Younger children in the child welfare system could benefit from specialty mental health services

December 06, 2004

CHICAGO - Children in the child welfare system, especially younger children and those remaining in their homes, have low rates of mental health services use, according to an article in the December issue of The Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, children involved with child welfare systems are at high risk for emotional and behavioral problems. Additionally, many children with mental health problems do not receive care, especially ethnic and minority children, the article states. "Delivery of appropriate and timely mental health services may be an important element in reducing long-term negative consequences for children served by child welfare agencies and in decreasing placement instability among children removed from their homes," the authors write.

Michael S. Hurlburt, Ph.D., of the Child and Adolescent Services Research Center at Children's Hospital, San Diego, and colleagues examined how patterns of specialty mental health service use among children involved with child welfare vary by the degree of coordination between local child welfare and mental health agencies.

The researchers examined mental health services used for one year after contact with child welfare in a national sample of children aged two to 14 years. Child and agency data were collected between October 15, 1999, and April 30, 2001. A total of 2,823 child welfare cases were included.

The researchers found that "only 28.3 percent of children received specialty mental health services during the year." Out-of-home placement, age, and race/ethnicity were strong predictors of service use rates. Additionally, increased coordination between local child welfare and mental health agencies was associated with stronger relationships between poorer measures of mental health and service use, and decreased differences in rates of service use between white and African American children.

"Younger children and those remaining in their homes could benefit from increased specialty mental health services," the authors write. "They have disproportionately low rates of service use, despite high levels of need. Increases in interagency coordination may lead to more efficient allocation of service resources to children with the greatest need and to decreased racial/ethnic disparities."
(Arch Gen Psychiatry. 2004;61:1217-1224. Available post-embargo at

Editor's Note: This research was supported through the Caring for Children in Child Welfare study, which was funded by a grant from the National Institute of Mental Health, Bethesda, Md.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail .

To contact Michael S. Hurlburt, Ph.D., call Tom Hanscom at 858-966-4901.

The JAMA Network Journals

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