Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) who had been placed in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9–12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR = 2.50, p = .06) and/or educational (OR = 3.54, p = .04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services.     

Sudanese refugee youth in foster care: the "lost boys" in America

This study examined the resettlement experiences of unaccompanied Sudanese refugee youth placed in foster care from the perspectives of the youth, foster parents, and agency caseworkers. Youth experienced considerable success. The challenges of adjusting to school and family life, however, suggest a need for funding to support more intensive educational services, more cultural training and support for foster parents and school personnel, and flexibility to provide services in more culturally appropriate modalities.     

Can Machine Learning Create an Advocate for Foster Youth?

ABSTRACT

Statistics are bleak for youth aging out of the United States foster care system. They are often left with few resources, are likely to experience homelessness, and are at increased risk of incarceration and exploitation. The Think of Us platform is a service for foster youth and their advocates to create personalized goals and access curated content specific to aging out of the foster care system. In this article, we propose the use of a machine learning algorithm within the Think of Us platform to better serve youth transitioning to life outside of foster care. The algorithm collects and collates publicly available figures and data to inform caseworkers and other mentors chosen by the youth on how to best assist foster youth. It can then provide valuable resources for the youth and their advocates targeted directly toward their specific needs. Finally, we examine machine learning as a support system and aid for caseworkers to buttress and protect vulnerable young adults during their transition to adulthood.     

Improving Permanency: Caseworker Perspectives of Older Youth in Another Planned Permanent Living Arrangement

Researchers conducted focus groups with 52 child welfare caseworkers across five county child welfare agencies to understand their approach to working with and views about outcomes for youth in Another Permanent Planned Living Arrangement (APPLA). Analysis of the focus groups yielded five themes, including (a) youth and family factors contributing to APPLA as a case designation, (b) caseload intensity relative to this specific population, (c) perceptions of organizational support, (d) lack of focus on legal permanency, and (e) overemphasis on independent living services. The range of viewpoints from these child welfare professionals spoke to the complexities of addressing the needs for older youth in care and to identifying strategies to improve permanency outcomes for this population. The implications for practices that account for individual, organizational, and systemic factors impacting legal permanency for older youth are discussed.     

Fathers in child welfare: caseworkers' perspectives

Five focus groups substantially agreed about the lack of paternal participation in child welfare services and the reasons for low paternal involvement. The groups had considerable disagreement about whether child welfare professionals should address this issue. Some caseworkers believed that all fathers and mothers should be treated identically with respect to services to be offered and time frames for services; other caseworkers thought that the special circumstances of some fathers, such as lack of child care experience, called for service approaches that differ from those for mothers. Another disagreement was whether more fathers would be more involved if services were gender sensitive, that is, if agencies provided male caseworkers for fathers and had father-only services. Much of the debate focused on pragmatic considerations (would gender-sensitive services improve paternal participation and outcomes?), although some participants were concerned about equity (would such services give fathers an advantage in disputed custody cases?).     

“Project awareness:” Fostering social justice youth development to counter youth experiences of housing instability,trauma and injustice

Housing instability poses a challenge for the positive developmental trajectories of youth. Nevertheless, youth possess the knowledge, fortitude and resiliency to meet the needs and challenges of navigating housing instability. Youth Participatory Action Research (YPAR) methods coupled with Social Justice Youth Development (SJYD) were utilized with 6 youth experiencing housing instability accessing educational, life skill, and developmental services from a drop-in center. Participants were active members of youth-centered research workshops. Findings reveal the need for increased funding that secures community-based, positive youth development services; an open, fluid workshop structure to offer consistency, yet flexibility for highly mobile youth; and safe spaces in which youth can explore and analyze the socio-political contexts shaping their experiences to inform their approaches in navigating various social systems and structures.     

Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.     

Family Reunification of Youth in Foster Care with Complex Mental Health Needs: Barriers and Recommendations

This study presents findings of a formative evaluation of an innovative pilot program designed to reunify and reintegrate foster youth with complex mental and behavioral needs in residential treatment centers or therapeutic foster care with their families in the community. Data collection methods included in-depth structured case file reviews and semi-structured interviews with the youth, as well as their caregivers, Child Protective Services caseworkers, and pilot program staff. The participants provided important insights regarding system, program, and case-level barriers to the successful reunification of these youth back into the community. Training, practice, and policy recommendations are discussed.     

What is the purpose? Caseworkers’ perception of performance information

Caseworkers in welfare organisations play a pivotal part in the production of performance information (PI), since the information they record determines the quality of the PI. Previous studies have demonstrated how tasks that are considered illegitimate are stressful for the professionals performing them and are not performed properly. Caseworkers’ perception of the PI, which their recordings feed into, must therefore be of great importance with regard to how the caseworkers perform the task of recording. From a qualitative study of the production and use of PI in municipal disability services in Denmark, we gained insight into how caseworkers perceived the purposes of PI. We conclude that PI used in the planning of services to meet clients’ needs is recognised as a legitimate purpose. The distance between the manager and caseworkers seems to be important for the degree of understanding of the purpose of the tasks: The shorter the distance, the more understanding. Furthermore, caseworkers also see more subjective purposes of doing the recordings properly. Firstly, it makes management aware of the size of their workload. Secondly, the recordings serve as a documentation tool, which can be useful when clients file complaints.     

