Abstract
Background
Children, particularly minority children, referred to child welfare because of suspected
maltreatment are vulnerable and need many services. We sought to assess whether service
use has improved over the past decade and whether racial-ethnic disparities in service
use have decreased.
Methods
We used 2 national data sets (the National Survey of Child and Adolescent Well-Being
[NSCAW] I and II) collected a decade apart to assess changes over time in health,
education, mental health (MH), and dental services and overall service use.
Results
In NSCAW II more children were young, had lower Child Behavior Checklist (CBCL) scores,
and were Hispanic. We found significant increases in dental services, a decrease in
special education services, and a decrease in MH services on the bivariate level (all
P < .01). A large proportion of the change in MH services occurred in school settings,
but the pattern continued when examining only those services delivered outside of
school. The greatest decrease occurred for children with CBCL scores <64. However,
in multivariate analyses, older children, white non-Hispanic children, and children
placed out of the home were significantly more likely to receive MH services. Rates
of MH services controlling for CBCL scores showed no improvement over the decade,
nor was there a decrease in racial and ethnic disparities.
Conclusions
These data showed no change in MH services over time for children referred for child
welfare evaluation, but improvement in dental services was noted. Racial and ethnic
disparities persist. Decrease in MH services occurred predominantly among children
whose MH symptoms were below the clinical range.
Keywords
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Article Info
Publication History
Published online: February 03, 2016
Accepted:
January 29,
2016
Received:
May 26,
2015
Footnotes
Conflict of Interest: The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
