Purpose: Many children involved with child welfare agencies have mental health problems such as emotional or behavioral disorders. Previous studies of mental health services use by children in contact with child welfare systems have primarily focused on the role of placement types (e.g., kinship, non-kinship), maltreatment types (e.g., sexual abuse, physical or emotional maltreatment, neglect), and race/ethnicity. Few studies include a measure of caregiver support networks characteristics (e.g., network size, level of social support, satisfaction with social support) and caregiver mental health services use. The current study examines the impact of caregiver's support networks and caregiver mental health services use on their children's utilization of mental health services

Method: This study used the third wave data of the National Survey of Child and Adolescent Well-Being (NSCAW). NSCAW is a longitudinal survey using two cohorts: the Child Protective Service (CPS) sample and One Year in Foster Care (OYFC). The CPS sample includes 5,404 children, ages 0-14, who had an investigation closed and/or assessment completed during the sampling period. Wave 3 took place 18 months after the initial interviews. The current analysis used the third wave CPS sample aged 2 through 17 years (n=4,822). Mental health services include inpatient and outpatient services, ER visits, and in-home mental health services. NSCAW used the Child and Adolescent Services Assessment (CASA) to assess children's use of mental health services and a project-developed questionnaire to measure the service utilization by caregivers. Caregiver support networks were measured by the Duke-UNC Functional Social Support Questionnaire. Analyses of variance and regression analyses were used to examine the relationship between caregiver's support networks, caregiver's mental health services use and children's mental health service uses in the past 12 months. All analyses were conducted with SAS-callable SUDAAN to account for the complex survey design.

Results: Bivariate analyses indicate that caregiver's mental health services use is significantly associated with children's mental health services use (chi square = 5.73, p<.05). Social networks size of caregiver is also significantly related to children's mental health services (chi square = 50.86, p<.05). Finally, Children's need for mental health services measured by CBCL is also significantly associated with children's mental health services use (chi square = 53.60, p<.001). Logistic regression analyses found that caregiver's mental health service use, types of maltreatment, clinical need of children, race/ethnicity, and current placement types are significant in predicting children's mental health services use.

Implication: This study supports the previous work indicating that utilization of mental health services by children involved with child welfare agencies is strongly influenced by predisposing variables (e.g., race/ethnicity, placement types) and need variable (maltreatment types, clinical need of children). The current study also demonstrates that caregiver's receptivity to mental health services is a strong predictor of children's services use. This suggests that early mental health screening of children of mentally ill caregivers may be an important preventive practice.