Does mental health screening and assessment in child welfare improve mental health service receipt, child safety, and permanence for children in out-of-home care? An evaluation of the Gateway CALL demonstration

Alicia C Bunger; Kathryn Maguire-Jack; Susan Yoon; Douglas Mooney; Kristopher Y West; Gretchen Clark Hammond; Christiana Kranich

doi:10.1016/j.chiabu.2021.105351

Does mental health screening and assessment in child welfare improve mental health service receipt, child safety, and permanence for children in out-of-home care? An evaluation of the Gateway CALL demonstration

Child Abuse Negl. 2021 Dec:122:105351. doi: 10.1016/j.chiabu.2021.105351. Epub 2021 Oct 7.

Authors

Alicia C Bunger¹, Kathryn Maguire-Jack², Susan Yoon³, Douglas Mooney⁴, Kristopher Y West⁵, Gretchen Clark Hammond⁶, Christiana Kranich³

Affiliations

¹ College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, USA. Electronic address: bunger.5@osu.edu.
² School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI 48109, USA.
³ College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, USA.
⁴ Early Moon Consulting, LLC, Columbus, OH, USA.
⁵ Nationwide Children's Hospital, 495 East Main Street, Columbus, OH 43215, USA.
⁶ Mighty Crow Media, LLC, 5701 N. High Street, Worthington, OH 43085, USA.

PMID: 34628151
DOI: 10.1016/j.chiabu.2021.105351

Abstract

Background: Unmet mental health service needs among children in out-of-home care are sometimes attributed to poor assessments and referrals in child welfare. The Gateway CALL project implemented mental health screening, diagnostic assessment, and referral to treatment practices.

Objective: We examined the effectiveness of Gateway CALL for improving children's mental health service receipt, safety, and permanency outcomes.

Participants and setting: Participants included 538 children (birth to 18 years) in out-of-home placements through a county-based child welfare agency over a 17-month period.

Methods: We compared the mental health service receipt, safety, and permanency outcomes for 175 children who received Gateway CALL with 175 children who received "services as usual" identified through propensity score matching. Participant demographics, safety, and permanency outcomes were drawn from child welfare administrative records, and mental health service visits and diagnoses were drawn from Medicaid billing records.

Results: Gateway CALL appeared to increase the number of mental health service visits children received (z = 2.14, p = 0.032), although not the likelihood of receiving services. In terms of child safety, children in Gateway CALL had a greater number of screened-in calls after the intervention than those in the comparison group [t(348) = -1.92, p = 0.03]; there were no differences in substantiations. There were also no observed effects on permanency.

Conclusions: Despite systematic efforts to identify, assess, and refer children to mental health services through the Gateway CALL intervention, substantial unmet mental health service needs among children persisted. Results have implications for designing interventions that promote cross-system service access.

Keywords: Child welfare; Mental health; Referrals; Safety; Service access; Service cascade.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Child
Child Protective Services
Child Welfare / psychology
Home Care Services*
Humans
Mental Health
Mental Health Services*
United States