Child Welfare Recommendations to Improve Mental Health Services for Children who have Experienced Abuse and Neglect: A National Perspective

Abstract

This study uses a key informant approach to understand the nature, extent, and quality of outpatient mental health services for children in the child welfare system (CWS) in the United States. We interviewed 89 county child welfare administrators to determine the status of outpatient mental health services and provide recommendations for enhancing care and service delivery. Developed for this study (Caring for Children in Child Welfare), the interview was incorporated in the second formal data collection wave (i.e., 18 months after study baseline assessment) of the National Survey of Child and Adolescent Well-Being. The results highlighted general variability in the degree to which these agencies used evidence-based interventions within outpatient services, demonstrated clinical expertise with this population, and met the needs of their families. Community agency use of evidence-based interventions was found to predict their effectiveness in improving clients' mental health problems. Proposed suggestions for service improvement varied across domains and reflected the need for more communication/coordination, service access, options and resources, and practice refinements to accommodate families' needs. We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system.

Children Exposed to the Arrest of a Family Member: Associations with Mental Health

“…Further, similar to previous findings (Kolko et al, 2009; Phillips & Zhao, 2010), children in our study exposed to the arrest of a family member were more likely to also have been exposed to other types of PTEs compared to those not exposed to arrest. Per caregiver report, almost all of the children who had been exposed to an arrest had also been exposed to multiple types of PTEs beyond the arrest of a family member, including domestic violence, separation from a loved one, or death of someone close.…”

“…Per caregiver report, almost all of the children who had been exposed to an arrest had also been exposed to multiple types of PTEs beyond the arrest of a family member, including domestic violence, separation from a loved one, or death of someone close. This mirrors research stating that children who experience the arrest of a family member are more likely to experience other types of PTEs (Kolko et al, 2009; Philips & Zhao, 2010, Snyder et al, 2012). …”

“…Studies that have examined arrest exposure have found that children who are exposed to arrest are significantly more likely to have been the victims of and witnesses to a broader range of violent and nonviolent crimes in their homes (e.g., physical abuse, drug dealing; Kolko, Herschell, Costello, & Kolko, 2009; Phillips & Zhao, 2010), and have a greater likelihood of developing serious problems than do children whose parents do not have a history of arrest (Dannerbeck, 2005), those from the general population (Murray & Farrington, 2005a), or children from high-risk populations (i.e., child welfare) (Phillips, Burns, Wagner, & Barth, 2004). For example, data from the National Survey of Child and Adolescent Well-being demonstrate that at least 1 in 3 children ages 8 years and older who are subjected to maltreatment have also experienced the arrest of someone with whom they have lived (Dowd et al, 2003).…”

Mental Health Services Expenditures among Children Placed in Out-of-Home Care

“…There is some evidence that interventions that are the most effective for children and adolescent affective disorders, are also the most cost-effective (Domino et al 2008;Haby et al 2004). Presently, as a recent survey of county child welfare administrators suggests, there is a high degree of variability in the implementation of evidence-based services (Kolko et al 2009). The second directions relates to characteristics such as age, ethnicity, and gender that are not directly amenable to treatment.…”

Traumatic Impact of Familial Arrest on Young Children

“…Research has demonstrated that children who have been exposed to arrest of a family member are significantly more likely to have been the victims of, or witness to, a broader range of violent and nonviolent crimes in their homes including child maltreatment or the use/selling of illegal substances [2–4]. Children exposed to the arrest of their parent have a greater likelihood of developing serious emotional and behavioral problems than children without this history [5], including children from the general population [6] and children from highrisk populations such as those involved in the child welfare system [7].…”