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He Y, Leventhal JM, Gaither JR, Jones EA, Kistin CJ. Trends from 2005 to 2018 in child maltreatment outcomes with caregivers' substance use. CHILD ABUSE & NEGLECT 2022; 131:105781. [PMID: 35820322 DOI: 10.1016/j.chiabu.2022.105781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/22/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Caregivers' substance use is associated with child maltreatment. OBJECTIVE Examine trends from 2005 to 2018 in percentages of three outcomes with caregivers' drug or alcohol use: child protective services (CPS) referrals, substantiated maltreatment reports, and foster care placements. PARTICIPANTS AND SETTING 22 U.S. states that contributed child-level maltreatment outcomes and caregivers' substance use data to the National Child Abuse and Neglect Data System from 2005 to 2018. METHODS Joinpoint regression was used to examine the average annual percent change (AAPC) in outcomes with caregivers' drug or alcohol use and to identify temporal changes. RESULTS From 2005 to 2018, CPS referrals with caregivers' drug use increased (AAPC 2.33, p < .001), while referrals with alcohol use remained unchanged (AAPC -0.11, p = .92) (trend difference p = .04). Substantiated reports with caregivers' drug and alcohol use increased (AAPC drug use 3.63, p < .001, AAPC alcohol use 1.28, p = .03), with a greater increase observed with drug use (difference p = .03). Foster care placements with caregivers' drug use increased (AAPC 2.54, p < .001), while placements with alcohol use did not change (AAPC -1.22, p = .29), (difference p = .005). Within the study period, changes in trends with caregivers' drug use included increased substantiated reports from 2010 to 2018 (p < .001) and increased foster care placements from 2009 to 2018 (p < .001). With caregivers' alcohol use, CPS referrals and foster care placements decreased from 2007 to 2018 (all p < .001). CONCLUSIONS Trends differed for outcomes with caregivers' drug versus alcohol use. Findings can inform policies to improve care for families affected by substance use.
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Affiliation(s)
- Yuan He
- Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, 801 Albany Street, Boston, MA 02119, United States of America.
| | - John M Leventhal
- Department of Pediatrics, Yale School of Medicine, 20 York Street, New Haven, CT 06510, United States of America
| | - Julie R Gaither
- Department of Pediatrics, Yale School of Medicine, 20 York Street, New Haven, CT 06510, United States of America
| | - Eric A Jones
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), 85 East Newton Street, Boston, MA 02118, United States of America
| | - Caroline J Kistin
- Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, 801 Albany Street, Boston, MA 02119, United States of America
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Dickerson KL, Lyon TD, Quas JA. The Role of Kinship and Siblings in Young Children's Placement Preferences. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9299-NP9316. [PMID: 31203710 PMCID: PMC7001856 DOI: 10.1177/0886260519854560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although considerable attention has been directed toward the most appropriate placement for children following removal from home due to maltreatment, very little of this attention has focused on children's stated preferences, particularly when children are young. Specifically, children below 12 years of age are often presumed incompetent to form reasoned judgments about their best interests in placement. This assumption, however, has rarely been tested directly. We surveyed 100 4- to 11-year-olds removed from home because of maltreatment about their placement preferences. Children were less likely to indicate they wanted to return home if they were placed with siblings or with kin, consistent with statutory placement preferences. These results suggest that young children may express more mature preferences than recognized by the law, and that there may be value in asking even relatively young children about with whom they would like to live following their removal from home as a result of maltreatment.
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Filippelli J, Fallon B, Fuller-Thomson E, Trocmé N. Infants Investigated by the Child Welfare System: Exploring a Distinct Profile of Risks, Service Needs, and Referrals for Support in Ontario. Brain Sci 2017; 7:E101. [PMID: 28805695 PMCID: PMC5575621 DOI: 10.3390/brainsci7080101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 11/25/2022] Open
Abstract
The science of early childhood development underscores that maltreatment and other adversities experienced during infancy heightens the risk for poor developmental and socio-emotional outcomes. Referrals to supportive services by the child welfare system are particularly critical during infancy given the rapidity of brain development and infants' sensitivity to their environment. The main objectives of the current study are to: (1) examine age-specific differences in clinical and case characteristics; (2) determine the factors associated with the service referral decision involving infants; and (3) explore the types of services families have been referred to at the conclusion of a maltreatment-related investigation. Using data from the Ontario Incidence Study of Reported Child Abuse and Neglect for 2013, descriptive analyses were conducted, as was a logistic regression to identify factors associated with the decision to refer families of infants to supportive services. Overall, the findings reveal that the profile of infants and their families differs distinctly from those of older children with respect to risks, service needs, and service referrals, although this is rarely reflected in child welfare practice and policy. Investigations involving infants were most likely to have a referral made to supportive services, least likely to have an infant functioning concern identified; most likely to have a primary caregiver risk factor identified; and, the greatest likelihood of experiencing economic hardship. Multiple risks, identified for the primary caregiver of the infant are correlated to referral decisions for infants. However, the needs of the infant are likely under-identified and require cross-sectorial collaboration.
