Child Welfare Recommendations to Improve Mental Health Services for Children who have Experienced Abuse and Neglect: A National Perspective
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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.
KeywordsChild 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.
- Auerbach, C. F., & Silverstein, L. B. (2003). Qualitative studies in psychology. New York: New York University Press.Google Scholar
- Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J. B., Rolls, J., Hurlburt, M. S., et al. (2005). Parent-training programs in child welfare services: Planning for a more evidence-based approach to serving biological parents. Research on Social Work Practice, 15(5), 353–371.CrossRefGoogle Scholar
- Bazeley, P., & Richards, L. (2000). The Nvivo qualitative project book. London: Sage.Google Scholar
- Bledsoe, S. E., Weissman, M. M., Mullen, E. J., Ponniah, K., Gameroff, M. J., Verdeli, H., et al. (2007). Empirically supported psychotherapy in social work training programs: Does the definition of evidence matter? Research on Social Work Practice, 17(4), 449–455.Google Scholar
- Bruns, E. J., Hoagwood, K. E., Rivard, J. C., Wotring, J., Marsenich, L., & Carter, B. (2008). State implementation of evidence-based practice for youths, part II: Recommendations for research and policy. Journal of the American Academy for Child and Adolescent Psychiatry, 47(5), 499–504.CrossRefGoogle Scholar
- Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., et al. (2004). Mental health need and access to mental health services by youth involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 960–970.PubMedCrossRefGoogle Scholar
- Chambers, D. (2005, April 15) Improving the fit between evidence based treatment. Paper presented at the Outreach Partnership Program 2005 Annual Meeting. Retrieved December 31, 2008, from http://www. nimh.nih.gov/health/outreach/partnershipprogram/meetings/2005/improving-the-fit-between-evidence-based-treatment-and-real-world-practice.shtml. Saturday April 2, 2005
- Glisson, C., Landsverk, J., Schoenwald, S., Kelleher, K., Hoagwood, K. E., Mayberg, S., et al. (2008a). Assessing the organizational social context (OSC) of mental health services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35, 98–113.PubMedCrossRefGoogle Scholar
- Glisson, C., Schoenwald, S. K., Kelleher, K., Landsverk, J., Hoagwood, K. E., Mayberg, S., et al. (2008b). Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Administration and Policy in Mental Health, 35, 124–133.PubMedCrossRefGoogle Scholar
- Kerkorian, D., McKay, M., & Bannon, W. M., Jr. (2006). Seeking help a second time: Parents’/caregivers’ characterization of previous experiences with mental health services for their children and perceptions of barriers to future use. American Journal of Orthopsychiatry, 76(2), 161–166.PubMedCrossRefGoogle Scholar
- Kolko, D. J., Cohen, J. A., Mannarino, A. P., Baumann, B. L., & Knudsen, K. (2008). Community treatment of sexually traumatized children: Service description in the National Child Traumatic Stress Network. Administration and Policy in Mental Health and Mental Health Services Research (in press).Google Scholar
- Minkler, M., & Wallerstein, N. (2003). Community-base participatory research for health. San Francisco: Jossey Bass.Google Scholar
- Raghavan, R., Leibowitz, A. A., Andersen, R. M., Zima, B. T., Schuster, M. A., & Landsverk, J. (2006). Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system. Children and Youth Services Review, 28(12), 1482–1496.CrossRefGoogle Scholar
- Schoenwald, S. K., Chapman, J. E., Kelleher, K., Hoagwood, K. E., Landsverk, J., Stevens, J., et al. (2008). A survey of the infrastructure for children’s mental health services: Implications for the implementation of empirically supported treatments. Administration and Policy in Mental Health, 35, 84–97.PubMedCrossRefGoogle Scholar
- Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., et al. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child and Adolescent Psychology, 37(1), 156–183.PubMedCrossRefGoogle Scholar
- U. S. Department of Health and Human Services Administration on Children Youth and Families. (2007). Child maltreatment 2005. Washington, DC: U.S. Government Printing Office.Google Scholar