Parental substance use is a risk factor for child maltreatment amongst 40-80% of families involved in child welfare (Testa & Smith, 2009), with the youngest children being the most vulnerable to maltreatment. In 2020, there were 216,838 who entered foster care with 35% of child removals due to parental substance use (USDHHS, 2022). Over the past decade, there has been an increase in awareness as it relates to women’s health, specific to the impact of psychosocial risks as it relates to mothers. Though the literature has demonstrated that maternal psychosocial risks can contribute to adverse outcomes for children (Ringoot et. al, 2015), there have been minimal studies addressing the interconnectedness between maternal health, substance use, and reunification. The primary aim of this study is to examine: (1) the relationship between substance use and reunification of mothers and children involved in the child welfare system and (2) identify the relationship between child welfare history, service engagement, and substance use characteristics of mothers involved within the foster care system.
This study employed a secondary data analysis using the 2020 National Data Archive on Child Abuse and Neglect (N=42,396). For this study biological mothers, women aged 18 and higher were included (n=4623). Bivariate and multivariate comparisons were conducted by examining the associations among child and mother sociodemographic characteristics, mother’s substance use characteristics (i.e. primary substance problem, time to treatment, time in treatment, treatment admission status), and mother’s service engagement characteristics (i.e. domestic violence, employment/vocation, housing services, mental health, and parenting education, mental health). Ordinal logistic regression was used to examine whether the mother’s sociodeomographic characteristics, substance use characteristics, and service engagement characteristics predicted reunification with the child.
The collective variables fit the model well (-2LL=4785.97, X2=479.82, df=20, p<.000) with both Pearson and Deviance Goodness-of-Fit test being non-significant. Ultimately, significant associations remained between reunification status and time to treatment, level of care, time in SUD treatment, and treatment completion status. Time to treatment contributed to the model (ordered log odds =.631, SE = .106, Wald=35.617, p<.000). The estimated odds ratio favored a positive relationship (Exp=1.88, 95% CI (.424, .838)) compared to the reference variable no time in treatment. Level of care contributed to the model (ordered log odds =.360, SE = .149, Wald=5.803, p=.016. The estimated odds ratio favored a positive relationship (Exp=1.43, 95% CI (.067, .653)) compared to the reference variable no residential treatment. Thus, the model indicates that if one has experienced intervention treatment (2.91 greater odds) or treatment completion (3.90 greater odds) they have an increased likelihood of being reunified with their child.
The motivating feature for introducing parental substance use treatment interventions in child welfare has been, a basic belief that integrating interventions for a target population that have been specifically designed to increase parenting capacities will improve child and family functioning and well-being. Results from this study indicate that treatment interventions have the capacity to enhance parental engagement with services and facilitate familial success, which increases the rate of reunification for mothers and children.