In the system for too long: former foster youth and the structural ambivalence towards mental health

Abstract

A growing research literature documents that young people who "age out" of foster care (after turning 18 or in some states 21) frequently encounter challenging obstacles during their transition into adulthood, and in particular are susceptible to poor mental health and substance abuse problems throughout their early twenties. Drawing from an 8-month longitudinal study of 26 young people transitioning out of care, the dissertation reports on the conflicted relationship that some former foster youth have with service providers, mental health programs and ideas of seeking help more generally, during their transition out of care. The dissertation argues that many former foster youth endorse conventional health beliefs about the efficacy of mental health treatments, but are nonetheless ambivalent about re-integrating themselves with what they perceive as an inconsistent and untrustworthy system of social services and public supports. This sense of what I describe as "structural ambivalence " reflects the inconsistent and contradictory forms of support that many foster youth received while wards of the state, and underpins many of their decisions as young adults to avoid and resist prolonged engagement with social services. Structural ambivalence has implications for meso-level theories of health seeking behavior, and in particular recent frameworks that emphasize the role that social networks and culture play in shaping the dynamic engagement that young consumers have with mental health treatments. This conceptual framework also highlights the contradictory logics of welfare and public health institutions more broadly in the US, and the troubling situation that former foster youth find themselves in while navigating these public systems during their uncertain transition to adulthood.