Mental Health Need and Access to Mental Health Services by Youths Involved With Child Welfare: A National Survey
Abstract
Objective This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Method Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were weighted to provide population estimates. Results Nearly half (47.9%) of the youths aged 2 to 14 years (N = 3,803) with completed child welfare investigations had clinically significant emotional or behavioral problems. Youths with mental health need (defined by a clinical range score on the Child Behavior Checklist) were much more likely to receive mental health services than lower scoring youth; still, only one fourth of such youths received any specialty mental health care during the previous 12 months. Clinical need was related to receipt of mental health care across all age groups (odds ratio = 2.7-3.5). In addition, for young children (2-5 years), sexual abuse (versus neglect) increased access to mental health services. For latency-age youths, African-American race and living at home significantly reduced the likelihood of care. Adolescents living at home were also less likely to receive services, whereas having a parent with severe mental illness increased (odds ratio = 2.4) the likelihood of service use. Conclusions Routine screening for mental health need and increasing access to mental health professionals for further evaluation and treatment should be a priority for children early in their contact with the child welfare system.
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Access to mental health services is especially limited for Black and Latinx foster youth.
“Access is especially limited for Black and Latinx foster youth [4,5].”
Children and young people in residential care have often lived lives saturated with loss, neglect, rejection, and traumatic experiences.
“Children and young people in residential care have often lived lives saturated with loss, neglect, rejection, and traumatic experiences.”
From AN EVIDENCE-BASED PROGRAM MODEL FOR FACILITATING THERAPEUTIC RESPONSES TO PAIN-BASED BEHAVIOR IN RESIDENTIAL CARE (2019) · cites this paper as Burns et al., 2004
The population of young people living in residential care is at high risk of experiencing poor developmental outcomes throughout the life course.
“and is at high risk of experiencing poor developmental outcomes throughout the life course.”
From AN EVIDENCE-BASED PROGRAM MODEL FOR FACILITATING THERAPEUTIC RESPONSES TO PAIN-BASED BEHAVIOR IN RESIDENTIAL CARE (2019) · cites this paper as Burns et al., 2004
When compared with the general population, the population of young people living in residential care has a disproportionately high rate of emotional and behavioral problems.
“When compared with the general population, the population of young people living in residential care has a disproportionately high rate of emotional and behavioral problems (Burns et al., 2004)”
From AN EVIDENCE-BASED PROGRAM MODEL FOR FACILITATING THERAPEUTIC RESPONSES TO PAIN-BASED BEHAVIOR IN RESIDENTIAL CARE (2019) · cites this paper as Burns et al., 2004
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- Authors
- BURNS, B. J., PHILLIPS, S. D., WAGNER, H. R., BARTH, R. P., KOLKO, D. J., CAMPBELL, Y., & LANDSVERK, J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- BURNS, BARBARA J.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2004-08
- Volume
- 43
- Issue
- 8
- Pages
- 960-970
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2130515184
- Cited by
- 1,153
- References
- 5
- Citations by year
- 2026: 21 · 2025: 38 · 2024: 31 · 2023: 32 · 2022: 37 · 2021: 51 · 2020: 43 · 2019: 63 · 2018: 59 · 2017: 85 · 2016: 68 · 2015: 80 · 2014: 74 · 2013: 61 · 2012: 69
- FWCI
- 81.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH 59672, R01MH059672)
- Topics
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- child welfare, child abuse, access to mental health care, emotional and behavioral problems, child welfare investigations, sexual abuse, neglect, African American children, parental mental illness, mental health screening, Child Behavior Checklist
- MeSH terms
- Adolescent, Affective Symptoms, Child, Child Abuse, Child Behavior Disorders, Child Welfare, Child, Preschool, Female, Health Services Accessibility, Health Services Needs and Demand, Health Surveys, Humans, Male, Mental Health Services, United States, Utilization Review, Cohort Studies
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