Mental health services for children and caregivers remaining at home after suspected maltreatment |
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| Institution: | 1. Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, 13th Floor, Philadelphia, PA 19104, United States;2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, United States;3. Department of Biostatistics and Epidemiology, University of Pennsylvania, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, United States;4. Department of Pediatrics, University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA 19104, United States;5. Division of General Pediatrics, The Children''s Hospital of Philadelphia, 34th and Civic Center Boulevard, 12th floor Northwest, Philadelphia, PA 19104, United States;6. PolicyLab, The Children''s Hospital of Philadelphia, Philadelphia, Pennsylvania, 3535 Market Street, 15th floor, Philadelphia, PA 19104, United States;1. Department of Social Welfare, Gyeongsang National University, Republic of Korea;2. Department of Family and Policy, German Youth Institute, Germany;1. School of Social Work, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA 02467, United States;2. Children''s Services, Lutheran Immigration and Refugee Service, 700 Light Street, Baltimore, MD 21230, United States;1. Casey Family Programs, Seattle, WA, United States;2. Juvenile Protective Association, Chicago, IL, United States;3. Seattle, WA, United States;1. Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, 12th Floor, Chicago, IL 60611, United States;2. University of Ottawa, 136 Jean-Jacques Lussier Private, Ottawa, ON K1N 6N5, Canada;3. Froedtert Health, Administration, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, United States |
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| Abstract: | ObjectiveBehavioral problems are common among children remaining at home after suspected maltreatment, but the effectiveness of current mental health services to improve these behavioral problems is unknown. The objective was to determine whether receipt of child and caregiver mental health services was associated with improvements in behavioral problems in maltreated children remaining at home.MethodsWe retrospectively analyzed Second National Survey of Child and Adolescent Well-being data. We included 1117 children ages 2–17 remaining at home after a maltreatment investigation, excluding children with missing outcome, covariate, or survey weight data. We compared mean Child Behavioral Checklist (CBCL) change scores from baseline to 18 months between children who did and did not receive mental health services, before and after adjusting for child, caregiver, and child welfare agency factors using survey-weighted linear regression.ResultsNearly one-quarter (22.6%) of children and 16.0% of caregivers received mental health services. Children receiving services had worse unadjusted baseline and 18-month CBCL scores than children not receiving services (all P < 0.001). Adjusted CBCL change scores revealed behavioral worsening among children receiving services but improvement among children not receiving services (all P < 0.001). However, children had improved behavior, regardless of their own service receipt, if their caregivers received services and reported an absence of depression at 18 months.ConclusionsChildren receiving mental health services had worse behavioral changes than children not receiving services. Caregiver receipt of services was associated with improved child behavior, suggesting that a family-centered approach may be most influential in improving behavioral outcomes among this population. |
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