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

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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.

Original languageEnglish
Article number105351
JournalChild Abuse and Neglect
Volume122
DOIs
StatePublished - Dec 2021

Bibliographical note

Funding Information:
This work was supported by the Department of Health and Human Services , Administration for Children, Youth, and Families, Children's Bureau (Grant # 90CO1104 ). This study was also funded in part by the Ohio Department of Medicaid , through the MEDTAPP program administered by the Ohio Colleges of Medicine Government Resource Center. Views stated in this manuscript are those of the researchers only and are not attributed to the study sponsors, the Ohio Department of Medicaid or to the Federal Medicaid Program. MEDTAPP HCA initiative funding supports teaching and training to improve the delivery of Medicaid services and does not support the delivery of Medicaid eligible services.

Publisher Copyright:
© 2021 The Author(s)

Keywords

  • Child welfare
  • Mental health
  • Referrals
  • Safety
  • Service access
  • Service cascade

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