Crime and physical health: illnesses, injuries and accidents in the Cambridge Study. Crim Behav Ment Health1995;54:261-78.

171.

Wade TP, Pevalin D. Adolescent delinquency and health. Can J Criminol. 2005;47:619–654.

172.

Felitti VJ. The relation between adverse childhood experiences and adult health: Turning gold into lead. Perm J. 2002;6:44–47. [PMC free article: PMC6220625] [PubMed: 30313011]

173.

Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–258. [PubMed: 9635069]

174.

Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF. Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord. 2004;82:217–225. [PubMed: 15488250]

175.

Harkonmäki K, Korkeila K, Vathera J, Kivimäki M, Souminen S, Sillanmäki L, Koskenvuo M. Childhood adversities as a predictor of disability retirement. J Epidemiol Community Health. 2007;61:479–484. [PMC free article: PMC2465717] [PubMed: 17496255]

176.

Björkenstam E, Hjern A, ­Mittendorfer-Rutz E, Vinnerljung B, Hallqvist J, Ljung R. Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults. PLoS One 2013;8:e53551. [PMC free article: PMC3547022] [PubMed: 23341951]

177.

Björkenstam E, Burström B, ­Vinnerljung B, Kosidou K. Childhood adversity and psychiatric disorder in young adulthood: An analysis of 107,704 Swedes. J Psychiatr Res. 2016;77:67–75. [PubMed: 26994339]

178.

Björkenstam E, Dalman C, ­Vinnerljung B, Weitoft GR, Walder DJ, Burström B. Childhood household dysfunction, school performance and psychiatric care utilisation in young adults: a register study of 96 399 individuals in Stockholm. J Epidemiol Community Health. 2016;70:473–480. [PubMed: 26646690]

179.

Björkenstam E, Hjern A, ­Vinnerljung B. Adverse childhood experiences and disability pension in early midlife: results from a Swedish National Cohort Study. Eur J Public Health. 2017;27:472-7. [PubMed: 28040736]

180.

Björkenstam E, Vinnerljung B, Hjern A. Impact of childhood adversities on depression in early adulthood: A longitudinal cohort study of 478,141 individuals in Sweden. J Affect Disord 2017;223:95-100. [PubMed: 28735168]

181.

Basto-Pereira M, Miranda A, Ribero S, Maia A. Growing up with adversity: From juvenile justice involvement to criminal persistence and psychosocial problems in young adulthood. Child Abuse Negl. 2016;62:63–75. [PubMed: 27794243]

182.

Fridell Lif E, Bränsström L, ­Vinnerljung B, Hjern A. Childhood adversities and later economic hardship among child welfare clients: Cumulative disadvantage or disadvantage saturation. Br J Soc Work. 2017;47:2137–2156.

183.

Rebbe R, Nurius PS, Aharens KR, Courtney ME. Adverse childhood experiences among youth aging out of foster care: A latent class analysis. Child Youth Serv Rev. 2017;74:108–116. [PMC free article: PMC5404688] [PubMed: 28458409]

184.

Butler I, Payne H. The health of children looked after by the local authority. Adoption & Fostering. 1997;21:28–35.

185.

Ward H, Jones H, Lynch M, Skuse T. Issues concerning the health of looked after children. Adoption & Fostering. 2002;26:8–18.

186.

Kling S. Fosterbarns hälsa - det medicinska omhändertagandet av samhällsvårdande barns hälsa i Malmö. Malmö stad 2010.

187.

Hultman E, Cederborg A-C Cederborg A-C, Alm C, Fählt Magnusson K. Vulnerable ­children’s health as described in ­investigations of reported children. Child Fam Soc Work. 2013;18:117–128.

188.

Blennow M, Fiedler Backteman U, ­Lindfors A. Hälsovård för barn placerade I samhällsvård. Brister finns, för­bätt­ringar möjliga. Stockholm: Stockholms läns landsting 2014.

189.

Swank JM, Gagnon JC. A national survey of mental health screening and assessment practices in juvenile correctional facilities. Child Youth Care Forum. 2017;46:379–393.

190.

Hochstadt NJ, Jaudes PK, Zimo DA, Schachter J. The medical and psychosocial needs of children entering foster care. Child Abuse Negl. 1987;11:53–62. [PubMed: 3828875]

191.

Child Welfare League of America (CWLA). Standards for health care services for children in out-of-home care. Washington, DC: CWLA, 1988.

192.

American Academy of Pediatrics (AAP) American Academy of Pediatrics (AAP) Health care of children in foster care. Pediatrics. 1994;93:335–338. [PubMed: 8121749]

193.

American Academy of Pediatrics (AAP) American Academy of Pediatrics (AAP) Health care for children and youth in the juvenile correctional care system. Pediatrics. 2001;107:799–803. [PubMed: 11335764]

194.

American Academy of Pediatrics (AAP) American Academy of Pediatrics (AAP) Health care of young children in foster care. Pediatrics. 2002;109:536–541. [PubMed: 11875156]

195.

American Academy of Pediatrics (AAP) American Academy of Pediatrics (AAP) Health care for youth in the juvenile justice system. Policy statement. Pediatrics. 2011;128:1219–1235. [PubMed: 22123883]

196.

Leslie LK, Hurlburt MS, Landsverk J, Rolls JA, Wood PA, Kelleher KJ. Comprehensive assessments for children entering foster care: a national perspective. Pediatrics. 2003;112:134–142. [PMC free article: PMC1519418] [PubMed: 12837879]

197.

Leve LD, Harold GT, Chamberlain P, Landsverk JA, Fisher PA, Vostanis P. Practitioner review: Children in foster care-vulnerabilities and evidence-based interventions that promote resilience processes. J Child Psychol Psychiatry. 2012;53:1197–1211. [PMC free article: PMC3505234] [PubMed: 22882015]

198.

Luke N, Sinclair I, Woolgar M, Sebba J. What works in preventing and treating poor mental health in looked after children? London: NSPCC & Oxford: The Rees Centre, University of Oxford 2014.

199.

SBU. Tandförluster. En systematisk litteraturöversikt. Stockholm: Statens beredning för medicinsk utvärdering (SBU); 2010. SBU-rapport nr 204. ISBN 978-91-85413-40-9.

200.

Alsfjell J, Stenberg J. Psykiatriska diagnoser och förändringar hos en grupp SiS-ungdomar. Allmän SiS-­rapport, 2008:4. Stockholm: Statens institutionsstyrelse.

201.

Ståhlberg O, Anckarsäter H, Nilsson T. Mental Health Problems in youth committed to juvenile institutions: prevalences and treatment needs. Eur Child Adolesc Psychiatry. 2010;19:893–903. [PMC free article: PMC2988998] [PubMed: 20949366]

202.

Kling S, Nilsson I. Fysisk och psykisk hälsa hos barn som utreds inom socialtjänsten. Stockholm: Socialstyrelsen 2015.