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Context matters: The state of racial disparities in mental health services among youth reported to child welfare in 1999 and 2009
Affiliation:1. School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104-6214, United States;2. Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong;1. ASUP 106, Fayetteville, AR 72701, School of Social Work, University of Arkansas, United States;2. Enderis Hall 1165, Milwaukee, WI 53211, Helen Bader School of Social Welfare, University of Wisconsin at Milwaukee, United States;3. 1010 W. Nevada Street Suite 2080, Urbana, IL 61801, Children and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign, United States;1. Department of Social Work and Child Advocacy, Montclair State University, Dickson Hall, room 302, Montclair, NJ 07043, United States;2. Department of Sociology and Social Work, Texas Woman''s University, P. O. Box 425887, CFO 306, Denton, TX 76204, United States;1. Michigan State University, School of Social Work, United States;2. New York University, Silver School of Social Work, United States;1. University of Pennsylvania School of Social Policy & Practice, USA;2. University of Chicago School of Social Service Administration, USA
Abstract:Upwards of 50% of youth reported to the child welfare system (CWS) do not receive mental health services, despite need. While children of color are less likely to receive services than Caucasians, the mechanisms through which disparities are sustained remain largely unknown. Data come from two nationally representative cohorts of youth who were referred to the CWS in 1999 and 2009. Results showed that while need for mental health services decreased, significant differences in the number of children who received services was not detected between cohorts. African American youth were less likely to receive services compared to their Caucasian counterparts, even after controlling for age, gender, type of maltreatment, and placement instability. However, after taking into account urbanicity, poverty, and the organizational-social context, the disparity between African American and Caucasian youth dissipated. Service disparities between Latino and Caucasian youth were not detected. The odds of service receipt were lower among youth nested within stressful organizational climates and urban (versus rural) counties, and the organizational-social context did not moderate the relationship between race and service receipt. Findings underscore the need to develop and implement strategies to increase access to services in urban counties and to promote an organizational climate conducive to reducing racial disparities.
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