The accelerated and compressed transition to independent living experience by youth in out-of-home care: extending care to 21 in Australia

By Madison James

Abstract

Under The National Framework for Protecting Australia’s Children 2009–2020, when an environment is deemed unsafe, a child is placed in state care. Responsible for the child, government policy must further protect and promote these children, with the inherent aim of fostering beneficial life outcomes. However, contemporary data analysis portrays that those exiting care at age 18 experience severe and unmatched economic and social marginalisation, particularly in comparison to archetypal young Australians. This article aims to compile academic research to form an argument alongside the Home Stretch Campaign, in favour of extending care to age 21. Distinct in nature, the article critiques current policy, relying upon a strong agglomeration of data for outcomes experienced by those exiting care. In contrast to existing policy frameworks, it proposes specific changes and evaluates the feasibility and benefit of implementing reforms. In divergence of other research, this article categorises the social worker as the cornerstone for a reformed program to be ultimately successful in Australia.

Introduction

Young people in out-of-home care (OOHC) transition to independent living at a compressed and accelerate rate, unlike most contemporary young Australians who live at home until their early 20s (Vassallo, Smart & Price-Robertson, 2009). Currently, most Australian jurisdictions offer OOHC until age 18, with funding and services allocated to ease the transition. However, research has indicated the ad hoc nature, and overall failure of this policy in promoting positive life outcomes. The current age structure ignores the well-documented complex needs, specifically in relation to childhood adversity and trauma. Forced to exit care at 18, youth are further disadvantaged by emotional, social and economic marginalisation, resulting in poor outcomes relating to mental health, support, housing, education and employment. International models offer credible evidence for extending care to 21, allowing for the provision of therapeutic and emotional support from carers. Through reducing a youth’s need for vigilance, or rather survival mechanisms, they are given an environment to focus on learning mechanisms for development (McLean, 2016). Social workers play a crucial role in fostering the carer-youth relationship, which would ultimately facilitate the uptake of the extension program. Based on the current outcomes of youth exiting care, international models and feasibility of an extended program, this article holds the position the Australian Commonwealth should and must implement a national extended care program to 21.

Australian policy context

Under The National Framework for Protecting Australia’s Children 2009–2020 the Commonwealth alongside State and Territory governments are responsible for the safety and wellbeing of children leaving OOHC. Arguably, underpinned by the focus of “a substantial and sustained reduction in child abuse and neglect over time” (Department of Social Services, 2010, p. 6). The framework specifies the government must uphold policies and initiatives that support young people to exit care at 18, through a strong preparation, transition and independence phase (Carmody, 2013). However, this is simply a framework, and each state and territory has its own legislative and policy framework for transitioning youth to independence.

State and territory legislation are framed through a discretionary and permissive power, rather than mandatory or obligatory. Financial support is particularly ambiguous, such that state legislation is founded on “may provide”, “considers necessary”, “at the discretion of”, “may include”, “may include” (Baidawi, 2016). Most of the funding provided is allocated to preparation or transition (15-18 years) rather than post care (18-21/25 years) (Campo & Commerford, 2016).

Failures in preparation and transition

Literature concludes young people are often unaware of their own leaving plan (Carmody, 2013). The Royal Commission into Institutional Responses to Child Abuse (2017) concluded that despite jurisdiction emphasis on leaving care plans, they are “often not done, or not done well” (p. 338). Furthermore, a survey conducted by the Warrior Woman Foundation exposed transition funding is not successful. Girls who have transitioned from care, reported low levels of support regarding all facets, inclusive of housing, education, employment, money management, legal rights, goal making and transport (James, 2020).

Failures in post care

Crane, Kaur & Burton (2014) liken exiting care ‘to jumping with no safety net’ with extensive research elaborating the doors of care as closed and locked after exiting the system (Coffee-Borden & Rosenau, 2020; Johnson et al., 2010, Moslehuddin & Mendes, 2007). Malvaso (2016) deems that when post care services are available, they fail in terms of accessibility, with the current model of contingency incongruous to how young people choose to engage. Specifically, the services are often structured and conditional, which ultimately fails to take into account the lived experience of those who have experienced OOHC. Alternatively, Queensland Child Protection Commission of Inquiry concluded legislation, policy and procedures are indicative of a desire to support those exiting care, however in reality it is ad hoc (Carmody, 2013).

Excluding Tasmania, South Australia and Australian Capital Territory, who extended care to 21 (2017, 2018 and 2021 respectively), Australia’s policy of forced care exit at 18 fails to reflect the realistic transition to independent living of most contemporary young people. The Australian Institute of Family Studies (AIFS) reported 43% of 20-24 year olds still live at home, and even poignant to this point, 17% of 25-29 year olds (2016). Youth forced to exit care at 18, are excluded from extended periods of financial, practical, social and emotional support (Vassallo, Smart & Price-Robertson, 2009). This is arguably even more important for those in OOHC, who are pre-disposed to greater social and economic marginalisation.

