Mental Health Services for Children and Youth in Child Welfare: A Focus on Contact for Services Vs. Actual Service Provision

Background:  Program and policy decisions are generally made based on service provision to clients.  Unfortunately, far too often, there is no distinction between clients who only made contact for services from those who actually received services, misleading program and policy makers to conclude all clients received equitable services.  With children and youth in the child welfare system, mental health service access and utilization have been a long standing concern as children who experience maltreatment are at a higher risk for mental health problems.  Numerous studies have examined receipt of mental health services among this population, but continue to find poor outcomes despite the documented receipt of services.  The purpose of this study is to identify children in the child welfare system that were identified as having received mental health services, and differentiate between those who only had contact with the mental health system, but never received actual services, from those who received services. 

Methodology:  A sample of 4,434 children and youth was identified as having received mental health services within the past year from a large, ethnically diverse child welfare agency.  The sample consisted of 54% Latino, 31% African American, 12% Caucasian, and 3% other ethnic group.  The majority was between the ages of 5 and 10 yrs. (39%), with minor differences in gender with males being 52% of the total sample.  On average the child welfare case had been open 1,359 days (SD=12.08) or 3 years and 72 days.    

Results:  Of the total number of children identified as having received mental health services, results indicate that 30% had only contact with the mental health system and never received actual services.  Of those who had actually received services, the mean number of times children were seen was 2.31 (SD=4.57) within the past year.  Results also show differences in age between those children who only had contact and those who actually received services, with older children receiving actual services (t=2.99, df=4432, p=.03).  Additionally, differences where also found among length of time children spent in placement, with children with a longer time in placement receiving actual services (t=8.24, df=4432, p=.001). 

Conclusion:  Results of this study suggest that while there appears to be a high number of children being identified as having received mental health services while in the child welfare system, the reality is that not all children received actual services.  In addition, of those children identified as having received actual services, results suggest children are seen minimally throughout the year.  Results also suggest that older children and children in placement for longer periods of time are the ones receiving actual services.  Findings of this study are important in funding programs for such a vulnerable population, as the distribution of goods, is not equitable for all children.  Interventions need to focus on ensuring actual receipt of services is taking place, and that services are being provided to all children in need of services.