A preliminary analysis of the receipt of mental health services consistent with national standards among children in the child welfare system.
OBJECTIVE
We sought to examine the extent to which children in the child welfare system receive mental health care consistent with national standards.


METHODS
We used data from 4 waves (3 years of follow-up) of the National Survey of Child and Adolescent Well-Being, the nation's first longitudinal study of children in the child welfare system, and the Area Resource File to examine rates of screening, assessment, and referral to mental health services among 3802 youths presenting to child welfare agencies. Weighted population-averaged logistic regression models were used to identify variables associated with standards-consistent care.


RESULTS
Only half of all children in the sample received care consistent with any 1 national standard, and less than one tenth received care consistent with all of them. Older children, those exhibiting externalizing behaviors, and those placed in foster care had, on average, higher odds of receiving care consistent with national standards.


CONCLUSIONS
Adverse consequences of childhood disadvantage cannot be reduced unless greater collaboration occurs between child welfare and mental health agencies. Current changes to Medicaid regulations that weaken entitlements to screening and assessment may also worsen mental health disparities among these vulnerable children.
Raghavan
Ramesh
R
Washington University, Brown School of Social Work, St Louis, MO 63130, USA. raghavan@wustl.edu
Inoue
Megumi
M
Ettner
Susan L
SL
Hamilton
Barton H
BH
Landsverk
John
J
D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000628:therapy; D002669:Child Welfare / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008605:Mental Health Services / Q000592:standards* / Q000600:supply & distribution; D016017:Odds Ratio; D014481:United States