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June 2004Vol. 5, No. 5Mental Health Issues Documented in Child and Family Services Reviews

States report an ongoing lack of mental health services for children in the child welfare system, but strategies to address this deficit are being developed, according to a recent analysis of Child and Family Services Reviews (CFSRs) and Program Improvement Plans (PIPs). This analysis was a cooperative effort by the National Technical Assistance Center for Children's Mental Health at the Georgetown University Center for Child and Human Development and the Technical Assistance Partnership for Child and Family Mental Health at the American Institutes of Research (authored by Jan McCarthy, Anita Marshall, Marisa Irvine, and Bianca Jay).

Results from the CFSRs showed a great deal of variability across States. For instance, 10 of the 38 States reviewed required mental health screenings for all children entering foster care; however, only 1 State's final report indicated that all children actually received an initial formal mental health screening. None of the final reports indicated whether all children in need of mental health services actually received them. Twelve States listed available services but did not report that these were provided to all children who needed them. Twenty-seven States mentioned deficits in specific services, including:

  • Substance abuse treatment (for parents and children)
  • Services to address maltreatment trauma
  • Treatment for youth who have been sexually abused
  • Residential treatment for children with serious emotional disorders

In addition, CFSRs cited a shortage of mental health providers with appropriate expertise, lack of services in rural areas, and funding issues (such as budget deficits or restrictions imposed by managed care).

All 28 States with PIPs mentioned addressing mental health issues as part of these plans. In many cases, the PIPs included specific strategies for meeting mental health needs, including:

  • Developing screening and assessment instruments
  • Building service arrays to address deficits in specific types of services
  • Training staff, clinicians, and foster parents on mental health issues
  • Monitoring services and child and family outcomes
  • Collaborating across agencies to achieve improved service delivery
  • Replicating systems of care

The full report on mental health issues addressed by the CFSRs and PIPs, "An Analysis of Mental Health Issues in States' Child and Family Service Reviews and Program Improvement Plans," can be downloaded at (PDF - 260 KB).

Related Item

Funding for mental health services was addressed by Children's Bureau Express in "Strategies for Funding Comprehensive Mental Health Services for Children" (December 2003/January 2004).