Mental Health Services Research

, Volume 6, Issue 3, pp 127–141 | Cite as

Predictors of Outpatient Mental Health Service Use—The Role of Foster Care Placement Change

  • Sigrid James
  • John Landsverk
  • Donald J. Slymen
  • Laurel K. Leslie
Article

Abstract

This study examined the relationship between placement change and outpatient mental health service use. It is based on (1) conceptual propositions about the impact of the foster care living context on mental health service use, and (2) empirical knowledge about the adverse consequences of placement change. Results of the study, which were based on a cohort of 570 children in foster care in San Diego County, suggest an association between placement changes in child welfare and use of outpatient mental health services. Specifically, an increase in the number of placement changes predicted a greater rate of outpatient mental health visits. The study further found that children who experienced behavior-related placement changes received more outpatient mental health visits than children who experienced placement changes for other reasons. Follow-up analyses of the 144 children who experienced any behavior-related placement changes further indicated that the rate of outpatient mental health service use almost doubled in the 90 days following the first behavior-related placement change. Findings from this study have implications for the practice, policy and research fields in child welfare as well as mental health.

foster care placement change mental health services pathways to mental health services 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Achenbach, T. M. (1991). Manual for the Child Behavior Checklist and 1991 Profile.Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
  2. Aday, L. A., & Andersen, R. M. (1974).Aframework for the study of access to medical care. Health Services Research, 9 ,208–220.Google Scholar
  3. Allison, P. D. (2001). Logistic regression using the SAS system: Theory and application. Cary, NC: SAS Institute.Google Scholar
  4. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36 ,1–10.Google Scholar
  5. Andrade, A. R., Lambert, E. W., & Bickman, L. (2000). Dose effect in child psychotherapy: Outcomes associated with negligible treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 39(2), 161–168.Google Scholar
  6. Bazelon Center for Mental Health Law. (2003). Suit against nation's largest child welfare system settled with commitment to reform. Retrieved April 10, 2003, from Bazelon Center for Mental Health Law Website: http://www.bazelon. org/newsroom/3–17-3katiea.htmGoogle Scholar
  7. Bergin, A. E., & Garfield, S. L. (1994). Handbook of psychotherapy and behavior change.New York: John Wiley & Sons.Google Scholar
  8. Berrick, J. D., & Barth, R. P. (1994). Research on kinship foster care:What do we know: Where do we go from here? Children and Youth Services Review, 16 ,1–5.Google Scholar
  9. Bilaver, L. A., Jaudes, P. K., Koepke, D., & Goerge, R. M. (1999). The health of children in foster care. Social Service Review, 73 ,401–417.Google Scholar
  10. Blankertz, L. E., Cnaan, R. A., & Freedman, E. (1993). Childhood risk factors in dually diagnosed homeless adults. SocialWork, 38(5), 587–596.Google Scholar
  11. Burns, B. J., & Hoagwood, K. (2002). Community treatment for youth. Evidence-based interventions for severe emotional and behavioral disorders.New York: Oxford University Press.Google Scholar
  12. Chamberlain, P., & Mihalic, S. F. (1998). Multidimensional treatment foster care. In D. S. Elliott (Ed.), Book eight: Blueprints for violence prevention.Boulder, CO: Institute of Behavioral Science, University of Colorado at Boulder.Google Scholar
  13. Chen, M. K. (1978). Comment on health status indices and access to medical care. American Journal of Public Health, 68 ,1027–1028.Google Scholar
  14. Combs-Orme, T., Chernoff, R. G., & Kager, V. A. (1991). Utilization of health care by foster children: Application of a theoretical model. Children and Youth Services Review, 13 ,113–129.Google Scholar
