Background: Social workers and other mental health service providers often deliver services in isolation, working with children exclusively without consideration of how family networks influence the mental health of child members (Lindsey, Korr, Broitman, et al, 2005). Family processes, in particular caregiver functioning, are important to consider when examining the mental health of children from disproportionately vulnerable and low-income groups, e.g. African-Americans. In order to provide effective mental health treatment to African-American children and bridge the gap between mental health need and services for this population, we need to better understand the influence of caregivers on child mental health. This understanding has implications for improving the identification of mental health problems among low income African American children and providing necessary treatment.

Method: Sample: Six hundred ten (47% male, 53% female) African American eight-year old children and their caregivers who completed the year 8 Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) interview. Procedure: This study was a secondary data analysis of the LONGSCAN data. Measures: Child mental health need was operationalized with Child Behavior Checklist (CBCL) internalizing and externalizing scores. Caregiver network was operationalized as neighborhood satisfaction and perceived support. Caregiver capacity was operationalized as Brief Symptom Inventory global score, CAGE total score, and CES-D total depressive symptoms score. Data analysis: A structural equation model was created with caregiver network and capacity as the exogenous variables and child mental health need as the endogenous variable. Analyses were conducted with AMOS 4.01.

Results: All paths in the model were significant, and the full model fit the data well (c²(17) = 33.54, p = .01, c²/df = 1.97, NFI = .99, CFI = .99, RMSEA = .04). The model accounted for 51% of variance in child mental health need. Caregivers with less supportive networks and whose capacity to parent was challenged by alcohol, depression, or other mental health problems, had children with higher mental health needs as indicated by elevated CBCL internalizing and externalizing scores.

Implications: Although the importance of family variables in children's mental health treatment has long been articulated, it is too often ignored in clinical and services research. This study highlights the significant role that African American caregivers have on the mental health of their children. In particular, social workers working with African American caregivers who present with co-occurring mental health and substance abuse problems, and who have limited social support (e.g. small support networks) should take precaution to asses their children regarding mental health needs. Conversely, when treating African American children with mental health needs, social workers should consider the possible needs of their caregivers and provide or refer to services as needed. Findings support the need for treating the entire family system in mental health service delivery when working with either group: caregivers or children. Strategies for how to best achieve this will be discussed.