Children at risk of maltreatment more likely to have mental health concerns but less likely to receive services

Mental health concerns, in the form of emotional or behavioral disorders, are increasingly common among children. However, there are indications that only half of children who need mental health services will receive them, and this unmet need may be even greater for children served by the child welfare system. Using U.S. data from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) and Structural Equation Modeling, this study found that family environments characterized by low family functioning, high caregiver distress, and low social support had higher than average child mental health needs yet used fewer mental health services.

These findings were independent of socio-economic status and were valid for all ethnic groups studied but more pronounced for African American children. Different family compositions (intact family, single/cohabitating parent, and foster/substitute family) were similar to one another, but the findings were weaker for foster/substitute families; these families appear to be more sensitive to children’s needs. . Families with disrupted environments (i.e., low family functioning, high caregiver distress and low social support) experienced greater child mental health issues, yet were less likely to receive less mental health services. Caregivers who were isolated, distressed and caught up in maladaptive patterns of family functioning often accessed fewer needed mental health services for their children —they appeared to have fewer financial resources to use, less ability to reflect on their children’s needs, and difficulty evaluating their children’s behavioural and mental health.