  15. Cooper, C. S., Peterson, N. L., & Meier, J. H. (1987). Variables associated with disrupted placement in a select sample of abused and neglected children. Child Abuse and Neglect, 11 ,75–86.Google Scholar
  16. Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care.Washington, DC: Georgetown University Child Development Center.Google Scholar
  17. Dore, M. (1999). Emotionally and behaviorally disturbed children in the child welfare system: Points of preventive intervention. Children and Youth Services Review, 21(1), 7–29.Google Scholar
  18. Dubowitz, H., Feigelman, S., & Zuravin, S. (1993). A profile of kinship care. Child Welfare, 72 ,153–169.Google Scholar
  19. Fanshel, D. (1992). Foster care as a two-tiered system. Children and Youth Services Review, 14 ,49–60.Google Scholar
  20. Garland, A. F., & Besinger, B. A. (1997). Racial/ethnic differences in court referred pathways to mental health services for children in foster care. Children and Youth Services Review, 19 ,1–16.Google Scholar
  21. Garland, A. F., Hough, R. L., Landsverk, J., McCabe, K. M., Yeh, M., Ganger, W. C., et al. (2000). Racial/ethnic vacations in mental health care utilization among children in foster care. Children's Services: Social Policy, Research and Practice, 3(3), 133–146.Google Scholar
  22. Garland, A. F., Landsverk, J. A., Hough, R. L., & Ellis-MacLeod, E. (1996). Type of maltreatment as a predictor of mental health service use in foster care. Child Abuse and Neglect, 20 ,675–688.Google Scholar
  23. Gebel, T. (1996). Kinship care and nonrelative family foster care: A comparison of caregiver attributes and attitudes. Child Welfare, 75 ,5–18.Google Scholar
  24. Glisson, C. (1994). The effects of services coordination teams on outcomes for children in state custody. Administration in Social Work, 18 ,1–23.Google Scholar
  25. Glisson, C. (1996, June)</del>. Judicial and service decisions for children entering state custody: The limited role of mental health. Social Service Review, 70 ,257–281.Google Scholar
  26. Goldstein, J., Freud, A., & Solnit, A. J. (1973). Beyond the best interests of the child.New York: Free Press.Google Scholar
  27. Halfon, N., Berkowitz, G., & Klee, L. (1992a. Mental health service utilization by children in foster care in California. Pediatrics, 89 ,1238–1244.Google Scholar
  28. Halfon, N., Berkowitz, G., & Klee, L. (1992b). Children in foster care in California: An examination of Medicaid reimbursed health services utilization. Pediatrics, 89 ,1230–1237.Google Scholar
  29. Harman, J. S., Childs, G. E., & Kelleher, K. J. (2000). Mental health care utilization and expenditures by children in foster care. Archives of Pediatric and Adolescent Medicine, 154 ,1114–1117.Google Scholar
  30. Heck, R. H., & Thomas, S. L. (2000). An introduction to multilevel modeling techniques.Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  31. Heflinger, C. A., Simpkins, C. G., & Combs-Orme, T. (2000). Using the CBCL to determine the clinical status of children in state custody. Children and Youth Services Review, 22(1), 55–73.Google Scholar
  32. Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents.New York: Guilford Press.Google Scholar
  33. Hoberman, H. M. (1992). Ethnic minority status and adolescent mental health services utilization. The Journal of Mental Health Administration, 19 ,246–267.Google Scholar
  34. Hough, R. L., Landsverk, J. A., Karno, M., Burnam, M. A., Timbers, D. M., Escobar, J. I., et al. (1987). Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic Whites. Archives of General Psychiatry, 44 ,702–709.Google Scholar
  35. Iglehart, A. (1994). Kinship foster care: Placement services and outcome issues. Children and Youth Services Review, 16 ,107–127.Google Scholar
  36. James, S. (in press). Why do foster care placements disrupt? An investigation of reasons for placement change in foster care. Social Service Review. Google Scholar
