Many abused kids don’t get mental health services

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Abused and neglected children who are removed from their homes or otherwise become involved in the child welfare system have a high rate of emotional and behavioral problems. Yet, many of these children do not receive needed mental health services, new study findings show.

Young children and those who remained in their homes while authorities investigated potential maltreatment—as many children usually do—were found to be less likely to receive mental health services than older children and those placed in group or foster care.

"Younger children and those remaining in their homes could benefit from increased specialty mental health services,” write study author Dr. Michael S. Hurlburt, from the Child and Adolescent Services Research Center at Children’s Hospital, San Diego, and his colleagues.

“They have disproportionately low rates of service use, despite high levels of need.”

Increased coordination between child welfare systems and mental health agencies, however, may help ensure that mental health services are targeted to children who need it most, Hurlburt and his team report in this month’s Archives of General Psychiatry.

“When child welfare systems and mental health service systems have more and stronger formal ties with one another, specialty mental health services may be more directly targeted to those children with greatest need,” Hurlburt told Reuters Health.

He added that this may, potentially, increase “the equitability of service delivery to children from different racial/ethnic backgrounds.”

To determine the factors associated with mental health service use, Hurlburt and his colleagues analyzed data from the National Survey of Child and Adolescent Well-being and the national Caring for Children in Child Welfare study. Specifically, they looked at 2,823 child welfare cases involving 2- to 14-year-old children from 97 counties throughout the United States.

About 42 percent of the children had behavioral and emotional problems that required some type of mental health treatment, but only 28 percent received such help within a one-year period, the researchers report.

Children from counties in which the local child protective services agency and mental health agencies shared office space, participated in joint training or otherwise worked together were more likely to receive mental health services than those from areas with low levels of interagency coordination.

In fact, the likelihood of mental health services use increased along with increasing levels of interagency coordination, the report indicates.

In other findings, children who were removed from their homes and placed in group or foster care with a non-relative were up to six times more likely to receive mental health services than those who remained at home.

“Given the large difference in rates of service use between children who remained at home and those removed from home, clearly service systems have something to do with whether children and families receive services,” Hurlburt said. Yet, he added, “the degree to which this is due to increased resources, staff attention, or other reasons, I don’t know.”

Older children and white children were also more likely to receive needed services than were their counterparts, the study findings show.

SOURCE: Archives of General Psychiatry, December 2004.

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