A Chance to Help Kids' Mental Health

Mental health issues high among children in families visited by child welfare agencies

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Child welfare agencies can do more than investigate families under suspicion of abuse or neglect of a child. They could help identify children at higher risk for mental health problems.

A recent study found that a significant number of children whose families had been under investigation showed a higher risk for developing mental health problems, but their mental health needs were not necessarily being met.

"Keep all pediatrician appointments."

Sarah McCue Horwitz, PhD, of Stanford University, and colleagues included 1,117 children from one to three-years-old in their study.

The data were pulled from the National Survey of Child and Adolescent Well-Being II, a long-term study of children from newborns up to 17-year-olds from across the United States who were part of child welfare investigations that were closed between February 2008 and April 2009.

The researchers looked at the results from two assessment tools for the children, one called the Brief Infant-Toddler Social Emotional Assessment (BITSEA) and another called the Child Behavior Checklist (CBCL), to determine the child's risk of mental health problems.

Among the one-year-olds to 18-month-olds, 35 percent scored high on the BITSEA, indicating possible mental health issues, and 21 percent showed low levels of social competence.

Social competence relates to development of a wide range of social, emotional, cognitive and behavioral skills, such as empathy, motivation, self-efficiency, sociability and moral development.

Among the 19-month-olds to three-year-olds, 10 percent scored in a range on the CBCL that indicates being at risk for mental health conditions.

African-American children were less likely to have the high scores indicating mental health needs, but children whose caregiver had never been married were about five times more likely to have a high score.

Yet only 19 percent of the children in the study who had mental health problems appeared to have received mental healthcare or have had their parents go through parenting skills training.

The researchers reported that the children also had high rates of chronic health conditions. Those with a prior history of interactions with child welfare organizations were more likely to have low social competence.

"The fact that so many very young children in contact with child welfare are showing signs of social and emotional problems is somewhat surprising, but that so few children and caregivers receive any services is disturbing given that effective interventions are available and could produce positive changes in the lives of these children," McCue Horwitz said.

McCue Horwitz hopes the study is a call to action to improve the services for these children.

"There are data to suggest that evidence-based early intervention services potentially can improve mental health outcomes, and this underscores the need for more aggressive efforts to identify and treat vulnerable young children who are investigated by child welfare agencies," the authors wrote.

The study appeared online May 2 in The Journal of the American Academy of Child and Adolescent Psychiatry. The research was funded by the National Institutes of Health, and the authors reported no relevant financial disclosures.

Reviewed by: 
Review Date: 
June 22, 2012
Last Updated:
November 12, 2012