Outcomes for youth exiting care at 18

The ramifications of an accelerated and compressed transition to independent living manifests in several domains. According to the AIFS this is inclusive of, but not limited to, low educational attainment, significantly higher levels of psychological distress and health problems, underemployment or unemployment, early parenthood, insecure housing and involvement in the criminal justice system.

Trauma

Policy that terminates OOHC living arrangements at 18, fails to recognise the complex and unique situational needs of those in care. Predominately from “highly disadvantaged families characterised by poverty, relationship breakdown, substance abuse, violence, disability and mental illness” (Mendes et al., 2011b, p. 3). The Australian Institute of Health and Wellbeing (2019) revealed that of those in care, 54% had suffered emotional abuse, 21% neglect, 15% physical abuse and 10% sexual abuse. Extensive literature has further illustrated deep associations of these adverse and traumatic events to delays in mental, health and physical outcomes, with a particular focus on cognitive development (McLean, 2016; Campo & Commerford, 2016; McLaughlin et al., 2014). Atkinson (2013) breaks this down as the survival mechanisms of the brain overriding the learning mechanisms, ultimately affecting the neurobiological development of the brain. These ‘learning mechanisms’ extend but are not limited to cognitive and language delay, bias in processing emotional and social information, metacognitive skills and behavioural regulation (McLean, 2016). These neurological effects are documented to affect a youth’s ability “to achieve age-appropriate behavior” (Avery & Freundlich, 2009, p. 251). The exit age of 18, fails to recognise the unparalleled nature of a young persons age and their actual development and maturity. Further to this, research has shown even despite maturity or development, ongoing psychological difficulties from trauma inhibit one’s ability to develop life skills and live independently (Mendes et al., 2014). 

Fairhurst et al. (2016) understands that this long-term impact of abuse, neglect and maltreatment is further exacerbated by poor government support. Such that research has found children from similar backgrounds (of adversity and trauma) will experience higher levels of behavioural and mental health if they are placed in OOHC (Ford, Vostanis, Meltzer & Goodman, 2007). The knock on effects of childhood adversity and trauma are extensive and touch most facets of a youth’s life.

Support and mentorship

Forced to exit care at 18, young people are stripped of their support network and their capacity to develop one (Thomson et al., 2020). Evaluation of mentoring programs revealed a wide and consistent impact on youth outcomes, particularly across high-risk behaviour, social competence, educational attainment and career preparation (DuBois, Holloway, Valentine & Cooper, 2020). OOHC can provide a source of “felt security”, which Cashmore & Paxman (2007) argue is the key determinate as to whether a young person will fare well in adult life. Evidence also suggests this security is indicative of a young person’s experience of maintaining a supportive network, compromised of friends, school and community activities (Beauchamp, 2014). The care provided through an OOHC placement, is often a main pillar of support “due to the fragmented nature of relationships with next of kin due to the physical separation brought about ….as well as because of the source of family abuse itself” (Osborn & Bromfield, 2007 as cited in DAE, 2018, p. 19). The CREATE Foundation survey (n=1098) revealed over a third (36%) of youth in OOHC regarded their ‘special person’ to be their carer, followed by a friend (16%) (McDowall, 2018). However, despite this research, direct care from a carer is cut at age 18 – ultimately stripping a young person of their main support person, and from this their supportive network.

Housing

Indicative of research, the compressed exiting age from OOHC often leaves youth underprepared for independent living, which subsequently leads to an experience of homelessness (Courtney & Dworsky, 2006). The disrupted care from their carer, and unreliable support networks outside of this, contribute to the heightened experience of insecure housing. A study into youth homelessness (n=298) extrapolated the failings of Australian policy to support those exiting care into stable accommodation. Finding a concrete and positive correlation between homelessness and OOHC, with two-thirds of youth homelessness having exited OOHC (Flatau, 2015). Additionally, the Australian Bureau of Statistics (2017) reported on census night 1% of those aged 19-24 were homeless whilst 35% of those exiting care experienced homelessness in the first year.

The exclusion of youth from living arrangements beyond 18, fails to take into account known childhood adversities and trauma. Sexual and physical abuse, which occurs for 15% of youth in OOHC, increases the relative risk of becoming homeless once exiting care (Dworsky et al., 2013). Further to this, housing is perceived as more than a ‘roof’; it is an embodiment of belonging to a place, and to a support network. A survey conducted by the Warrior Woman Foundation (James, 2020), reported a girls sense of belonging was impacted ‘ a great deal’ (46%) and ‘a lot’ (30%) by exiting care at 18.  

