title: Child maltreatment and the transition to adult-based medical and mental health care.
abstract: BACKGROUND
  Child maltreatment is a public health problem with lifelong health consequences for survivors. Each year, >29 000 adolescents leave foster care via emancipation without achieving family permanency. The previous 30 years of research has revealed the significant physical and mental health consequences of child maltreatment, yet health and well-being have not been a priority for the child welfare system.
  
  
  OBJECTIVE
  To describe the health outcomes of maltreated children and those in foster care and barriers to transitioning these adolescents to adult systems of care.
  
  
  METHODS
  We reviewed the literature about pediatric and adult health outcomes for maltreated children, barriers to transition, and recent efforts to improve health and well-being for this population.
  
  
  RESULTS
  The health of child and adult survivors of child maltreatment is poor. Both physical and mental health problems are significant, and many maltreated children have special health care needs. Barriers to care include medical, child welfare, and social issues. Although children often have complex medical problems, they infrequently have a medical home, their complex health care needs are poorly understood by the child welfare system that is responsible for them, and they lack the family supports that most young adults require for success. Recent federal legislation requires states and local child welfare agencies to assess and improve health and well-being for foster children.
  
  
  CONCLUSIONS
  Few successful transition data are available for maltreated children and those in foster care, but opportunities for improvement have been highlighted by recent federal legislation.
authors.affiliation: Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. christian@email.chop.edu
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Christian
authors.forename: Donald F
authors.initials: DF
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000628:therapy*; D005581:Foster Home Care; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008605:Mental Health Services; D055815:Young Adult