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The purpose of this study was to develop a framework for assessing the quality of children's mental health services that reflects the primary concerns and perspectives of diverse stakeholders. A participatory research approach was adopted in order to incorporate caregivers of children with mental health problems, mental health service providers, and managed care administrators in identifying and developing quality of care indicators and methods for assessment. This research occurred in three phases that moved from very qualitative and exploratory to more quantitative as we sought to refine and verify the resulting Quality of Care Framework. We found that the use of a participatory approach was beneficial in ensuring the validity of research tools and utility of the framework, and also greatly increased the sense of ownership of research findings among participants.

This article compares and contrasts the services needed by families in child welfare systems with the services that families receive. A mixed-methods approach was used to triangulate data from a variety of sources, including administrative databases, case file reviews, and focus groups with child welfare caseworkers and clients. Through this analysis, four overarching themes are explored: (a) perceptions of system-involved families' needs, (b) engagement of families in service planning, (c) availability and accessibility of services, and (d) the quality and appropriateness of services provided to families. Findings suggest that considerable gaps and barriers exist that prevent systeminvolved families from receiving the services they need. The manuscript concludes with research and practice recommendations about meeting the service needs of families in child welfare systems.