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Research highlights that residential care experienced children and young people in Scotland have poorer educational outcomes than their peers within the wider population. Despite this, poor educational attainment is not inevitable, and further research is needed to increase the understanding of long-term trajectories. This paper aims to address a gap in contemporary literature that is of benefit to practitioners, academics and policymakers. Despite experiencing adversity, attachment, separation and loss, school attainment data on leaving care only reflects part of the educational journey.

Using a mixed methodology and social constructionist theoretical framework, a practitioner-led PhD study gathered data from questionnaires and qualitative information from 13 semi-structured interviews with young people who had experienced residential care in Scotland. Recruitment was through a gatekeeper within a national third-sector organisation. The educational trajectories for young people with experience of residential care in Scotland are complex. A lived experience perspective from a PhD study illustrates that statistical data only captures part of the journey and the author needs to reconsider how success is measured.

Of the 13 participants in the study, 12 achieved success educationally, although for the majority of those interviewed, attainment continued after leaving compulsory education. Barriers to greater success included placement uncertainty and movement, stigma, low expectations, pressure to not become a statistic, procedural obstacles and inconsistency or poor relationships.

Supportive relationships and stable placements can create circumstances conducive to effective learning, but evidence reflects that support is necessary throughout the life course if children, young people and adults with care experience are to reach their full academic potential.

Research into the educational outcomes for those with experience of residential care in Scotland is limited. This paper, from a PhD, provides lived experience accounts from a practitioner-led study.

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.