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October 2004Vol. 5, No. 8Study Finds Unmet Mental Health Needs Among Children in the Child Welfare System

In a recent study involving a nationally representative sample of children ages 2 to 14 involved in the child welfare system, nearly one-half were found to have clinically significant emotional or behavioral problems. But far fewer children, only about one-quarter, received mental health treatment. Data for the study, published in the August 2004 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, were obtained from the National Study of Child and Adolescent Well-Being (NSCAW), a study that includes both children who remained at home and those who were removed from the home.

The study found that the greatest predictor of receiving mental health services was the level of clinical need, as determined by the Child Behavioral Checklist (CBCL). Those children with higher (more severe) CBCL scores were more likely to receive services in the 12 months prior to the interview than those with lower scores. Other predictors of mental health service utilization included:

  • Age. Children ages 11 to 14 were more likely to receive services than younger children.
  • Placement Type. Children in nonrelative foster care or a group home were more likely to receive services than those who remained at home.
  • Type of Maltreatment Reported. Children who were referred to child protective services for neglect were less likely to receive mental health services than those who were referred for other types of maltreatment.
  • Parenting Skills. Children of parents with impaired parenting skills (as reported by child welfare workers) were more likely to receive services than those whose parents were not reported as having impaired parenting skills.

According to the authors, these results speak to the need to overcome systemic barriers to providing mental health services to children in the child welfare system. The authors pointed to several specific needs, including more mental health needs assessments and referrals by child welfare workers, an enhanced ability of the public mental health system to address the unique needs of this population, parent-focused interventions, and stronger links between child welfare and mental health service systems.

The full article, "Mental Health Needs and Access to Mental Health Services by Youth Involved with Child Welfare: A National Survey," is available in the August 2004 issue of the Journal of the American Academy of Child and Adolescent Psychiatry 43(8). Find information about the journal at

Related Items

Another recently published article from the NSCAW research group examines how children in foster care, kinship care, and group home care feel about topics such as their current living situation and contact with their biological families. The article, "Children's Voices: The Perceptions of Children in Foster Care," is available in the American Journal of Orthopsychiatry 74(3) at

Find more information about the NSCAW study in "Well-Being of Children in Foster Care" in the March 2004 issue of Children's Bureau Express.