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Affiliation(s)
- Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
| | - Nico Trocmé
- Centre for Research on Children and Families, McGill University, 3506 University Street, Montreal, QC H3A 2A7, Canada.
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Liu CH, Yasui M, Giallo R, Tronick E, Seidman LJ. U.S. Caregivers with Mental Health Problems: Parenting Experiences and Children's Functioning. Arch Psychiatr Nurs 2016; 30:753-760. [PMID: 27888971 PMCID: PMC6628684 DOI: 10.1016/j.apnu.2016.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/21/2016] [Accepted: 07/09/2016] [Indexed: 11/25/2022]
Abstract
The 2007 National Survey of Children's Health was used to determine the prevalence of poor mental health among U.S. mothers, fathers, and guardians, specific parenting experiences and children's functioning. More guardians (13.7%) reported poor mental health compared to mothers (7.7%) and fathers (5.3%), generalizing to 4.6 million U.S. caregivers with poor mental health. Caregivers with poor mental health were at least 3 times more likely to report children's problematic functioning after accounting for sociodemographic factors and parenting stress and experiences. Research and clinical activities should recognize poor caregiver mental health as a condition that affects parenting and children's functioning.
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Affiliation(s)
- Cindy H Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; University of Massachusetts, Boston, MA.
| | - Miwa Yasui
- School of Social Service Administration, University of Chicago, Chicago, IL
| | - Rebecca Giallo
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | | | - Larry J Seidman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Staudt M, Jolles MP, Chuang E, Wells R. Child Welfare Caseworker Education and Caregiver Behavioral Service Use and Satisfaction with the Caseworker. JOURNAL OF PUBLIC CHILD WELFARE 2015; 9:382-398. [PMID: 27746704 PMCID: PMC5063240 DOI: 10.1080/15548732.2015.1060919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Social work has long been identified with child welfare, and research has generally found that child welfare caseworkers with a social work degree are better prepared than aseworkers with other degrees. Little knowledge exists though about the relationship between caseworker professional background and caregiver behavioral health service use or their satisfaction with the caseworker. Using data from the National Survey of Child and Adolescent Well-Being, we found no significant relationships between having a social work degree and caregiver use of services or satisfaction with the caseworker. More research is needed to clarify how caseworker characteristics, including professional preparation, influence child welfare outcomes.
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Affiliation(s)
- Marlys Staudt
- College of Social Work, University of Tennessee, Knoxville, TN, USA
| | - Mónica Pérez Jolles
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
| | - Emmeline Chuang
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Rebecca Wells
- School of Public Health, University of Texas, Houston, TX, USA
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Jaffee SR, Christian CW. The Biological Embedding of Child Abuse and Neglect: Implications for Policy and Practice and commentaries. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/j.2379-3988.2014.tb00078.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Cindy W. Christian
- University of Pennsylvania; Perelman School of Medicine, Children's Hospital of Philadelphia
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Heneghan A, Stein REK, Hurlburt MS, Zhang J, Rolls-Reutz J, Fisher E, Landsverk J, Horwitz SM. Mental health problems in teens investigated by U.S. child welfare agencies. J Adolesc Health 2013; 52:634-40. [PMID: 23375826 DOI: 10.1016/j.jadohealth.2012.10.269] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 09/04/2012] [Accepted: 10/30/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine prevalence and correlates of five mental health (MH) problems among 12-17.5 year olds investigated by child welfare. METHODS Data from the National Survey on Child and Adolescent Well-being (NSCAW II) were analyzed to examine depression, anxiety, substance use/abuse, suicidality, and attention deficit hyperactivity disorder (ADHD) as reported by teens and their caregivers. In a sample of 815 adolescents, prevalence for each MH problem and correlates (e.g., age, placement location) were identified using bivariate and multivariable logistic analyses. RESULTS After investigation for maltreatment, 42.7% of teens reported at least one MH problem, regardless of placement. Nine percent reported depression, 13.9% reported suicidality, 23% had substance use/abuse, 13.5% reported anxiety, and 18.6% had ADHD. Of 332 teens with any MH problem, 52.1% reported only one problem, 28.3% had two problems, and 19.6% had ≥ three problems. Teens with prior out-of-home placement had odds 2.29 times higher of reporting a MH problem and odds 2.12 times higher of reporting substance use/abuse. Males were significantly less likely to report depression. Older teens were more likely to report substance use/abuse. Black teens were significantly less likely to report suicidality and ADHD and almost half as likely to report anxiety. Teens with a chronic health condition and teens whose caregiver reported depression had more than twice the odds of reporting anxiety. CONCLUSIONS This study highlights high rates of MH problems in teens of all ages and placement locations and suggests that all teens involved with child welfare should be screened for MH problems, regardless of initial placement status.
