Infants in OutofHome Care in NSW, Australia

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Infants in Out-of-Home Care in NSW, Australia
Marilyn Chilvers Albert Zhou Economics,
Statistics Research Directorate NSW Department
of Community Services ISCI Conference June 26-28
2007 Chicago, Illinois
marilyn.chilvers_at_community.nsw.gov.au
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Introduction

• Analysis focuses on vulnerable group of children
  (infants) admitted to Out-of-Home Care (OOHC)
  before their first birthday
• Based on administrative data (from 1996 to 2006),
  collected by the NSW Department of Community
  Services (DoCS)
• Examines
• Child protection history prior to care
• Rate of entry to care
• Duration of first spell / care period
• Re-entry to care / moves in care

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Overall trend

• Infants have a high rate of child protection
  reports and a high rate of entry into OOHC.
• Infants represent around 5 of the NSW 0-17 year
  population.
• 9 of all children aged 0-17 years reported to
  DoCS in 2005/06 were infants.
• 21 of all children aged 0-17 years admitted to
  care for the first time in 2005/06 were also
  infants.

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Child protection experiences of infants

• Prior to entry into OOHC - early adverse
  experiences with child protection risks.
• The majority of infants in the system (73) were
  reported by police and health professionals (both
  mandatory reporters).
• The children come from vulnerable families where
  parents were in difficult relationships resulting
  in domestic violence, and/or with drug alcohol,
  or mental health problems.
• For infants reported, administrative data show
• 50 of reports with associated carer DV issues,
• 23 with carer DA, and
• 21 with carer mental health problems.
• Comparative percentages for all age groups are
  37, 15 and 12 respectively.
• Case files show much higher rates.

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Table 1 Selected reported issue for infants
reported in 2004/05, by age at first report in
2004/05
Note a The total refers to the total number of
children reported in 2004/05. A child can have up
to three issues reported in any one report. So
the number of issues reported is greater than the
number of children.
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Children reported before birth and admitted into
care

• In 2004/05, 5.3 of infants reported to DoCS were
  admitted to care later within the same reporting
  period, twice the proportion for all children
  (2.7).
• The proportion of entry into care for children
  who were first reported before birth was even
  higher (9.2).
• Of the 131 children who were reported to DoCS
  before birth and subsequently admitted into care
  when born in 2004/05, 95 were reported more than
  once before birth and 86 three times or more.
• Drug and/or alcohol abuse appears to be the most
  prevalent issue amongst mothers of these unborn
  children (47.3).

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Entry to OOHC (1)

• Between 1996 and 2005, about one out of every
  five children entering OOHC for the first time
  was an infant.

Figure 1 Age at first entry to care, by year
of entry, percentage distribution 1996-2005
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Entry to OOHC (2)

• Infants (indigenous infants in particular) had a
  notably high entry rate per 10,000 population,
  compared to all children aged 0-17 years
• 10-fold difference between indigenous and others
  in 2005

Table 2 Incidence rates of first entry to care,
by age at first entry and year Rate per 10,000
children
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Entry to OOHC (3)

• Infants in regional areas were at higher risk of
  entering care than their metropolitan
  counterparts.

Table 3 Incidence rates of first entry to care,
by age at first entry and region in 2005, Rate
per 10,000 children
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Entry to OOHC (4)

• Foster care was the most common type of placement
  for the first care period in which an infant was
  placed.

Table 4 Placement type of first care period by
age at entry, counts and percentage, 1996-2005
a Others include supported accommodation,
residential care and independent living.
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Duration of stay in care (1)

• On average, infants stayed in care twice as long
  as all children aged 0-17 years.
• Median for infants 5 months vs 2-3 months for
  others

Table 5 Duration quartiles (in days) of first
care period for infants by year of entry cohort
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Duration of stay in care (2)

• Indigenous infants stayed much longer in care
  than non-indigenous infants, and the median
  duration was extremely high for infants placed in
  relative and kinship care.

Table 6 Median duration (in days) of first care
period for infants by year of entry, indigenous
status and selected placement type, 1996-2005
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Duration of stay in care (3)

• The results from a proportional hazards model
  show that infants experienced the longest
  duration for their first care period compared to
  children of other ages (while year of entry,
  gender, indigenous status and placement type were
  controlled).

Table 7 Hazard rates of duration for age
Notes p lt 0.05. a lt1 is the
referent category.
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Re-entry to OOHC

• The majority of infants (75) experienced only
  one care period (spell) in OOHC
• Infants were less likely than other children to
  be discharged from care
• If discharged, they were more likely to return
• A significant group of children move in and out
  of care many times

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Re-entry to OOHC (1)

• A small proportion of children accounted for a
  disproportionate number of movements in and out
  of care (10 of children accounted for 40 of
  moves).

Figure 2 Cumulative percentage of movements in
and out of care and cumulative percentage of
infants with at least one re-entry, 1996-2005
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Re-entry to OOHC (2)

• There is a negative relationship between the
  likelihood of re-entry to care and the duration
  of prior care period.

Table 8 Out-of-Home Care Re-entry, by age at
first entry and duration of prior care period,
1996-2005 cohorts, as at 31/08/2006
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Re-entry to OOHC (3)

• Indigenous infants had a higher re-entry rate
  than non-indigenous infants (57.9 re-enter vs
  34.7)

Table 9 Re-entry of infants to OOHC, by
indigenous status, 1996-2005 cohorts, as at
31/08/2006
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Re-entry to OOHC (4)

• Compared to those in foster care, infants who
  were first placed in relative and kinship care
  experienced a lower discharge level, a lower
  re-entry level given discharge and a lower
  overall re-entry level.

Table 10 Re-entry of infants to OOHC, by
selected placement type, 1996-2005 cohorts, as at
31/08/2006
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Placements stability and moves in care (1)

• There was a positive association between the
  number of placements in the first care period and
  the length of time a child spent in care.

Figure 3 Number of placements by infants in
first care period by length of first care period,
1996-2006
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Placement stability and moves in care (2)

• There was a negative relationship between the
  likelihood of re-entry to care and number of
  placements in the first care period.

Figure 4 OOHC re-entry by number of placements
in first care period, 1996-2006 cohorts, as at
31/08/2006
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Conclusions and implications

• Implications for the development of policy and
  early intervention programs safety, stability
  permanency.
• High reporting rate and high rate of entry to
  OOHC by infants, and by indigenous infants in
  particular.
• Tendency for infants to stay in care longer than
  other children, coupled with high entry rate to
  OOHC.
• Focus resources and service delivery on young
  children to prevent escalation in the child
  welfare system and to improve outcomes
• Opportunity for improvement through the
  longitudinal study of children and young people
  in OOHC.

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Safety

• Significant investment in Brighter Futures
  Early Intervention Program.
• Expansion of the Aboriginal Maternal and Infant
  Health Strategy across NSW with linkages to
  Brighter Futures to improve health and well-being
  for indigenous children.
• Focus on infants affected by domestic violence,
  parental substance abuse and mental ill health.
• Co-operation, coordination and integration of
  community, police, health and family support
  services.
• Pre-natal reporting policy addresses the issues
  of timely and appropriate interventions for
  at-risk infants and their families.

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Placement stability and permanency planning

• Effective permanency planning required for
  infants who enter care More reliable assessment
  of restoration viability, development of
  realistic case plans to support restoration.
• Permanency Planning project focused on 0-2 year
  age group
• Research and funding of family preservation
  services
• Research to Practice and professional
  development for caseworkers