Educational attainment

Educational attainment is a platform for financial stability and “one of the strongest predictors of adult self-sufficiency” (Cage, 2018, p. 234). Thus, educational attainment, with Year 12 completion as a baseline, closes disparities experienced by those from OOHC, in relation to unemployment rates and earning potential (Okpych & Courtney, 2014). However, the current policy, which exits youth from the system at 18, which is during Year 12, results in extremely low completion rates. According to the ABS (2012) 39% of care leavers completed year 12, in comparison to 79% of the general population. Further to this, a study following care leavers (n=47) revealed only 25% were in employment, education or both, in comparison to 70% of 20-24 years old in the general population (Cashmore & Paxman, 2007).

Qualitative research conducted by Cashmore, Paxman & Townsend (2007) revealed a significant adult has the capacity to foster educational success. Participants completing tertiary education after exiting care were consistently found to have a support network comprised of a significant adult mentor and/or community involvement. Forced exit strips the potential for continued psychological and emotional support from a caring adult or mentor (Mendis, 2012).

Employment

Employment is the centrepiece for outcomes. Affected by educational attainment, and forthcoming of experiences of housing and involvement in the criminal justice system. Delayed development during childhood, and forced independence at 18 results in poor foundations, cementing lower likelihood of income success. Those who have exited care at 18 were found to experience an unemployment rate of 29% in comparison to 9% of non-care leavers (ABS, 2017). Low unemployment rates are strongly connected to drug or alcohol use, and from this more likely to commit a crime (DAE, 2018). A cyclical effect, as involvement in the criminal justice system, reduces the probability of securing employment in the future (Mendes et al., 2012). The interrelated nature of this is key to assessing the failures of current policy, in tackling the complex needs of those exiting care, and taking initiative in providing a safety net to improve outcomes.

International models of success

The United States (US) introduced the Fostering Connections to Success and Increasing Adoptions Act of 2008, legislating extended funding for the provision of care until 21, on the grounds of employment or education participation. Implemented through assistance payments, the cost is borne by both the Federal and State Government, and thus depends on whether the latter chooses to enact the program. As of 2018, forty-five states elected to extended care to 21 under the Act, and some through state-initiated programs. Okpych & Courtney (2019) agglomerated findings from the Midwest Study (2003-2011, n=732) and CalYOUTH (2012-2020, n=727), to reveal a positive relationship between educational attainment and extended care. Specifically, each year spent in care past 18, increased the probability of attaining secondary credential by 8% (Courtney, Okpych & Park, 2018). Further to this, Netzel & Tardanico (2014) observed extended care specifically in San Bernardino and California. In the first 6 months of extended care, 31.6% of youth were attending college or vocational training, however after two or more years in the extended model, 85.7% were attending college or vocational care. Inclusive of employment and education, higher participation was perceived as beneficial, particularly in relation to reducing illegal substance use and crime. Further to this, extended care in the US has had specific benefits, such as “fewer earlier pregnancies, lower levels of homelessness, reduced mental health difficulties or involvement in the criminal justice system” (McDonald & Mendes, 2019).

The United Kingdom (UK) extended care to parallel the parenting model, with the legislation of the Children and Families Act 2014. The ‘Staying Put’ arrangement is a voluntary model whereby a young person can make an agreement with their carer to ‘stay put’ up until the age of 21. Evaluation of the pilot found higher rates of education (55% versus 22%), training and employment (25% versus 22%) for those choosing to ‘stay put’ (Munro et al., 2010). Further to this, 41% of all youth exiting care in 2010, moved to stable and independent housing through private or council rented property. Of this 41%, 67% had chosen to ‘stay put’ for an additional year.

Extending care to 21 in Australia

A policy shift that extends care to 21 is conducive to what Mendes et al. (2013) describes as the basis of need – level of maturity and skill development – rather than a fixed chronological age. As has been extensively demonstrated in this article, the abrupt transition at 18 undermines prospects for those leaving care and proliferates the poor outcomes faced by youth (Mendes, Snow & Baidawi, 2013), whilst international models have shown the mitigating power of extending care to 21. The NSW Home Stretch Campaign Committee breaks this policy need into two segments, (1) the option to voluntarily extended living arrangements until age 21 and (2) a personal case worker/mentor to support the youth through a range of outcomes (DAE, 2018). Success of extending care has been proven through multiple international models, and as such South Australia and Tasmania have already implemented extended care, with trials in Western Australia, Victoria and ACT. A national Australian extended care program implemented by the Commonwealth is arguably well overdue. National implementation will ensure it is mandated across all states and territories; youth who move remain eligible (Mendes & Rogers, 2020).

