Racial and Ethnic Variations in Mental Health Care Utilization Among Children in Foster Care

Garland, Ann F.; Hough, Richard L.; Landsverk, John; McCabe, Kristen M.; Yeh, May; Ganger, William; Reynolds, Beth

doi:10.1207/s15326918cs0303_1

Cited by 86 publications

(75 citation statements)

References 20 publications

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“…It is estimated that 50% to more than 80% of children in foster care have developmental and mental health problems (Garland et al, 2000). Therefore, the young people in this study who have experienced multiple placements are at risk for serious outcomes.…”

Section: Child Transitionsmentioning

confidence: 91%

A Qualitative Study of Early Family Histories and Transitions of Homeless Youth

Tyler

2006

J Interpers Violence

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Using intensive qualitative interviews with 40 homeless youth, this study examined their early family histories for abuse, neglect, and other family problems and the number and types of transitions that youth experienced. Multiple forms of child maltreatment, family alcoholism, drug use, and criminal activity characterized early family histories of many youth. Leaving home because of either running away or being removed by child protective services often resulted in multiple transitions, which regularly included moving from foster care homes to a group home, back to their parents, and then again returning to the streets. Although having experienced family disorganization set youth on trajectories for early independence, there were many unique paths that youth traveled prior to ending up on the streets.

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Section: Child Transitionsmentioning

confidence: 91%

A Qualitative Study of Early Family Histories and Transitions of Homeless Youth

Tyler

2006

J Interpers Violence

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“…A considerable amount of research has shown that Latinos generally underutilize mental health services (e.g., Acosta, 1979;Alegria et al, 2002;Flaskerud & Hu, 1992;Garland et al, 2000;Padgett, Patrick, Burns, & Schlesinger, 1994b;Vega et al, 1998;Williams & Collins, 1995). A study of the hospitalization rates of U.S. ethnocultural groups found that Latinos, when compared to Whites, underutilize outpatient mental health services and that they were less likely to be admitted to psychiatric services at nonfederal general hospitals and VA medical centers (Rosenstein, Milazzo-Sayre, MacAskill, & Manderscheid, 1987).…”

Section: Low Utilization Ratesmentioning

confidence: 99%

Barriers to Community Mental Health Services for Latinos: Treatment Considerations

Kouyoumdjian¹

2003

Clinical Psychology: Science and Practice

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“…Other investigators have also observed that older children in foster care have greater mental health needs, with nearly 40% to 80% of older children meeting criteria for serious emotional or behavioral disorders at the time of entry into foster care. 6,[35][36][37][38][39][40] There is also increasing evidence that children with significant behavioral and emotional problems utilize regular health services at much greater rates than their peers. 41,42 Therefore, our results offer important evidence to support the implementation of more comprehensive interventions, such as specialized health centers 10 or treatment foster care 43 (which includes weekly mental health services and in-home behavioral therapy), to serve those older children who are most at risk for suboptimal health care.…”

Section: Discussionmentioning

confidence: 99%

Placement Changes and Emergency Department Visits in the First Year of Foster Care

et al. 2004

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ABSTRACT. Objectives. Despite great needs, many children in foster care do not receive adequate medical care. Suboptimal care may be attributable in part to placement changes, which disrupt continuity of care by both a consistent surrogate parent and potentially a primary care physician. These disruptions in turn may lead to increased use of the emergency department (ED) for outpatient care. The primary aim of this study was to test whether a greater rate of placement changes was associated with increasing use of the ED among children in their first year of foster care. The secondary aim was to compare ED visit rates with rates of visits to other ambulatory care settings among children in foster care and other Medicaid-eligible children not in foster care.Methods. Using Medicaid claims linked to foster care administrative data, we assembled a retrospective cohort of foster children in a large urban municipality from 1993 to 1996. Eligible children spent at least 9 months in a new episode of foster care and were continuously eligible for Medicaid during a 1-year follow-up period. A comparison cohort was drawn from Medicaid-eligible children not in foster care during fiscal year 1995. The dependent variable was the rate of visits to the ED or other ambulatory care settings during a 1-year follow-up period. A negative binomial model estimated visit rates to the ED and other ambulatory care settings as the number of foster care placements increased. Potential interactions were considered between age and location of service use (ED or ambulatory care setting), between age and foster care placements, and between location of service use and number of foster care placements.Results. The 2358 children in the sample accounted for 1206 ED visits during the follow-up period; 38% experienced >2 placement changes. Children of all ages exhibited increasing reliance on the ED for ambulatory care services as the number of placements increased, with the rates of ED use more than doubling for all age groups beyond infancy. However, other ambulatory care service use increased by only 41% to 53%; there was much less utilization in these nonemergency settings for all children but particularly toddlers and infants, compared with their Medicaid-eligible peers. Although the absolute rates of all visits for younger foster children (<6 years of age) were low, older foster children had increasingly greater ED use than did their Medicaid-eligible peers, with nearly double the rate of ED visits in the adolescent age group. A temporal relationship between placements and ED visits was also identified; 75% of ED visits occurring within 3 weeks of a placement change occurred in the period after a placement change.Conclusions. Foster children received fewer overall outpatient services than did their Medicaid-eligible peers, but with age and increasing numbers of placements, had higher visit rates and received a greater proportion of their overall outpatient care in the ED. These results suggest that poor access to nonemergent ambulatory care sett...

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Racial and Ethnic Variations in Mental Health Care Utilization Among Children in Foster Care

Cited by 86 publications

References 20 publications

A Qualitative Study of Early Family Histories and Transitions of Homeless Youth

A Qualitative Study of Early Family Histories and Transitions of Homeless Youth

Barriers to Community Mental Health Services for Latinos: Treatment Considerations

Placement Changes and Emergency Department Visits in the First Year of Foster Care

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