Monitoring Trends and Outcomes

Effective oversight of the over 600 residential service providers across Ontario requires both the capacity (1) to ensure that every individual service provider meets provincial standards for quality care (see Chapter 3 Quality of Care) and (2) to track service trends and monitor outcomes to determine at the aggregate level whether residential services are effectively supporting young people. While the youth justice sector and some service providers are reporting information that provides a sense of service trajectories and outcomes, it is not possible at this time to determine the extent to which the current design and delivery system is effectively meeting the needs of children and youth in residential care in Ontario.

The province has no easily accessible and reliable information to answer the most basic questions, for example: What is the age and sex distribution of young people entering residential care? Are there any trends in admissions and discharges broken down by Aboriginal status? What is the average number of placement changes young people experience while in care? Where do young people go when they leave residential care? How well do children and youth in care do on educational and other outcomes? Even where data is collected in these areas, it is not effectively managed and analyzed to provide insight into these questions.

Answering these and other questions requires a comprehensive and integrated approach to collecting data over time from the child welfare, children and youth mental health, youth justice, and complex special needs sectors. It also involves examining existing sources of data to identify how to maximize the utility of these sources by creating user-friendly databases that can be easily analyzed to provide both simple descriptive outputs as well as more complex longitudinal and multilevel analyses. This exercise of transforming existing data sources into datasets rich with information must occur in the context of collaboration across sectors, in order to move toward comparable cross-sector approaches to asking and answering critical questions about children and youth in residential care as well as the quality of care provided by residential services.

Existing reporting on service trends, service provider quality, and child and youth outcomes in Ontario is limited. Available data on children in residential care is typically presented as point-in-time snapshots, with little information on trajectories over time. Trends data, where available, only represent trends over a few years making it very difficult to assess the impact of incremental changes. Data is rarely representative of the population of children living in residential services across sectors and there is no way to track young people between sectors. Random sampling techniques, which can maximize representativeness while limiting the costs and time associated with population-based research, are not commonly employed in the child welfare, youth justice, children and youth mental health, and complex special needs sectors. Finally, issues of the reliability and validity of data are rarely discussed in reports on residential services, and findings are rarely presented with a clear explanation of the research methods and the limitations of those methods.

The province does not systematically collect important information in order to monitor the safety and well-being of young people receiving residential services. MCYS and residential service providers also do not have a method of consistently and publicly reporting on other important issues for children and youth in care, treatment, and custody/ detention, including schooling, friends, skills, significant adults and relationships, and satisfaction with services. Even basic demographic and service data that exist are not being fully accessed and analysed.