As discussed extensively in this article, youth in OOHC experience adversities, however this is not to say they are a homogenised group. An individual’s comfort and sense of belonging in OOHC is greatly dependent on previous life experiences as well as the nature of their carer relationship, and as such it is recognised not all youth would wish to extend care or perhaps are not offered an extension. The DAE (2018) analysis based on international models estimates the retention rate would begin at 80% for the first year and eventually shrink to 25% by the third and final year. Dworksy, Napolitano, Courtney (2013) propose a re-entry policy, such that those who decide to leave care and later find they are not prepared for independent living are able to re-enter the care system, up until the age of 21. Further to this the Home Stretch campaign suggests those who cannot or choose not to extend care are provided with safe, secure and support to live independently.

A cost analysis conducted by DAE (2018), drawing on international research, concluded the economic feasibility of extending care to 21. Although dependent on increased funding from the Federal Government, DAE analysed this cost is in fact counteracted by costs reductions in welfare and hospital expenditure. On a state level, increasing the age to 21 resulted in savings for housing support, alcohol and drug costs, and justice costs. Specifically looking to Victoria, the expense of carer reimbursement and program costs as well as caseworker support, would amount to $28,000, however in turn provide $51,520 cost benefit – for every $1 invested, calculated to have a $1.84 cost benefit. In terms of public spending, it was calculated age extension would see a benefit cost ratio of $1.60. Overall, it was concluded the OOHC extension program would see a return investment of at least $1.40, with half of jurisdictions at least doubling monetary investment.

Placing costs aside, it also contributes positively to reducing intergenerational disadvantage, mental health and social connectedness. Extending care facilitates the Model of Youth Mentoring (Rhodes et al., 2006), which has been found to improve social emotional development (strengthen and modify relationships), cognitive development (educational attainment, competence, motivation, behavioural adjustment) and identity development (aspirations, less crime). Supported by the DAE Analysis, which predicted extensive capacity for improvement across all domains, including an absolute reduction of 19.5% in homelessness, 10% hospitalisation, 6.4% teen pregnancy and 24.3% poor wellbeing.

Social workers as the centrepiece

The success of extending care rests on the foundations of OOHC living arrangements. The extension of OOHC in all Australian jurisdictions is voluntary, and as such although research indicates youth should stay in care and carers should offer an extension, there is no legal obligation to do so. Review of the ‘Staying Put’ program in the UK established ‘part of the family’ as the main reason for youth and carer willingness to extend care. Thus, social workers have a crucial role at the beginning, effective care planning and matching (Munro et al., 2010).

Children and youth desire this strong connection with their carer, with the CREATE Foundation survey (n=1275) revealing a ‘good placement’ was defined by a carer who provided positive support and included them as part of the family (McDowall, 2018). A nurturing relationship is thus the forefront of placement satisfaction (McFarlane, 2015) and will influence whether youth extend care. Social worker practice has the capacity to facilitate this relationship; such literature has extensively entangled carer retention and support from social workers. Lack of support has been documented as the main reason for discontinuing care (Maclay et al., 2006; Rhodes et al., 2001), with alternative research indicating a correlation of placement disruption (Taylor & McQuillan, 2014; Tregeagle et al., 2011). Social workers are required to proactively engage and intervene during disruptions, through acknowledging both the carer and the youth. Intensive support during the first year of a placement has been proven to ensure the “small issues did not build up”, and in doing so sustain stability and establish relationships (Tregeagle et al., 2011).

Barnes (2012) discusses this practice as caring advocacy, whereby social workers retain focus of the youth as central to the work, in turn respecting their autonomy. This shift away from paternalism can guide the social work workforce to advocate for the lived experiences of those in extended OOHC. An emphasis must be placed on understanding stage development as a product of time and environment (Bronfenbrenner & Morris, 2006; Bronfenbrenner, 2005). Understanding leaving care at 18 is unparalleled vis-a-vis a youth’s capacity to live independently (due to adverse behavioral and emotional development) and therefore are warranted any additional support.

As discussed above, it is the carer relationship that holds capacity for support and mentorship, and social workers are crucial in facilitating this. However, this is not to say social workers themselves don’t have a direct impact. Social worker engagement as well as capacity to take action is necessary for program success. A youth-social worker relationship perceived to be honest and trusting has proven to empower youth. When empowered, youth are more likely to be involved in decisions relating to their care, which leads to positive life outcomes (Thomas, 2000; Bell, 20020). Further to this, social workers hold a strong predictive capacity as to whether a young person is prepared, with research concluding such a prediction is strongly correlated to whether they achieve educational attainment (Okpych & Courtney, 2019). Intervening on these predictions is necessary for effective practice to promote positive outcomes. 

Conclusion

In conclusion, the ominous state for those exiting care at 18, compared with the success of extension programs, is indicative of Australia’s inaction on these issues. The solution necessitates a policy shift, which is financially feasible and promising in improved outcomes, as well as commitment from the social work workforce. This article emphasises the importance of the Home Stretch Campaign, which is positively lobbying the Commonwealth, State and Territory governments to recognise and address the complex needs of care for youth in OOHC, for whom they are ultimately responsible for.

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