PhD Defence: Ronja Helénsdotter "Court-Ordered Care"

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Opponent:
Professor Manudeep Bhuller, Department of Economics, University of Oslo.

Grading committee:
Professor Matthew Lindquist, Swedish Institute for Social Research, Stockholm University.
Professor Mikael Lindahl, Department of Economics, University of Gothenburg.
Associate Professor Arizo Karimi, Department of Economics, Uppsala University.

Chair:
Professor Randi Hjalmarsson, Department of Economics, University of Gothenburg.
 

Abstract

Surviving Childhood: Health and Crime Effects of Removing a Child From Home
This paper studies the effects of the court-ordered removal of children from home on health and crime. To isolate causal effects, I exploit quasi-random variation in judge assignment together with across-judge variation in the tendency to favor removal in an instrumental variable (IV) design. Using a novel data set (N=26,481) based on Swedish court documents that I transcribe and link with detailed register data, I find that court-ordered out-of-home placement has large adverse effects on the mortality of the marginal child. These effects are primarily driven by suicides that occur while the removed child is still placed in out-of-home care. Removal also causes an increase in hospitalizations for mental illness and non-narcotic crimes. For birth parents, I again find an increase in non-narcotic crimes but there is little evidence of adverse health effects. I explore potential explanations for the detrimental effects on child health. Peer victimization, peer-to-peer spillovers, and adverse care home conditions appear to be important channels.

Treated Together: Spillovers Among Youths Admitted to Residential Treatment
Individuals struggling with substance abuse and self-harm are often treated in group-based programs. However, concerns have been raised about the risk of adverse outcomes through peer-to-peer spillovers. This paper analyses the effects of peers placed in residential treatment facilities on each other's outcomes. I use novel data on the universe of youths (over 16,000) admitted to state-owned treatment facilities in Sweden between 2000 and 2020. To overcome the issue of nonrandom assignment of youths, I make use of the natural flow of youths to and from facilities within a given year by including facility-by-year fixed effects. I find strong evidence of reinforcing peer effects in substance abuse and self-harm: exposing youths with a history of substance abuse (self-harm) to peers with a similar background increases the risk of experiencing adverse events (for example, hospitalization) related to substance abuse (self-harm) post- discharge.

Making Better Choices: The Role of Learning in the Judicial System
A large literature documents substantial variation in decision-making for otherwise similar cases across decision-makers and over time in an array of government institutions, including the judicial system. This paper studies the drivers of variation in decision-making, with a focus on judges' learning under limited information. The analysis is based on over 20,000 Swedish child protection court cases from 2001 to 2019, which are linked with rich register data and novel data on appellate court decisions. Using quasi-random assignment of cases, we find robust evidence that judges become more stringent with experience, conditional on judge fixed effects. This increase in removal tendency with experience is driven by male judges. The behavior change is not consistent with skill improvements as children who are randomly assigned to more experienced judges are more likely to die by the year they turn 19. The lack of learning is likely rooted in the limited access to information about the consequences of the court's decision. A potential driver of the positive relationship between stringency and experience can be signals from appellate courts. Indeed, we find that judges respond to appellate courts' decisions to reverse the judges' previous judgment to not remove a child from home by increasing their stringency. However, this effect is short-term and there is no detectable effect after one month. A more likely explanation is a change in judge preferences.

Read the full thesis: 
Court-Ordered Care