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Child / Adolescent - Trauma / Maltreatment

(PS4-C53) Direct Care Staff Vacancies and Adverse Youth Events in Illinois Child Welfare Residential Treatment During the COVID-19 Pandemic

Friday, November 17, 2023
1:00 PM – 2:00 PM PST
Location: Regency Ballroom, Level 7
Direct care staff provide 24/7 care and supervision in youth residential treatment.  Of concern, shortages of direct care staff are chronic and widespread; this study found a 50% increase in staff vacancy rates during the pandemic. Residential staff turnover is linked to decreased stability, longer waits for permanent placements, retraumatization from additional caregiver interruption, and a general loss of trust for youth (Colton & Roberts, 2007; Curry, 2019).  This study used multi-level, two-stage least squares regressions to examine the relationship between staff vacancies and adverse events experienced by 1352 youth in Illinois child welfare residential care between October 2019 and February 2022.  We found a positive, insignificant relationship between the overall number of adverse youth events and direct care staff vacancies.  Through hierarchical cluster analysis, we also found 8 distinct clusters of events which showed different magnitudes and directions of association with staff vacancies.  Legal/School events were positively and significantly related to staff vacancy rates (p< .001).  There were also several incidental findings, with various youth and facility level factors showing significant relationships with the frequency of overall, and specific clusters, of adverse events.  Further, we found that adverse events are ubiquitous in residential care, with 88% of youth experiencing at least one adverse event in care. This study provides novel empirical findings that we argue should inform funding and staffing necessary to promote effective residential care for youth.  Given that more fully staffed residential agencies are linked to fewer overall adverse events, and fewer Legal/School events specifically, structural changes allowing staff the time and bandwidth to form secure attachments with youth may reduce the frequency of adverse events.  Several evidence-based approaches to increasing staff retention and capacity to carry out job responsibilities will be discussed including: enhanced and accessible staff training about de-escalation and trauma-informed care, acknowledgment of staff secondary traumatic stress, increased supervision,  staff processing after youth crises, enhanced staff safety, and increased pay (Colton & Roberts, 2007; Kothari et al., 2019; Middleton & Potter, 2015; Smith et al., 2017; Strand & Dore, 2009).   

NOTE: This abstract was also submitted for a Spotlight Research Presentation; should it not be accepted for the oral proposal the authors would like for it to be considered for a poster, if possible.