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Journal Article

Citation

Bunger AC, Maguire-Jack K, Yoon S, Mooney D, West KY, Hammond GC, Kranich C. Child Abuse Negl. 2021; 122: e105351.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.chiabu.2021.105351

PMID

34628151

Abstract

BACKGROUND: Unmet mental health service needs among children in out-of-home care are sometimes attributed to poor assessments and referrals in child welfare. The Gateway CALL project implemented mental health screening, diagnostic assessment, and referral to treatment practices.

OBJECTIVE: We examined the effectiveness of Gateway CALL for improving children's mental health service receipt, safety, and permanency outcomes. PARTICIPANTS AND SETTING: Participants included 538 children (birth to 18 years) in out-of-home placements through a county-based child welfare agency over a 17-month period.

METHODS: We compared the mental health service receipt, safety, and permanency outcomes for 175 children who received Gateway CALL with 175 children who received "services as usual" identified through propensity score matching. Participant demographics, safety, and permanency outcomes were drawn from child welfare administrative records, and mental health service visits and diagnoses were drawn from Medicaid billing records.

RESULTS: Gateway CALL appeared to increase the number of mental health service visits children received (z = 2.14, p = 0.032), although not the likelihood of receiving services. In terms of child safety, children in Gateway CALL had a greater number of screened-in calls after the intervention than those in the comparison group [t(348) = -1.92, p = 0.03]; there were no differences in substantiations. There were also no observed effects on permanency.

CONCLUSIONS: Despite systematic efforts to identify, assess, and refer children to mental health services through the Gateway CALL intervention, substantial unmet mental health service needs among children persisted.

RESULTS have implications for designing interventions that promote cross-system service access.


Language: en

Keywords

Safety; Mental health; Child welfare; Referrals; Service access; Service cascade

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