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Background/Purpose: Despite receiving service referrals and uptake, families engaged with Child Protective Services (CPS) often still have unmet needs. CPS workers assess the service needs of reported families, provide service referrals, monitor service uptake, and frequently cover service expenses to mitigate risk factors for child maltreatment, such as mental health issues, substance abuse, financial hardship, and poor parenting skills. However, the connection between service needs, referrals, uptake, and subsequent CPS involvement remains unclear. This study aims to bridge this gap by investigating how service needs, referrals, and uptake are associated with the risks of re-reporting and foster care entry among families reported to CPS.
Methods: This study used data from the National Survey on Child and Adolescent Well-being II on a nationally representative sample of families reported to CPS. Among these families, we excluded those with children in foster care to examine potential influences on intact families. We assessed two outcomes: (1) whether there was a re-report within three years and (2) whether there was a foster care entry within three years. Service needs, referrals, and uptake were measured by CPS caseworker interviews. Within the total cohort of reported families (N=2,939), we analyzed the relationships between service needs and outcomes. Within the subset of families with identified service needs (N=1,506), we investigated the connections between service referrals and the outcomes. Within the subgroup of families receiving service referrals (N=1,207), we explored the links between service uptake and outcomes. Logistic regression was used for analysis.
Results: We found that service needs related to caregiver mental health and child learning/developmental issues were linked to a higher likelihood of re-report (OR=1.30-1.35). Additionally, service needs associated with caregiver substance abuse and child routine checkups were correlated with an increased likelihood of foster care entry (OR=2.47-1.44). In terms of service referrals, caregiver mental health was predictive of a higher likelihood of re-report (OR=1.38), while both mental health and substance abuse services were associated with an elevated likelihood of foster care entry (OR=1.76-1.71). Regarding service uptake, caregiver income assistance was linked to an increased likelihood of re-report (OR=2.24), and once again, mental health and substance abuse services were connected to a higher likelihood of foster care entry (OR=1.57-1.73).
Conclusions/Implications: Service needs and referrals related to caregiver mental health, caregiver substance abuse, child learning/developmental issues, and child routine checkups were linked to increased subsequent CPS involvement, including re-reports and foster care entries. These findings underscore the importance of clinicians paying attention to relevant risk factors to prevent subsequent CPS involvement. While service uptake is expected to mitigate risk factors and ultimately reduce CPS involvement, our observations reveal that uptake of income assistance, mental health, and substance abuse services was associated with increased CPS involvement, indicating discrepancies between service uptake and mitigation of relevant risk factors. Further research on service gaps among CPS-involved families is warranted to inform policy options aimed at addressing these discrepancies.