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February 2018Vol. 19, No. 1Screening for Trauma-Related and Mental Health Needs in California's Child Welfare Systems

Many children involved in child welfare have experienced trauma in one form or another, including interpersonal violence, accidents, injuries, maltreatment, and other adverse childhood experiences. Although screening for trauma has become an integral part of trauma-informed care, to date there has been no systemic evaluation of how screening efforts have been implemented by child welfare leaders.

The article "Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California's Child Welfare Systems" discusses California's screening implementation process under Pathways to Mental Health Services (a class-action settlement agreement) and how child welfare systems have responded to implementation mandates. The article also provides new frameworks for other child welfare systems as they implement their own screening processes.

The evaluation included a web-administered survey to obtain information on mental health and trauma screening in each county in California. Of the 58 counties in the state, 46 participated in the survey, which  contained questions about the extent to which screening had been implemented in the county, the degree of satisfaction with the current procedures, and whether changes to the existing procedures were being considered. The survey respondents were also asked to review a list of tools commonly used to screen for mental health and trauma-related issues (e.g., the Acute Stress Checklist for Children, Children's Revised Impact of Event Scale, Trauma Symptom Checklist) and indicate which tools were used in their county.

About 85 percent of respondents reported that a screening procedure to assess mental health and trauma had been implemented in their counties, 13 percent indicated their county had partially implemented a screening procedure, and about 2 percent indicated that their county was planning to implement a screening procedure. Nearly all respondents (96 percent) reported use of at least one of the tools listed in the survey or of at least one other tool that was not listed, and almost a quarter of the respondents reported that at least one tool was being considered for use in their county.

The report also provides three implementation considerations for future trauma-informed care efforts:

  • Maintain a focus on childhood trauma rather than general mental health.
  • Acknowledge the need for collaboration among child welfare leaders with diverse science- and practice-related expertise.
  • Implement a feasible, evidence-based screening process.

"Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California's Child Welfare Systems," by Brent R. Crandal, Andrea L. Hazen, and Jennifer Rolls Reutz (Advances in Social Work, 18), is available at