Caregiver involvement in behavioural health services in the context of child welfare service referrals: a qualitative study

Human service agencies serve a growing number of adults with behavioural health needs. Despite these agencies' key role in identifying need and facilitating services, many individuals do not receive care or end services prematurely. Few studies have explored the experiences of families referred to behavioural health services by such agencies or the extent to which families' perceptions of service need align with those of treatment providers and frontline workers. This study presents findings from a qualitative study of caregivers involved with child welfare agencies who were referred to behavioural health services. Researchers reviewed agencies' case records and conducted in‐depth interviews with 16 caregivers, 9 child welfare caseworkers and 12 behavioural health treatment counsellors. Findings suggest that when deciding to engage in services, caregivers weigh not only their individual and family behavioural health needs but also potential agency intervention, including loss of child custody. Many professionals reported that involvement with a child welfare agency hindered the caregiver's disclosure of behavioural healthcare needs. Implications for managers and practitioners are discussed.     

Sampling procedures and survey methodologies for the 1996 survey with comparisons to earlier national roadside surveys.

This article describes the multistage sampling system employed in the 1996 national roadside survey and compares it to the sampling methods employed in the two prior surveys in 1973 and 1986. Also described are the data collection procedures at the selected sites, the breath-test devices used to collect blood alcohol concentration (BAC) data, and the methods used to impute BAC values where breath-test measures were not obtained. Overall, almost twice as many (6,298 in 1996 compared to 3,698 in 1973 and 3,043 in 1986) drivers were interviewed in the most recent national survey as in the previous efforts. The procedures implemented in the three surveys are sufficiently similar to permit comparison of these surveys conducted at 10-year intervals.     

Integrating cultural competency and empirically-based practices in child welfare services: A model based on community psychiatry field principles of health

Acknowledging the existence of racism in our society is crucial to understanding the need for a culturally competent approach to developing empirically-based practices in child welfare, thereby providing a foundation for evidence-based practice in the field. Advancements have already been made in mental health to address cultural competence and evidence-based practice. This article presents a model of seven field principles of health promotion successfully used in the mental health services. Examples of the use of the model in various settings and evaluation projects are provided. Each of the seven principles – rebuilding/supporting the village; providing access to health care; improving bonding, attachment and connectedness; improving self-esteem; increasing social skills of target recipients; reestablishing/strengthening the adult protective shield; and minimizing residual effects of trauma (Bell et al., 2002) – is elaborated. The model's critical role in establishing culturally competent evidence-based practice is further outlined for application in the field of child welfare.     

Bias, racism and evidence-based practice: The case for more focused development of the child welfare evidence base

In spite of continuing concerns about disproportionate representation of African Americans, American Indians, and selected other groups in foster care, development of the practice and policy evidence base has paid scant attention to incorporating the specific concerns of these communities in intervention research. The authors review the current foundation of evidence-based practice and identify gaps in the knowledge base with specific reference to race/ethnicity/culture and class. They recognize the current concerns regarding disproportionality in child welfare services; and summarize the current research on bias and racism to establish potential mechanisms contributing to racially disproportionate outcomes. Addressing these literatures in concert with one another gives new meaning to the phrase, culturally competent evidence-based practice. Culturally competent practice goes beyond admonishing practitioners and policy makers to be more sensitive or to undertake such training. It is a pathway to the development of a more targeted and relevant evidence base: 1) rigorous intervention research with diverse populations could be more intentionally developed and 2) existing rigorous research on successfully addressing bias could be more broadly applied and tested in child welfare. A model for evaluating the validity of the evidence base with respect to diverse populations is proposed.     

Chafee Educational and Training Voucher Programs: System Coordination in Rural New England

This paper explores service providers’ perspectives on a series of issues associated with systemic coordination in the implementation of the Chafee Educational and Training Voucher (ETV) Program in three relatively rural states. Findings derived from mail surveys (N = 105) and in-depth interviews (N = 17) with child welfare and educational service providers highlight challenges and innovations related to working with Chafee ETV eligible youth. Findings suggest that raising awareness of the Chafee ETV program’s provisions, improving access to concrete services, and facilitating collaboration among service providers may aid the transition to post secondary education for youth in out-of-home care.     

Does Family Structure Really Influence Educational Attainment?

This paper examines the effects of family structure on educational attainment after controlling for common family influences, observed and unobserved, using data from siblings. The use of sibling data permits us to examine whether the apparent effects of family structure are due to unmeasured characteristics of families that are common to siblings. The data come from pairs of siblings in the National Longitudinal Survey of Youth, 1979–1992. The results suggest that taking into account the unmeasured family characteristics yields estimates of the effects of family structure on educational attainment that are smaller, but still statistically significant, than estimates based on analyses that do not take unmeasured family influences into account.     

A national evaluation of Safe Schools/Healthy Students: outcomes and influences

The Safe Schools/Healthy Students (SS/HS) Initiative has awarded over $2 billion in grants to more than 350 school districts in partnership with local mental health, law enforcement, and juvenile justice agencies. To estimate the impact of grantee characteristics, grant operations, and near-term outcomes in reducing violence and substance use, promoting mental health, and enhancing school safety, logged odds ratios (LORs) were calculated contrasting Year 3 with Baseline performance from grantee-provided data on seven outcome measures. After comparing grantee performance across outcomes and outcomes across grantees, the LORs were entered as dependent variables in a series of meta-regressions in which grantee characteristics, grant operations, and near-term outcomes were tested after controlling for pre-grant characteristics. Findings indicate that the SS/HS Initiative significantly improved most outcomes, that within-grantee performance varied greatly by outcome, and that random-effects meta-regression appreciably decreased the variance available for modeling. The approach demonstrates that the SS/HS Initiative is effective and that locally collected performance data can be used to estimate grantee success in improving youth outcomes.     

Social services for sexual minority youth: Preferences for what,where, and how services are delivered

As part of an internet-based study to investigate experiences of sexual minority youth in the U.S., 544 youth, ages 14–19, were surveyed about their need for services, where they preferred to receive these services, and their preferred method of service delivery. The survey was anonymous and youth were recruited from LGBTQ-specific listservs and venues as well as through social networking sites as a way of reaching youth often not represented in LGBTQ surveys. Youth highly endorsed many types of services, settings, and modes of delivery. Some subgroup differences emerged. Transgender youth and those uncertain about their gender identity expressed stronger interest than others in services to address stress, family issues, and self-defense, and in receiving support and guidance from LGBTQ adults. Few differences in service preferences along demographic lines such as race/ethnicity emerged; however, African American youth were more likely than others to prefer services offered in a place of worship. Contrary to predictions, geographic and community variables were not related to service type, delivery format, or location preferences.