The Role of Resilience as a Mediating Factor between Adverse Childhood Experience and Mental Health in Adolescents Receiving Child Welfare Services in Nova Scotia

While the relationship between adverse childhood experiences (ACEs) and mental health problems (depression, suicidal thoughts, PTSD, and functional impairments) among youth is well studied, there is less known about the mediating role played by resilience for youth receiving child welfare services. This study explored the mediating effects of resilience in relationship to ACEs and mental health outcomes for youth receiving child welfare services. Participants and setting: The study included 251 participants (14-19 years of age, 58% female) receiving child welfare services from the government of Nova Scotia, Canada. A cross-sectional design was used with seven measures administered to youth through phone interviews. Risk exposure was measured using the ACEs scale while resilience was assessed with the CYRM-17. Mental health outcomes included depression symptoms (BDI-II), suicidal thoughts (SBQ-R), post traumatic stress reactions (PTSRS), and functional impairment (IATSS). Structure equation modelling (SEM) and general linear model (GLM) were used to analyze the data. Resilience directly affects mental health outcomes (beta = - 0.409, p < .001) and indirectly mediates the effect of ACEs on outcomes (beta = 0.236, P < .001). Resilience showed different patterns in terms of sex and education. The youth who identified themselves as non-binary and were not enrolled in an educational program had lower levels of resilience. Resilience decreases the risk of mental health problems among youth receiving child welfare services. The impact of resources to build relational, caregiver, and social-contextual resilience may be influenced by a youth's sexual identity and engagement in education.