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Affiliation(s)
- Amy Heneghan
- Palo Alto Medical Foundation, Palo Alto, CA, USA.
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Bunger AC, Chuang E, McBeath B. Facilitating Mental Health Service Use for Caregivers: Referral Strategies among Child Welfare Caseworkers. CHILDREN AND YOUTH SERVICES REVIEW 2012; 34:696-703. [PMID: 22389544 PMCID: PMC3289154 DOI: 10.1016/j.childyouth.2011.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Unmet needs for mental health care are common among caregivers involved in the child welfare system. Although child welfare caseworkers are well positioned to identify service needs and refer caregivers to treatment, little is known about the types of referral strategies used in practice, or their effectiveness for promoting mental health service use. The current study examined child welfare caseworkers' use of different referral strategies and the extent to which these strategies are associated with caregivers' receipt of mental health services within a national sample of child welfare cases. Analyses of the second cohort of families from the National Survey of Child and Adolescent Well-Being suggest that child welfare workers more often use informational strategies for referring caregivers, including suggesting treatment or providing information about treatment options. However, social referral strategies such as providing caregivers with direct assistance in completing applications and making and attending appointments were associated with a greater likelihood of caregivers receiving mental health services. Findings support evidence from other service contexts that service use is facilitated by caseworkers' direct support for arranging services. Implications for research and for child welfare managers and administrators are discussed.
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Affiliation(s)
- Alicia C. Bunger
- Cecil G. Sheps Center for Health Services Research, University of North Carolina – Chapel Hill, 725 Martin Luther King Jr. Blvd; CB #7590, Chapel Hill, NC 27599-7590, , Phone: 919-843-6103, Fax: 919-966-1634
| | - Emmeline Chuang
- Graduate School of Public Health, San Diego State University,
| | - Bowen McBeath
- School of Social Work and Hatfield School of Government, Portland State University,
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9
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Jaffee SR, Maikovich-Fong AK. Effects of chronic maltreatment and maltreatment timing on children's behavior and cognitive abilities. J Child Psychol Psychiatry 2011; 52:184-94. [PMID: 20735512 PMCID: PMC2998571 DOI: 10.1111/j.1469-7610.2010.02304.x] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chronic maltreatment has been associated with the poorest developmental outcomes, but its effects may depend on the age when the maltreatment began, or be confounded by co-occurring psychosocial risk factors. METHOD We used data from the National Survey of Child and Adolescent Well-Being (NSCAW) to identify four groups of children who varied in the timing, extent, and continuity of their maltreatment from birth to 9 years. Internalizing and externalizing problems, prosocial behavior, and IQ were assessed 21 months, on average, following the most recent maltreatment report. RESULTS Children maltreated in multiple developmental periods had more externalizing and internalizing problems and lower IQ scores than children maltreated in only one developmental period. Chronically maltreated children had significantly more family risk factors than children maltreated in one developmental period and these accounted for maltreatment chronicity effects on externalizing and internalizing problems, but not IQ. The timing of maltreatment did not have a unique effect on cognitive or behavioral outcomes, although it did moderate the effect of maltreatment chronicity on prosocial behavior. CONCLUSION There is a need for early intervention to prevent maltreatment from emerging and to provide more mental health and substance use services to caregivers involved with child welfare services.
