Use of mental health services in children in residential care: factors associated with referral to therapeutic attention

Children in residential care show many mental health needs as consequence of their risk background. Researches in this area have emphasised that a high proportion of children with emotional and behavioral disorders are not... [ view full abstract ]

Children in residential care show many mental health needs as consequence of their risk background. Researches in this area have emphasised that a high proportion of children with emotional and behavioral disorders are not receiving mental health treatment. Furthermore, some investigations have associated the existence of different personal and family factors with the probability of referral to therapeutic attention. In the light of these findings, there seems to exist a failure in the detection and referral to early treatment. The main objective of this presentation is to explore the therapeutic coverage and the factors that are associated with referral to therapeutic attention in a sample of children in residential care. For this purpose, this study was carried out with 1,216 children from 6 to 18 ages who were living in residential facilities in several regions of Spain. The information was collected through different questionnaires: a questionnaire designed ad-hoc to obtain the basic descriptive information (socio-demographic process of intervention, family background, therapeutic attention and type of mental health treatment) and the Child Behavior Checklist (CBCL) applied to detect mental health needs. All information was collected through the key residential worker. Main results showed that four out of ten cases identified with mental health needs according to results obtained in CBCL were not receiving treatment. Factors such as intellectual disability, experiences of previous foster care or adoption breakdown, clinical ranges in internalizing or total scale in CBCL, experiences of sexual abuse and suicidal behavioral were associated with a high probability of referral to mental health services. In contrast, the fact of being an unaccompanied asylum seeking child was related with a lower likelihood of referral to therapeutic attention. Results show the importance of examining the use of mental health services in this vulnerable group. Several factors seem to influence the detection of mental health problems and the decision of referral. In addition, the challenge for the coming years is to establish objective procedures based on screening test that could ensure the most efficient strategy for treatment referrals.