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.

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.

Residential family treatment for parents with substance use disorders who are involved with child welfare: two perspectives on program design, collaboration, and sustainability.

This article discusses the service design, implementation, and evaluation findings of two residential family treatment programs: Wayside House (MN) and OnTrack (OR). Both programs specialize in family-centered services for adults with substance use disorders (SUD) who are involved with child welfare. Information on program design, services offered, and key collaborations are detailed. Implications for program sustainability are provided.

Exploring smoking prevalence, quit attempts, and readiness to quit cigarette use among women in substance abuse treatment.

Client questionnaires from 38 gender-specific substance abuse facilities throughout Ohio were analyzed to explore smoking prevalence, quit attempts, and readiness to quit cigarette use. The analysis revealed 79.7% of women used cigarettes at the time of the survey, 33.5% of current smokers had made at least one quit attempt within the past 12 months, and 55.2% of current smokers reported either contemplating or preparing to make a quit attempt. A multinomial logistic regression revealed that clients who experienced a past quit attempt were more likely to be in the contemplation and preparation stages and clients who smoked 30 out of the past 30 days were least likely to be in the preparation stage. Clients who reported smoking between 10-15 cigarettes a day were more likely to be in the contemplation stage than those who reported smoking <10 cigarettes a day. A three-pronged approach that examines the physiological, emotional, and social components of addiction is recommended.