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February 18, 2005
Predictors of Mental Health Service Use Among Children in the U.S.
Child Welfare System
Evidence from a study indicates that roughly one quarter of children in the U.S. child
welfare system who need mental health services receive it. In addition, access to support
is largely determined by race and socioeconomic background. |
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Many in this population have severe emotional problems and are at a high risk of
developing behavior and mental health problems. The children most affected are usually
minority children. Past studies have indicated that placement outside the home has an
enormous impact on a child’s development. The goal of this study was to compare the
degree of cooperation between local child welfare and mental health agencies with the
delivery of specialty mental health services.
Methods
Researchers utilized data on 2,823 children aged 2 to 14 years old from the National
Survey of Child and Adolescent Well-being of Children (NSCAW). The subjects lived within
97 U.S. counties and were in the child welfare system between October 15, 1999, and April
30, 2001. Researchers measured rates of specialty mental health service one year after
children entered the system.
862 subjects had been removed from the home and 1,961 remained at home. Over the course of
one year researchers obtained data from interviews and follow up home visits with legal
guardians and foster parents on the mental condition of the children.
Researchers measured sociodemographics and placement, maltreatment history, family risk
factors and insurance status, need for mental health services, linkages between child
welfare and mental health agencies at the local level, mental health specialist supply and
county population and poverty level.
The Child Behavior Checklist (CBCL) was used to measure emotional and behavioral problems
in the subjects.
Results
Findings of the study indicate that 28.3% of subjects received mental health services
within the first year after entry into the child welfare system. However, 42.4% received
scores on the Child Behavior Checklist, which indicated they need special services.
Being placed out of the home, age, and ethnicity were leading predictors to usage of
special mental health services. Cooperation between social and mental health agencies was
associated with positive outcomes in children and was responsible for similar rates of
mental health service usage between white and African American children.
Black and Latino children were much less likely to get mental health services than white
children. Increased interagency cooperation was related to improved outcomes in African
American children but not in other minorities. Researchers attributed this to possible
language barriers and lack of knowledge on the subject.
Conclusions
Investigators asserted that young children and those placed at home have much to gain from
improved access to mental health services. They added that those who require the most
services usually don’t receive it. Increased cooperation between social and mental
health organizations could lead to better utilization of resources and narrow the gap
between whites and non-whites who receive specialty mental health support.
Complete findings of the study appear in the December 2004 issue of the Archives of
General Psychiatry Visit our bookshop for tools to help the
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