Friday, 14 January 2005 - 8:00 AM

This presentation is part of: Secondary Analysis of NSCAW: Effects of Social Supports, Special Caregiver Needs and Family Structure on the Well-being of Children Receivng In-home Child Welfare Services

The Impact of Home & Community-Based Services on Children's Behavioral and Mental Health Outcomes Among Mothers with Substance Abuse and/or Depressive Disorders

Purpose: Research reveals that children of mothers with substance abuse and/or depressive disorders are at high risk for poorer behavioral and mental health outcomes than children of mothers without these disorders. Although services have been shown to be effective in ameliorating the risks associated with these disorders, few studies have examined the effects of maternally focused services on children’s well being. Furthermore, most studies utilized cross-sectional designs lacking the ability to track change over time. The purpose of the current study is to determine whether maternal and family-focused services predict change in behavioral and mental health outcomes in children age 6-11 who have been the subject of investigations by Child Protective Services.

Method: Using prevention theory, a secondary data analysis of the National Survey of Child and Adolescent Well-Being (NSCAW) was conducted to investigate the relationship between maternal substance abuse and/or depression, service provision, and child behavioral and mental health outcomes both cross-sectionally and longitudinally. Mothers of children ages 6-11 (n = 907) were categorized into one of four disorders: substance abuse, depressive, dually diagnosed, or no diagnosis (reference group). To examine the impact of home and community-based services (HCBS) on child outcomes, a series of cross-sectional and hierarchical regression analyses were performed, in which raw score changes (Wave 3 – Wave 1) on the CBCL were regressed on Wave I raw scores, socio-demographic controls, maternal diagnostic status, and HCBS variables.

Results: Thirty-eight percent of biological mothers with children between the ages of 6-11 in this sample had a substance abuse and/or depressive disorder, yet, many of these mothers were not provided with appropriate treatment. Specifically, 64% of mothers with a depressive disorder were not receiving any mental health treatment, while 74% of mothers with a substance abuse disorder did not receive any substance abuse services. Cross-sectional analyses indicated that children of mothers who received instrumental or financial services had higher CBCL scores, while there were no significant differences on CBCL scores when mothers were provided with treatment matched with their disorder. Casual analyses indicated that, contrary to study hypotheses, children of mothers who received financial or instrumental services evidenced greater negative change between Wave I and Wave III than children of mothers without those services, while children of mothers who received supportive/emotional services evidenced greater positive change. Matching services to mental health or substance abuse needs had no effect on CBCL change scores.

Implications for Practice: Prior cross-sectional research suggested that services have a direct positive effect. Results from the present study indicate that sole reliance on cross-sectional data to determine service effectiveness can be misleading, and that contrary to current beliefs, current services may not be providing long-term benefits to children and families involved in the child welfare system. These results suggest that the child welfare system needs to take a closer look at the individual needs of each family as well as which families are referred for services. Furthermore, child welfare agencies need to determine whether services are being delivered efficiently in a cost effective manner.

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