L’environnement social et les familles vulnérables : une étude longitudinale à multiniveau sur l’intervention récurrente en protection de la jeunesse

Esposito, Tonino; Précourt, Stéphanie; Caldwell, Johanna; Saint Girons, Marie; Chabot, Martin; Hélie, Sonia; Clément, Marie-Ève; Trocmé, Nico

doi:https://doi.org/10.7202/1093880ar

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Objectif : Les facteurs socio-environnementaux tels que la pauvreté, l’utilisation des services psychosociaux et les dépenses des services sociaux pourraient tous influencer les défis auxquels sont confrontées les familles vulnérables. Cet article examine dans quelle mesure la vulnérabilité socio-économique, les consultations de services psychosociaux et les dépenses de services sociaux préventifs ont un impact sur l’intervention récurrente de la protection de la jeunesse (PJ).

Méthodologie : Ce devis de recherche longitudinal à multiniveau utilise trois sources de données : 1) les données clinico-administratives des services PJ au Québec; 2) les données du recensement canadien de 2011; 3) les données provinciales sur les dépenses en santé et l’utilisation des services sociaux provenant du Ministère de la Santé et des Services sociaux.

Échantillon : La population de l’étude inclut l’ensemble des enfants ayant été suivi à l’application des mesures par les services PJ à travers le Québec et dont le dossier avait été fermé entre 2002 et 2017 (N = 76 176).

Résultats : Les résultats d’analyses de régression de Cox à multiniveaux ont montré que la négligence, le trouble de comportement et la défavorisation socioéconomique étaient les principaux prédicteurs de récurrence au niveau individuel. Le taux de consultation psychosociale, en contrôlant pour les dépenses en santé et services sociaux et des facteurs individuels, prédisait une intervention PJ récurrente. Le taux de consultation psychosociale et les dépenses en santé et services sociaux expliquaient 27,9 % de la variation de la récurrence au niveau du territoire pour les jeunes enfants de moins de 5 ans, 30,4 % pour les enfants de 5 à 11 ans et 13,3 % pour ceux de 12 à 17 ans. Les auteurs décrivent les implications de ces résultats sur la mise en place de pratiques et politiques visant à réduire le taux de récurrence.

Mots-clés :

récurrence,
protection de la jeunesse,
vulnérabilité socioéconomique,
multi-niveau,
longitudinale

Abstract

Objective: Socio-environmental factors such as poverty, and avaibility and accessability of psychosocial services could all influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts multiple involvement with the child proteciton system in Quebec.

Participants and setting: The study population includes all children whose ongoing child protection intervention in Quebec closed between 2002 and 2017 (N=76,176).

Methods: This clinical population study uses a multilevel longitudinal research design drawing anonymized clinical administrative data from all of Quebec’s child protection jurisdictions spanning 15 years, and Quebec data extracted from the 2011 Canadian National Household Survey , and provincial data on health expenditures and use of social services from the Ministry of Health and Social Services.

Results: Of the total population studied, 32.5 % (N = 24,816) experienced a recurrence of maltreatment during the study period. Multilevel hazard results indicate that negelct, behavioural problems and socioeconomic vulnerabilities all contriuute to the increase risk at the individual level of maltreatment recurrence. Also , the rate of psychosocial consultations, controlling for social services spending and individual factors, predicted increased maltreatment recurrence. Specifically, psychosocial services, and social services spending account for 27.9 % of the variation in jurisdictional maltreatment recurrence for younger children less than 5 years of age, 30.4 % for children age 5 to 11 years and 13.3 % for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socio-environmental risk factors that increase maltreatment reccruence.

Keywords:

Child welfare,
Maltreatment recurrence,
administrative data,
census data,
multilevel longitudinal analysis,
socioeconomic vulnerability

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L’environnement social et les familles vulnérables : une étude longitudinale à multiniveau sur l’intervention récurrente en protection de la jeunesseRecurrent involvement with the child protection system: A multilevel longitudinal analysis

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