Mental health care for child welfare clients

Publication Date: 6/1/2001

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Description:

The Agency for Health Care Administration (AHCA) funded the Florida Mental Health Institute (FMHI) during the 2000-01 fiscal year to conduct an assessment of Medicaid-funded mental health services and the clinical needs of children in the child welfare system. Emphasis was placed on an empirically based description of mental health needs and whether or not the identified needs were addressed through the Medicaid-funded mental health services received. In addition, commonly encountered barriers to accessing the needed mental health services were examined.

Clinical case record reviews were designed to assess (a) access to and level of care provided to child welfare clients by fee for service and managed care plans/providers; (b) the appropriateness of provider networks for this population; and (c) whether the mental health needs of the children receiving protective services are being met. Specific attention was paid to examining linkages between characteristics of abuse/neglect, the traumagenic effects of the maltreatment, and provision of trauma-based interventions.

It was found that children who have accessed services have much higher rates of mental health symptomatology than their counterparts who have not received some form of Medicaid-funded mental health services. The children who have accessed Medicaid-funded mental health services have more extensive and pervasive mental health problems than non-service users. In addition, the children who did not access Medicaid-funded mental health services displayed much higher levels of resiliency overall. Specifically, the CANS assessment tool showed that Medicaid-funded mental health non-service users had stronger interpersonal relations, relationship permanence, educational / vocational capacities, and were more involved in the daily events of their social environment.

Common barriers to accessing necessary mental health services included client noncompliance with treatment, client lack of proper financial or emotional support to properly access and benefit from services, and client relocation. Other clients experienced problems during therapy due to the severity of their mental illness or the severity of past abuse.