Differences in mental health needs and service receipt for children in kinship versus foster care placements: What we know and what we need to do better!

Objectives: Although behavioral health problems are prevalent among children involved in the child welfare system, substantial service gaps persist. Children in kinship care placements are at especially high risk for unmet... [ view full abstract ]

Objectives:
Although behavioral health problems are prevalent among children involved in the child welfare system, substantial service gaps persist. Children in kinship care placements are at especially high risk for unmet behavioral health needs indicating a need to investigate how behavioral health service needs and use differ across placement types. The current study compares behavioral health diagnoses, and service use among children in foster and kinship care placements.
Method
We conducted a cohort study in an urban Midwestern county using administrative data. Case records were extracted for 2302 children who came into child welfare custody between January and June 2012. From these records, we collected data on demographics, safety, risks, placement type, behavioral health diagnoses, and receipt of behavioral health services. At the time of this study, the child welfare system did not employ any systematic approach to screen, assess, or refer children’s behavioral health needs.
Results
Behavioral health problems were more prevalent among children in foster care (25.9%) than kinship (13.7%) placements, and disruptive behavior problems were most commonly reported in both groups. However, children in kinship care with a diagnosis were less likely to receive care (33%) compared to children in foster care (44%). Conclusions
Data confirm substantial unmet needs for behavioral health services, especially among children in kinship care placements, and suggest the need for more systematic behavioral health screening, and service referrals for system-involved children. Kinship care providers may need additional supports and training to identify behavioral health needs among the children in their care, and follow-through with recommended services. Additional research examining the nature of kinship care, and contributing factors to the identification and treatment of children’s behavioral health conditions is needed to ensure that children receive needed services while in the care of their relatives.