title: Outpatient mental health services for children in foster care: a national perspective.
abstract: OBJECTIVE
  To determine factors influencing the use of outpatient mental health services provided by mental health professionals (OMHS) for children in foster care using a national probability sample in the United States.
  
  
  METHODS
  As part of the National Survey of Child and Adolescent Well-being, detailed survey data were collected on 462 children, ages 2-15, who had been in out-of-home care for approximately 12 months at the time of sampling. A multivariate logistic regression model was used to determine how clinical need, as measured by a Total Problem, Externalizing, or Internalizing Scale T-score of 64 or greater on the Achenbach Child Behavior Checklist (CBCL), and non-clinical factors affected OSMHS use.
  
  
  RESULTS
  Over half of the children in the sample received at least one OMHS. Need, older age, and history of sexual abuse history all positively predicted OMHS. A history of physical neglect negatively predicted OSMHS. African-Americans used fewer services than children of Caucasian ancestry at all values on the CBCL. This finding was particularly salient at lower levels of CBCL scores; at higher levels, the discrepancy in the use of services diminished but the proportion of children receiving services remained lower for African-American children.
  
  
  CONCLUSIONS
  This national study confirms previous findings regarding the use of mental health services based on regional data. Limitations in the use of services imposed by non-clinical factors, specifically, age, race/ethnicity and type of abuse, need to be examined in order to address implicit and explicit policies and practices that may result in inequitable distribution of services.
authors.affiliation: Child and Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA 92123-4282, USA.
authors.forename: Laurel K
authors.initials: LK
authors.lastname: Leslie
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hurlburt
authors.forename: John
authors.initials: J
authors.lastname: Landsverk
authors.forename: Richard
authors.initials: R
authors.lastname: Barth
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Slymen
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D005581:Foster Home Care; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008603:Mental Health; D010045:Outpatients; D012307:Risk Factors; D014481:United States; D044465:White People