A comparison of LGBTQ youth and heterosexual youth in the child welfare system: Mental health and substance abuse occurrence and outcomes

Purpose: LGBTQ youth enter the child welfare system often because they are at higher risk of experiencing child maltreatment compared to youth who are heterosexual (Friedman, Marshal, Guadamuz, Wei, Wong, Saewye, & Stall, 2011), and due to family rejection, which places them at higher risk of suicide, higher levels of depression and are more likely to use substances (Ryan, Huebner, Dias & Sanchez, 2009). Using national data from the Substance Abuse and Mental Health Services Administration (SAMHSA), this study had two purposes; first to examine mental health disparities among LGBTQ youth and their heterosexual peers who are involved in the child welfare system, and second to observe the effectiveness of systems of care with youth in child welfare and if any differences exist between LGBTQ youth and heterosexual youth. Methods: Chi-square and logistic regression were used to analyze differences at intake between youth who identified as LGBT or Q and their heterosexual counterparts. Repeated linear mixed modeling was used to evaluate the outcomes and to compare the groups at fixed time points (intake, 6-months, and 12-months). Findings: The study found LGBTQ youth had higher levels of suicidal ideation, suicide attempts, depression, and gender identity related problems compared to the heterosexual youth in child welfare. All youth in the study experienced significant improvement, further supporting the effectiveness of system of care approaches. Recommendations are also discussed.