  37. James, S., Landsverk, J., & Slymen, D. J. (2004). Placement movement in out-of-home care: Patterns and predictors. Children and Youth Services Review, 26 ,185–206.Google Scholar
  38. Knitzer, J. (1982). Unclaimed children: The failure of public responsibility to children and adolescents in need of mental health services.Washington, DC: Children's Defense Fund.Google Scholar
  39. Koot, H. M., & Verhulst, F. C. (1992). Prediction of children's referral to mental health and special education services from earlier adjustment. Journal of Child Psychology and Psychiatry, 33 ,717–729.Google Scholar
  40. Landsverk, J., Davis, I., Ganger, W., Newton, R., & Johnson, I. (1996). Impact of psychosocial functioning on reunification from out-of-home placement. Children and Youth Services Review, 18(4/5), 447–462.Google Scholar
  41. Landsverk, J., & Garland, A. F. (1999). Foster care and pathways to mental health services. In P. A. Curtis, G. Dale Jr., J. C. Kendall (Eds.), The foster care crisis (pp. 193–210). Lincoln, NE: Nebraska Press.Google Scholar
  42. Landsverk, J., Garland, A. F., & Leslie, L.K. (2002).Mental health services for children reported to child protective services. In J. E. B. Myers, L. Berliner, J. Briere, C. T. Hendrix, C. Jenny, & T.A. Reid (Eds.), The APSAC handbook on child maltreatment (2nd ed., pp. 487–507). Thousand Oaks: Sage.Google Scholar
  43. Landsverk, J., Kelleher, K., Burns, B. J., Leslie, L., Hurlburt, M., Slymen, D., Rolls, J., Barth, R., Fairbank, J. & Kolko, D. (under review). Overview, design, and field experience of Caring for Children in Child Welfare:ANational Study of the impact of organization and financing policy on mental health service provision.Google Scholar
  44. Landsverk, J., Litrownik, A., Newton, R., Ganger, W., & Remmer, J. (1996). Psychological impact of child maltreatment (Final Report to National Center on Child Abuse and Neglect). Washington, DC: National Center on Child Abuse and Neglect.Google Scholar
  45. Leslie, L. K., Landsverk, J., Ezzet-Lofstrom, R., Tschann, J. M., Slymen, D. J., & Garland, A. F. (2000). Children in foster care: Factors influencing outpatient mental health service use. Child Abuse and Neglect, 24(4), 465–476.Google Scholar
  46. Long, J. S. (1997). Regression models for categorical and limited dependent variables. Thousand Oaks, CA: Sage.Google Scholar
  47. Newton, R. R., Litrownik, A. J., & Landsverk, J. A. (2000). Children and youth in foster care: Disentangling the relationship between problem behaviors and number of placements. Child Abuse and Neglect, 24(10), 1363–1374.Google Scholar
  48. Offord, D. R., Boyle, M.H., Szatmari, P., Rae-Grant, N. I., Linkds, P. S., Cadman, D. T., et al. (1987). Ontario child health study: Part 2. Six-month prevalence of disorder and rates of service utilization. Archives of General Psychiatry, 44 ,832–836.Google Scholar
  49. Orme, J. G., & Buehler, C. (2001). Introduction to multiple regression for categorical and limited dependent variables. Social Work Research, 25 ,49–61.Google Scholar
  50. Parad, H. J., & Parad, L. G. (Eds.). (1990). Crisis intervention book 2: The practitioner's source-book for brief therapy.Milwaukee, WI: Family Service America.Google Scholar
  51. Pardeck, J. T. (1984). Multiple placements of children in foster family care: An empirical analysis. Social Work, 29 ,506–509.Google Scholar
  52. Penzerro, R. M., & Lein, L. (1995). Burning their bridges: Disordered attachment and foster care discharge. Child Welfare, 74(2), 351–366.Google Scholar
  53. Pescosolido, B. (1992). Beyond rational choice: The social dynamics of how people seek help. American Journal of Sociology, 97 ,1096–1138.Google Scholar
  54. Pescosolido, B. A. (1991). Illness careers and network ties: A conceptual model of utilization and compliance. Advances in Medical Sociology, 2 ,161–184.Google Scholar
