Service Receipt and Mental Disorders in Child Welfare and Mental Health Systems in Los Angeles County

Psychiatr Serv. 2017 Aug 1;68(8):776-782. doi: 10.1176/appi.ps.201600266. Epub 2017 Apr 17.

Abstract

Objective: Use of administrative data from child welfare (CW) and mental health systems in Los Angeles County provided a unique opportunity to more closely examine mental health needs of children dually served by these systems. This study examined the presence of mental disorders and correlates of receipt of mental health services by diagnostic classification in this population.

Methods: Data were obtained for 3,191 children receiving services from Los Angeles County's Department of Children and Family Services and Department of Mental Health (DMH) between July 2011 and July 2012. Multivariate linear and logistic regression models examined the relationship between sociodemographic and CW-related characteristics and receipt of outpatient services by clinician-diagnosed mental disorder.

Results: Of the 3,191 referred children, 68% met criteria for one of the four diagnostic classifications. Mood disorders were the most common diagnosis (30%), followed by anxiety disorders (20%), behavior disorders (9%), and attention-deficit hyperactivity disorder (9%). Children with prior DMH involvement received more services regardless of diagnosis. Older children (ages ≥15) received more services than younger children, whereas younger children were more likely to receive family therapy. Race-ethnicity did not play a significant role in predicting service receipt.

Conclusions: The unique mental health needs of CW-involved children were exemplified by the differences found in the percentages of children with diagnoses of mental disorders between this sample and children in the general population. Because of family and placement disruptions among CW-involved children, it is important that the provision of individual therapy is not overlooked in favor of family therapy.

Keywords: Child abuse; Mental health systems/hospitals; Service delivery systems; Social work/psychiatric.

MeSH terms

  • Adolescent
  • California / epidemiology
  • Child
  • Child Welfare / statistics & numerical data*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data*
  • Needs Assessment / statistics & numerical data*