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Affiliation(s)
- Sara R Jaffee
- Institute of Psychiatry, King's College London, London, UK.
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10
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Jonson-Reid M, Chung S, Way I, Jolley J. Understanding service use and victim patterns associated with re-reports of alleged maltreatment perpetrators. CHILDREN AND YOUTH SERVICES REVIEW 2010; 32:790-797. [PMID: 23420669 PMCID: PMC3571115 DOI: 10.1016/j.childyouth.2010.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Despite the fact that the goal of child welfare is to impact the caregiver's behavior rather than the child's, research on recurrence at the alleged perpetrator level is scant compared to research on child level recurrence. No prior studies both controlled for services participation by the caregiver and explored whether a recurrence happens with the same child. This study helps fill the gap by analyzing caregivers who are alleged perpetrators and later recurrence of abuse or neglect. In-home child welfare services were initially associated with lower recidivism but this effect moderates over time. Receipt of AFDC at study start did not impact likelihood of recidivism but receipt of AFDC (or later TANF) after the first report appears to lower the risk of recurrence. Among low income women, a history of mental health or substance abuse treatment was associated with higher recurrence. Among re-reports of alleged perpetrators, nearly 45% had at least one new child on the report. Caucasian and older perpetrators were less likely to have an alleged recurrence involving a new child. Women with mental health (but not substance abuse) treatment histories and those who had child welfare services after the first report were more likely to be re-reported for alleged maltreatment of a new child.
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Affiliation(s)
- Melissa Jonson-Reid
- George Warren Brown School of Social Work, One Brookings Dr., Washington University in St. Louis, St. Louis, MO 63130, United States
- Corresponding author. Tel.: +1 314 935 4962; fax: +1 314 935 8511
| | - Sulki Chung
- Department of Social Welfare, Chung-Ang University, 221 Heuksuk-Dong, Dongjak-Gu, Seoul 156-756, Republic of Korea
| | - Ineke Way
- School of Social Work, 1903 W. Michigan, Western Michigan University, Kalamazoo, Michigan 49008-5354, United States
| | - Jennifer Jolley
- George Warren Brown School of Social Work, One Brookings Dr., Washington University in St. Louis, St. Louis, MO 63130, United States
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11
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Young NK, Boles SM, Otero C. Parental substance use disorders and child maltreatment: overlap, gaps, and opportunities. CHILD MALTREATMENT 2007; 12:137-49. [PMID: 17446567 DOI: 10.1177/1077559507300322] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
There are relatively few empirically sound studies or nationally representative data on the number of children in Child Welfare Services (CWS) who are affected by their parents' substance abuse or dependence. The two systems that could systematically monitor this population, CWS and substance abuse treatment, are not required to capture the data elements that would identify families in both systems. The studies that are based on CWS populations or parents in treatment indicate that there is a substantial overlap in client populations. This review provides a summary of the available data; provides estimates of the overlap between populations, including the number of infants born each year with prenatal substance exposure; and suggests important opportunities to close the data gap between the systems. The findings underscore both the need for obtaining accurate data within the systems and the opportunities for states to improve their cross-system data efforts as part of their outcome monitoring.
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12
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Thompson R. UNDERSTANDING DISPARITIES IN USE OF MENTAL HEALTH SERVICES AMONG FAMILIES INVOLVED WITH CHILD WELFARE. Am J Public Health 2006; 96:1535-6; author reply 1536. [PMID: 16873734 PMCID: PMC1551942 DOI: 10.2105/ajph.2006.093096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Libby AM, Orton HD, Spicer P. LIBBY ET AL. RESPOND. Am J Public Health 2006. [DOI: 10.2105/ajph.2006.093310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anne M. Libby
- The authors are with the American Indian and Alaskan Native Programs, School of Medicine, University of Colorado, Denver, and Health Sciences Center, Aurora
| | - Heather D. Orton
- The authors are with the American Indian and Alaskan Native Programs, School of Medicine, University of Colorado, Denver, and Health Sciences Center, Aurora
| | - Paul Spicer
- The authors are with the American Indian and Alaskan Native Programs, School of Medicine, University of Colorado, Denver, and Health Sciences Center, Aurora
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