“Parents need a village”: Caseworkers' perceptions of the challenges faced by single parents of system-involved youth

Drawing upon the lived experience of juvenile justice caseworkers, this phenomenological study aimed to describe the challenges faced by single parents with children in the custody of the juvenile justice system, and how parenting practices are affected. Ten caseworkers were interviewed, from which the following essence emerged: “Parents need a village.” Five themes supported and contextualized this essence by detailing how challenges not only fall along each level of the Ecological Model, but also interact with one another, leaving parents with a profound sense of powerlessness and detachment from their children, themselves, and their futures. This study underscores that stakeholders combating youth violence must take an ecological approach in their efforts to support parents. Interventions should target neighborhood and individual needs, such as employment, housing, crime, service accessibility, and mental health problems, while simultaneously addressing issues of classism and racism that trap parents in cycles of poverty and violence.     

The Need for Mandatory Legislations to Enhance Services to People with Disabilities in Nigeria

The promises concerning the provision of services to individuals with disabilities contained in Nigeria's National Policy on Special Education have not been implemented due to the absence of a legislative mandate to support their implementation. Consequently, the majority of individuals with disabilities in the country are not receiving educational and other relevant services. Based on the evidence of the positive impacts of legislation on special needs provision from several countries, this paper advocates for the enactment of mandatory laws in Nigeria in order to ensure that the right services would be provided to individuals with disabilities in the country. Although the process of enacting legislation on special needs provision could be problematic due to the prevailing political and economic crises in the country, it is argued, however, that effective advocacy activities by patient and professional organisations in the field of special needs could influence the government to take the needs of citizens with disabilities into consideration in policyformulation and legislative mandates.     

The feminization of social services: Implications for black male youth

Throughout the institution of social services attention to the needs of black male youth has been subjugated relative to the needs of women and girls. Despite the educational failures and hyper-incarceration of black male youth they remain aloof from social services. In the aftermath is an invisible crisis not irrelevant to the feminization of social services. Such feminization is evident in the social work databases and social service help models where it has dominated. If social service agencies are to balance the influences of feminization, it is imperative to de-feminize social services by systematically addressing the needs of black male youths. The outcome will contribute to their academic successes and reduction in rates of hyper-incarceration. Only then will it be possible to sustain alternatives to the feminization of social services and the potency of the social work profession at-large.     

Relationship of risk assessment to placement characteristics in a statewide child welfare population

Risk assessments allow child and youth services to identify children who are at risk for maltreatment (e.g., abuse, neglect) and help determine the restrictiveness of placements or need for services among youth entering a child welfare system. Despite the use of instruments by many agencies within the U.S. to determine the appropriate placements for youth, research has shown that placement decisions are often influenced by factors such as gender, age, and severity of social–emotional and behavior problems. This study examined ratings of risk across multiple domains using a structured assessment tool used by caseworkers in the Rhode Island child welfare system. The relationship between ratings of risk and placement restrictiveness was also examined. Risk levels varied across placement settings. Multivariate analyses revealed that lower caseworker ratings of parent risk and higher ratings of youth risk were associated with more restrictive placements for youth. Implications for the child welfare system are discussed.     

Former system youth with mental health needs: Routes to adult mental health care, insight, emotions, and mistrust

Objective

Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care.

Methods

In-depth face-to-face interviews were conducted with 60 participants currently struggling with mental health difficulties regarding their service use experiences over the transition. Participants were recruited from one Midwestern state. Multi-phase analysis was conducted utilizing immersion/crystallization, constant comparison and concept matrices.

Results

Few participants received continuous mental health care across the transition, with the majority experiencing interruptions or discontinuation of care. Important facilitators of service use emerged, such as physicians, former caseworkers and family. Health clinics and parenting programs emerged as potential entrée points for reconnecting disengaged young adults to mental health services. Insight, mistrust, and emotions emerged as novel factors associated with service utilization among young adults.

Conclusions

Mental health service utilization remains a complicated phenomenon over the developmental transition to adulthood. Future research is needed that closely examines the associations between insight, emotion, mistrust and service use among young adults.     