  55. Pilowsky, D. (1995). Psychopathology among children placed in family foster care. Psychiatric Services, 46 ,906–910.Google Scholar
  56. Proch, K., & Taber, M. (1985). Placement disruption: A review of research. Children and Youth Review, 7 ,57–69.Google Scholar
  57. Risley-Curtiss, C., Combs-Orme, T., Chernoff, R., & Heisler, A. (1996). Health care utilization by children entering foster care. Research on Social Work Practice, 6(4), 442–461.Google Scholar
  58. Rogler, L. H., & Cortes, D. E. (1993). Help-seeking pathways: A unifying concept in mental health care. American Journal of Psychiatry, 150 ,554–561.Google Scholar
  59. Rosenfeld, A., Wasserman, S., & Pilowsky, D. J. (1998). Psychiatry and children in the child welfare system. Child and Adolescent Psychiatric Clinics, 7(3), 515–536.Google Scholar
  60. Saxe, L., Cross, T., & Silverman, N. (1988). Children's mental health: The gap between what we know and what we do. American Psychologist, 43 ,800–807.Google Scholar
  61. Schneiderman, M., Connors, M. M., Fribourg, A., Gries, L., & Gonzales, M. (1998). Mental health services for children in out-of-home care. Child Welfare, 77(1), 29–40.Google Scholar
  62. Simms, M. D., Dubowitz, H., & Szilagyi, M. A. (2000). Health care needs of children in the foster care system. Pediatrics, 106(4), 909–918.Google Scholar
  63. Simms, M. D., & Halfon, N. (1994). The health care needs of children in foster care: A research agenda. Child Welfare, 73(5), 505–524.Google Scholar
  64. Smith, D. K., Stormshak, E., Chamberlain, P., & Whaley, R. B. (2001). Placement disruption in treatment foster care. Journal of Emotional and Behavioral Disorders, 9(3), 200–205.Google Scholar
  65. Stroul, B. A., & Friedman, R. M. (1986). A system of care for severely emotionally disturbed children and youth.Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.Google Scholar
  66. Susser, E. S., Lin, S. P., Conover, S. A., & Streuning, E. L. (1991). Childhood antecedents of homelessness in psychiatric patients. American Journal of Psychiatry, 148(8), 1026–1030.Google Scholar
  67. Takayama, J. I., Bergman, A. B., & Connell, F. A. (1994). Children in foster care in the state of Washington: Health care utilization and expenditures. Journal of the American Medical Association, 271,1850–1855.Google Scholar
  68. Tuma, J. M. (1989). Mental health services for children: The state of the art. American Psychologist, 44 ,188–189.Google Scholar
  69. Webster, D., Barth, R., & Needell, B. (2000). Placement stability for children in out-of-home care: A longitudinal analysis.Child Welfare, 79(5), 614–632.Google Scholar
  70. Weiss, B., Catron, T., Harris, V., & Phung, T.M. (1999). The effectiveness of traditional child psychotherapy. Journal of Consulting and Clinical Psychology, 67(1), 82–94.Google Scholar
  71. Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited:Ameta-analysis of treatment outcome studies. Psychological Bulletin, 117 ,450–468.Google Scholar
  72. Wells, K., & Guo, S. (1999). Reunification and reentry of foster children. Children and Youth Services Review, 21(4), 273–294.Google Scholar
  73. Wulczyn, F., Kogan, J., & Harden, B. J. (2003). Placement stability and movement trajectories. Social Service Review, 76 ,212–236.Google Scholar
  74. Zahner, G. E. P., Pawelkiewicz, W., DeFrancesco, J. J., & Adnopoz, J. (1992). Children's mental health service needs and utilization patterns in an urban community:An epidemiological assessment. Journal of the American Academy of Child and Adolescent Psychiatry, 31 ,951–960.Google Scholar
  75. Zeger, S., & Liang, L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73 ,13–22.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2004

Authors and Affiliations

  • Sigrid James
    • 1
  • John Landsverk
    • 1
  • Donald J. Slymen
    • 1
  • Laurel K. Leslie
    • 1
  1. 1.Child and Adolescent Services Research Center, Children's Hospital, San Diego, CaliforniaLoma Linda University

Personalised recommendations