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The articles listed below can be accessed through the corresponding journal website or accessed at a local library or university.

Child welfare and mental health interorganizational relationships impact service use and outcomes

Source:   Bai, Y., Wells, R., & Hillemeiera, M. M. (2009). Coordination between child welfare agencies and mental health service providers, children’s service use, and outcomes. Child Abuse & Neglect, 33(6), 372–381.

Reviewed by:   Allison Eisner

There is often an assumption made that different service sectors that serve children and youth, such as child welfare and mental health organizations, should work together to improve services for children and youth. However, there is limited research with respect to service utilization and outcomes for such an approach. This study examined the impact of interorganizational relationships (IORs) on outcomes for children and youth in families who were investigated for child maltreatment in the United States. Their two research questions consisted of whether IORs between child welfare agencies' (CWAs) and Mental Health Agencies (MHAs) would increase children's mental health service use and if the IORs would improve children's mental health outcomes. IORs consisted of linkages between organizations such as joint resource allocation, cross-training of staff, working collaboratively on cases, and joint planning/policy formulation for service delivery. Using data from the Child Protective Services cohort from the National Survey of Child and Adolescent Well-Being (NSCAW), the sample consisted of 1,613 children and youth across 75 different CWAs in the United States. All children in the sample had been in contact with a CWA in some form, ranging from a closed investigation to coming into care, within a specific 15-month timeframe. The primary inclusion criteria from the overall CPS NSCAW cohort was those children and youth deemed in need of mental health services based on the Child Behavior Checklist (CBCL) cut off point. The results from this study indicated that the number of IORs was related to increased mental health service use by children and youth. More specifically, for every linkage between agencies, individual children and youth's mental health service use increased by 4%. In addition, after controlling for predisposing and enabling factors, they found that the intensity of the IORs between CWAs and MHAs was related to better mental health outcomes in children and youth. That is, for every additional type of IOR, the odds of having better mental health outcomes increased by 7%.

Methodological Notes:

The authors' predictor variable was the intensity of IORs as determined by the number of linkages between CWAs and MHAs, and this was captured at baseline. Their outcome variables consisted of mental health services, as determined by caregiver interviews, and mental health improvement, as determined by caregiver responses on the CBCL. Both dependent variables were tracked longitudinally across four time points. While the longitudinal nature of these outcomes is a strength of this study, there were some methodological limitations. First, the intensity of IORs was only captured at baseline, thus there is no indication as to whether the number of IOR’s increased or decreased over time. Secondly, the nature of this observational study precludes the possibility of establishing any causal effect on service use or outcomes. Finally, there were other factors that demonstrated stronger relationships to service use and outcomes such as whether a child had insurance coverage.

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