Mental health services use by children investigated by child welfare agencies

Sarah McCue Horwitz, Michael S. Hurlburt, Jeremy D. Goldhaber-Fiebert, Amy M. Heneghan, Jinjin Zhang, Jennifer Rolls-Reutz, Emily Fisher, John Landsverk, Ruth E. K. Stein

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

OBJECTIVE: To examine the rates and predictors of mental health services use for a nationally representative cohort of youths who had been investigated for alleged maltreatment. METHODS: Data came from caregiver and caseworker baseline and 18-month interviews in the second National Survey of Child and Adolescent Well-being. These interviews took place from March 2008 to September 2008 and September 2010 to March 2011. Data on family and child characteristics and service use were gathered and examined by using weighted univariate and multivariate analyses. RESULTS: Children had numerous challenges: 61.8% had a previous report of maltreatment, 46.3% had poor socialization skills, and 23.9% had a mental health problem measured by the Child Behavior Checklist (CBCL). At baseline, 33.3% received some mental health service and this varied by age, with younger children receiving fewer services. This percentage decreased to 30.9% at the 18-month follow-up, although the youngest children had increases in services use. For younger children, race/ethnicity, out-of-home placement, chronic physical health problems, low adaptive behaviors, and CBCL scores in the clinical range were related to use. For children ≥11, out-of-home placement, high CBCL scores, and family risk factors predicted services use at 18 months. CONCLUSIONS: Mental health services utilization increases as young children come into contact with schools and medical providers or have more intensive involvement with child welfare. Minority children receive fewer services adjusting for need. Over the 18-month follow-up, there was a decrease in service use that may be a result of the tremendous financial challenges taking place in the United States.

Original languageEnglish (US)
Pages (from-to)861-869
Number of pages9
JournalPediatrics
Volume130
Issue number5
DOIs
StatePublished - Nov 2012

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Mental Health Services
Child Behavior
Checklist
Child Welfare
Interviews
Socialization
Child Protective Services
Mental Health
Health Services
Psychological Adaptation
Medical Schools
Caregivers
Multivariate Analysis
Health

Keywords

  • Child mental health problems
  • Child welfare
  • Mental health services use

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Horwitz, S. M., Hurlburt, M. S., Goldhaber-Fiebert, J. D., Heneghan, A. M., Zhang, J., Rolls-Reutz, J., ... Stein, R. E. K. (2012). Mental health services use by children investigated by child welfare agencies. Pediatrics, 130(5), 861-869. https://doi.org/10.1542/peds.2012-1330

Mental health services use by children investigated by child welfare agencies. / Horwitz, Sarah McCue; Hurlburt, Michael S.; Goldhaber-Fiebert, Jeremy D.; Heneghan, Amy M.; Zhang, Jinjin; Rolls-Reutz, Jennifer; Fisher, Emily; Landsverk, John; Stein, Ruth E. K.

In: Pediatrics, Vol. 130, No. 5, 11.2012, p. 861-869.

Research output: Contribution to journalArticle

Horwitz, SM, Hurlburt, MS, Goldhaber-Fiebert, JD, Heneghan, AM, Zhang, J, Rolls-Reutz, J, Fisher, E, Landsverk, J & Stein, REK 2012, 'Mental health services use by children investigated by child welfare agencies', Pediatrics, vol. 130, no. 5, pp. 861-869. https://doi.org/10.1542/peds.2012-1330
Horwitz SM, Hurlburt MS, Goldhaber-Fiebert JD, Heneghan AM, Zhang J, Rolls-Reutz J et al. Mental health services use by children investigated by child welfare agencies. Pediatrics. 2012 Nov;130(5):861-869. https://doi.org/10.1542/peds.2012-1330
Horwitz, Sarah McCue ; Hurlburt, Michael S. ; Goldhaber-Fiebert, Jeremy D. ; Heneghan, Amy M. ; Zhang, Jinjin ; Rolls-Reutz, Jennifer ; Fisher, Emily ; Landsverk, John ; Stein, Ruth E. K. / Mental health services use by children investigated by child welfare agencies. In: Pediatrics. 2012 ; Vol. 130, No. 5. pp. 861-869.
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abstract = "OBJECTIVE: To examine the rates and predictors of mental health services use for a nationally representative cohort of youths who had been investigated for alleged maltreatment. METHODS: Data came from caregiver and caseworker baseline and 18-month interviews in the second National Survey of Child and Adolescent Well-being. These interviews took place from March 2008 to September 2008 and September 2010 to March 2011. Data on family and child characteristics and service use were gathered and examined by using weighted univariate and multivariate analyses. RESULTS: Children had numerous challenges: 61.8{\%} had a previous report of maltreatment, 46.3{\%} had poor socialization skills, and 23.9{\%} had a mental health problem measured by the Child Behavior Checklist (CBCL). At baseline, 33.3{\%} received some mental health service and this varied by age, with younger children receiving fewer services. This percentage decreased to 30.9{\%} at the 18-month follow-up, although the youngest children had increases in services use. For younger children, race/ethnicity, out-of-home placement, chronic physical health problems, low adaptive behaviors, and CBCL scores in the clinical range were related to use. For children ≥11, out-of-home placement, high CBCL scores, and family risk factors predicted services use at 18 months. CONCLUSIONS: Mental health services utilization increases as young children come into contact with schools and medical providers or have more intensive involvement with child welfare. Minority children receive fewer services adjusting for need. Over the 18-month follow-up, there was a decrease in service use that may be a result of the tremendous financial challenges taking place in the United States.",
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