A prospective examination of offending trajectories in men and women with out-of-home care experience followed up until retirement age

ICON member Ylva B Almquist published a prospective birth cohort study together with Hilma Forsman, Glena Hossein, Olof Bäckman and Lars Brännström. The study examines offending, psychiatric disorders and premature mortality from early adulthood to retirement age among individuals with and without childhood experience of out-of-home care.

About the study

Children placed in out-of-home care (OHC) are often exposed to substantial adversity before placement and have elevated risks of criminal involvement, mental health problems and premature mortality later in life. However, these outcomes are often studied separately. Less is known about how they co-occur across adulthood and whether long-term outcomes differ depending on the timing and reasons for placement.

The study used longitudinal data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen), following individuals born in 1953 from childhood into retirement age. The analytical sample included 14,545 individuals, of whom 1,318 had experience of OHC. Offending, psychiatric disorders and mortality were examined between ages 20 and 63. Sex-stratified analyses compared individuals with OHC experience with those who had been investigated by child welfare services but not placed, and with peers who had neither been investigated nor placed.

Individuals with OHC experience had elevated risks across all studied outcomes compared with majority population peers. The strongest associations were found for the co-occurrence of offending and psychiatric disorders. Risks were particularly high among individuals first placed during adolescence and among those whose placement was related to their own behaviour. Individuals who had been investigated by child welfare services but not placed generally showed intermediate levels of risk.

Including mortality as an outcome also showed that premature death forms an important part of long-term outcome patterns following OHC. The findings highlight substantial variation within the OHC population and point to the importance of identifying complex needs early and providing coordinated support across child welfare, mental health, education and justice services. Continued support through the transition to adulthood may be particularly important for groups facing multiple and overlapping disadvantages.

Highlights

“Individuals with childhood experience of out-of-home care faced elevated risks of offending, psychiatric disorders and premature mortality throughout adulthood, with particularly strong associations for co-occurring offending and psychiatric disorders.“

Publication details

Forsman, H., Hossein, G., Almquist, Y. B., Bäckman, O., & Brännström, L. (2026). Childhood out-of-home care and later crime, mental health, and mortality up to retirement age: A prospective birth cohort study. Child Protection and Practice, 10, 100349.

Read more: https://doi.org/10.1016/j.chipro.2026.100349

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