Child Welfare Recommendations to Improve Mental Health Services for Children who have Experienced Abuse and Neglect: A National Perspective

  • David J. Kolko
  • Amy D. Herschell
  • Amanda H. Costello
  • Rachel P. Kolko
Original Paper


This study uses a key informant approach to understand the nature, extent, and quality of outpatient mental health services for children in the child welfare system (CWS) in the United States. We interviewed 89 county child welfare administrators to determine the status of outpatient mental health services and provide recommendations for enhancing care and service delivery. Developed for this study (Caring for Children in Child Welfare), the interview was incorporated in the second formal data collection wave (i.e., 18 months after study baseline assessment) of the National Survey of Child and Adolescent Well-Being. The results highlighted general variability in the degree to which these agencies used evidence-based interventions within outpatient services, demonstrated clinical expertise with this population, and met the needs of their families. Community agency use of evidence-based interventions was found to predict their effectiveness in improving clients’ mental health problems. Proposed suggestions for service improvement varied across domains and reflected the need for more communication/coordination, service access, options and resources, and practice refinements to accommodate families’ needs. We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system.


Child welfare services Mental health services Service delivery Evidence-based treatment Stakeholder impressions Child welfare recommendations Dissemination 



This study was funded, in part, by NIMH Grant MH599672 (CCCW) to John Landsverk and Grant R01 MH074737 (PFF) to the senior author. The Caring for Children in Child Welfare project (CCCW) is a collaborative effort between the Child and Adolescent Services Group (CASRC) at the Children’s Hospital—San Diego, the Department of Psychiatry at the University of Pittsburgh (Pittsburgh), the Columbus Children’s Hospital, the Services Effectiveness Research Program at Duke University School of Medicine (Duke), and the Research Triangle Institute (RTI). Key personnel for the collaborative study include PIs John A. Landsverk (CASRC), Kelly Kelleher (Columbus Children’s Hospital), Barbara J. Burns (Duke), Paul P. Biemer (RTI); Co-PI Laurel K. Leslie (CASRC); Investigators Richard P. Barth (University of North Carolina), John A. Fairbank (Duke), Michael S. Hurlburt (CASRC), David J. Kolko (Pittsburgh), Don J. Slymen (CASRC); Project Coordinator Jennifer A. Rolls (CASRC). Key consultants include Jon B. Christianson (University of Minnesota), Anne M. Libby (University of Colorado), and Jan R. McCarthy (Georgetown University).


The information and opinions expressed herein reflect solely the position of the author(s). Nothing herein should be construed to indicate the support or endorsement of its content by ACF/DHHS or NIMH and may not reflect the opinions of the researchers on the masthead.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • David J. Kolko
    • 1
  • Amy D. Herschell
    • 1
  • Amanda H. Costello
    • 1
  • Rachel P. Kolko
    • 1
  1. 1.Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghUSA

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