A Review of Screened-out Families and Child Protective Services Involvement: A Missed Opportunity to Prevent Future Maltreatment

Background and Purpose:

The purpose of this paper is to summarize existing research on families screened-out by child protective services (CPS) after a referral alleging child abuse or neglect. State-level data suggest that screened-out families are at high risk of being re-referred to CPS though this remains an ongoing question at the national level because such estimates are currently unknown and national data are unavailable. As the field continues to discuss what form child protection should take, one thing is becoming more apparent: the use of preventative and supportive community services is becoming increasingly important. We review existing empirical work that evaluates community support interventions aimed toward screened-out families and frame it within the current context in which researchers are debating the role that CPS should play in keeping children safe and supporting families.

Methods:

A literature review was conducted regarding screened-out families and community support interventions geared toward screened-out families. Studies were included if (1) the program goal was to prevent or decrease future CPS involvement, (2) the population targeted families that were screened out or evaluated out by CPS, and (3) the program model offered community services. Studies and reports were also included if they had sufficient information on the program model and study design to allow for comparisons. The literary search yielded nine studies, including descriptive, outcome, and emerging intervention research, which we discuss and summarize.

Findings:

Screened-out families tend to be similar to "higher risk" families as they have comparable demographics and risks for negative child welfare and behavioral health outcomes. Furthermore, poverty tends to be a primary need among screened-out families referred to community response programs. Overall, the effect of services has been mixed though some of the mixed findings may be due to challenges involving sample size, research design, and variability in service models (as well as availability) across sites though more research is needed. Although intervention research is inconclusive, existing studies suggest that providing community-based services meets important family needs and may reduce future CPS involvement (re-referrals, substantiated re-referrals, and out-of-home placement) by focusing on economic needs. However, this research also highlights the difficulties of engaging screened-out families in services and their low service utilization rates.

Conclusions and Implications:

There is a growing consensus that the current reactive role of CPS should be supplemented by supportive and preventative services that focus on addressing poverty and other family needs to achieve this goal. Screened-out referrals present an opportunity to implement such preventative services. Based on our review of the existing literature, we argue that screened-out families should be provided preventative and supportive services through a community response. In developing these community response programs, CPS agencies as well as community agencies need to evaluate strategies to overcome barriers related to engagement and service utilization. Additionally, existing community response services provided to screened-out families should be rigorously evaluated with the goal of informing the development of a three-tiered, public health approach to the prevention of child maltreatment.