A long road ahead: A progress report on educating homeless children and youth in america

The plight of contemporary homelessness in American society has been well documented, including the growth in homeless families with school age homeless children and independent homeless youth. The impact of homelessness on schools and schooling has resulted in a school-age population with complex problems for which no simple solutions exist. This article chronicles the progress made in recent years in addressing the educational needs of homeless children and youth in America and notes particular areas of concern that remain to be solved if education is to hold a meaningful place in their disrupted lives. Specifically, concerns regarding awareness and perceptions of homelessness, early childhood educational needs, intervention with special populations, interagency collaboration in service delivery, and the need for comprehensive evaluations of homeless education efforts are discussed. Additionally, suggestions for improving policy and practice salient to educating homeless students are offered     

Transitioning youth: Policies and outcomes

The primary policies and outcome studies regarding youth transitioning from foster care and young adults who have aged out of foster care over the past quarter of a century are reviewed. Although several policies have increased services and funding for this population, overall, their outcomes have not significantly improved. In terms of educational achievement, employment, and well-being, many continue to fare poorly in young adulthood. Further policies and practice improvements may need to be implemented. The population of youth transitioning has far outpaced the funding available, state and program eligibility requirements may be eliminating the most vulnerable from services, in many states there is an inadequate provision of basic needs such as housing and healthcare, the expectations of self-sufficiency for this population now exceed societal norms, and the restrictions and placement instability associated with many older adolescents in care may be in contrast to their developmental needs. In order to more fully address the needs of youth transitioning from foster care, child welfare policies and practices may need to focus more attention on the relational and social development of youth while in foster care. Furthermore, during young adulthood, policies and practices may need to provide greater safety nets and resources to this population.     

Foster care transition services for youth with disabilities: findings from a survey of county service providers

This study explores the transition services available for youth with disabilities in foster care and the collaboration among foster care transition programs with other types of providers. Findings from this survey of independent living coordinators working for child welfare agencies indicate that while youth with disabilities are being served through transition programs and these programs collaborate with other government agencies, there are few services targeted directly toward their needs, little collaboration with community-based agencies, and a need for more information sharing.     

Educational risk,recidivism, and service access among youth involved in both the child welfare and juvenile justice systems

Dually-involved youth represent a population of youth who receive some level of supervision from both the child welfare and juvenile justice systems concurrently. The current study examined education-related risk factors, recidivism, referrals for services, and service access among dually-involved youth in Los Angeles County. Specifically, whether increased educational risk was associated with referrals to, and access of, educational services and supports and whether higher receipt of educational services reduced recidivism approximately six months post-disposition. Data for this study consisted of a sample of dually-involved youth (N = 131) who were adjudicated delinquent and also had a child welfare case open. An Educational Risk Index (ERI) was developed and included school attendance, credit deficiency, problem school behavior, and current grades. Results indicate that educational risk was negatively associated with mental health services accessed, demonstrating that those with higher educational risk accessed less mental health services. Educational risk, however, was not associated with increased educational service referrals or access, suggesting a possible mismatch in educational need and service referrals. Lastly, there were no significant differences between those that recidivated and those that did not recidivate in service access and educational risk.     

Facilitating Mental Health Service Use for Caregivers: Referral Strategies among Child Welfare Caseworkers

Unmet needs for mental health care are common among caregivers involved in the child welfare system. Although child welfare caseworkers are well positioned to identify service needs and refer caregivers to treatment, little is known about the types of referral strategies used in practice, or their effectiveness for promoting mental health service use. The current study examined child welfare caseworkers' use of different referral strategies and the extent to which these strategies are associated with caregivers' receipt of mental health services within a national sample of child welfare cases. Analyses of the second cohort of families from the National Survey of Child and Adolescent Well-Being suggest that child welfare workers more often use informational strategies for referring caregivers, including suggesting treatment or providing information about treatment options. However, social referral strategies such as providing caregivers with direct assistance in completing applications and making and attending appointments were associated with a greater likelihood of caregivers receiving mental health services. Findings support evidence from other service contexts that service use is facilitated by caseworkers' direct support for arranging services. Implications for research and for child welfare managers and administrators are discussed.     

Baseline Characteristics of Dependent Youth Who Have Been Commercially Sexually Exploited: Findings From a Specialized Treatment Program

ABSTRACT

Commercial sexual exploitation of children has emerged as a critical issue within child welfare, but little is currently known about this population or effective treatment approaches to address their unique needs. Children in foster care and runaways are reported to be vulnerable to exploitation because they frequently have unmet needs for family relationships, and they have had inadequate supervision and histories of trauma of which traffickers take advantage. The current article presents data on the demographic characteristics, trauma history, mental and behavioral health needs, physical health needs, and strengths collected on a sample of 87 commercially sexually exploited youth. These youth were served in a specialized treatment program in Miami-Dade County, Florida, for exploited youth involved with the child welfare system. Findings revealed that the youth in this study have high rates of previous sexual abuse (86% of the youth) and other traumatic experiences prior to their exploitation. Youth also exhibited considerable mental and behavioral health needs. Given that few programs emphasize the unique needs of children who have been sexually exploited, recommendations are offered for providing a continuum of specialized housing and treatment services to meet the needs of sexually exploited youth, based on the authors’ experiences working with this population.