Patterns of mental health service usage among youth involved with the child welfare system: A national analysis

This study examined the patterns of mental health service utilization among youth involved with the child welfare system within the first wave of the NSCAW II data set, which was collected between April 2008 and December 2009. Chi-square analyses were used to examine the trends on all but one research question in which a frequency distribution was conducted. The analytic findings indicated that youth that experienced alleged neglect received significantly less mental health services than youth that experienced alleged physical or sexual abuse or emotional maltreatment. Despite the abuse type, a very low percentage of youth, 10%-17% were actually administered a mental health screening. When a youth was identified by their caregiver as having an emotional problem, it appeared as though for some of the less restrictive settings (i.e., community mental health center, in-home counseling/crisis services, and family doctor), the percentage of children in treatment and not appeared to be similar. Youth tended to access school-based mental health services the most followed by private professionals. As gathered from caseworker reports, the main reason youth did not receive the necessary mental health service was because their caregiver refused. The association between the receipt of mental health services and specific demographic variables (i.e., race, gender, age) was examined. Notably, a shift in previously noted trends appeared to have occurred as the analysis indicated that minority youth are receiving more mental health services across three settings (community mental health, private professional help, and in-home counseling) compared to white youth, who are receiving more mental health services across only one setting (family doctor). Males only received significantly more mental health services from day treatment programs and family doctors than females. Receipt of mental health services was shown to increase with age. With respect to placement type, youth classified as residing in an in-home placement accessed more services across most settings compared to youth residing in out-of-home cart Furthermore, the utilization of mental health services for youth identified as having an emotional problem did not significantly differ between those that had and did not have Medicaid. The current study describes the socio-political factors possibly influencing the noted trends. Limitations of this study are explained and future research ideas are outlined.