2023/10/31 by Nina Kind, Süheyla Seker, Delfine d’Huart +9 · 1 voice · 1 citation
Social Sciences · Health Professions · #Child Welfare and Adoption #Intergenerational Family Dynamics and Caregiving #Employment and Welfare Studies
paper · doi:10.1016/j.childyouth.2023.107290
openalex publication_date 2023/10/31 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
Care leavers transitioning into adulthood represent a highly vulnerable population, confronted with usual developmental tasks under difficult predisposing conditions. Early-risk and persistent substance use may be an obstacle for care leavers transitioning from youth residential care settings into an independent adult life. This study aims to address the following questions: (1) How stable is high-risk substance use from within care to after care? (2) Do differences between longitudinal risk courses of substance use in sociodemographic characteristics, placement history, and adverse exposures exist? (3) Is the persistency of high-risk substance use associated with impaired young adult psychosocial functioning? Method: In a prospective longitudinal design, with a baseline in youth residential care (t1) and a follow-up ten years later (t2), we investigated the courses of substance use in 182 young adult care leavers in Switzerland (32.4% women; Mean age= 26.7 years). Psychosocial functioning was assessed across health, legal, educational, and financial outcomes. High prevalence of high-risk substance use was found (41.2% in residential care; 46.2% after leaving care). Of those care leavers who reported earlier high-risk substance use, 61.3% persisted, while 38.7% remitted. Four substance risk pathways were identified longitudinally: low risk (N=69, 37.9%), remitted risk (N=29, 15.9%), newly developed risk (N=38, 20.9%), and persistent risk (N=46, 25.3%). Persistent high-risk substance use was associated with higher rates of adverse functional outcomes. Findings of this study shed light on the high prevalence of earlier and persistent high-risk substance use in youth residential care leavers. High-risk substance use appears to have the potential to coincide with impaired psychosocial functioning during and after the transition to adulthood. Implications for educational and vocational paths as well as harm-reducing interventions are discussed. More research disentangling pathways and intervention research in high-risk populations is warranted.