Keywords
psychiatric service engagement
child welfare outcomes
mental health follow-up
child protection law
Abstract
Objective: This study aimed to identify factors associated with the resolution and duration of court-mandated health protection measures among children and adolescents in Türkiye.
Methods: A retrospective analysis was conducted on 160 cases followed between January 2015 and December 2024 at the Child and Adolescent Psychiatry Clinic of Ordu University Training and Research Hospital. Data were extracted from judicial decisions, psychiatric assessments, and social service records. Variables were categorized into sociodemographic, familial, clinical, service-related, and legal domains. Outcomes included case status (ongoing, terminated, or transferred) and duration. Multinomial logistic regression and Cox proportional-hazards models were used for analysis.
Results: Regular psychiatric follow-up (57.5%) was strongly linked to successful resolution (aRRR = 6.85, p < 0.001) and shorter protective duration (aHR = 2.91, p < 0.001). Legal reason, mandate orientation, and referral source had no significant effect. Although 49.4% of the cases had multiple psychiatric diagnoses, regular follow-up significantly increased both the likelihood of case termination (aRRR = 6.85, p < 0.001) and the speed of resolution (aHR = 2.91, p < 0.001). In unadjusted analyses, depressive symptoms, as well as behavioral risk factors such as conduct disorder and smoking, were associated with longer case durations.
Conclusion: Consistent psychiatric engagement emerged as the key determinant in resolving protective orders, surpassing diagnostic complexity or legal basis. These findings underscore the importance of sustained, structured care in driving recovery in vulnerable children.
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