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How is the mental health situation of children receiving assistance from child welfare service?


Background. During the last decades there has been a steady increase in the number of children receiving assistance from the child welfare services in Norway. In 2006 approximately three of 100 children between 0 and 17 years received intervention. In Norway child welfare service provide two types of interventions, child protection care and home based assistance. The majority of children receive assistance while living at home with their parents. The most common forms of intervention for children in school age are economic assistance, visit/relief home, support friend and leisure activity support.

Compared to other families, those who receive interventions from the Child Welfare Service (CWS) are more often single household, have poor economy and parents with low educational level. In addition, parental mental illness and drug abuse are more common. Together these conditions constitute an increased risk for mental health problems among these children. While high levels of mental health difficulties have been reported for children in residential and foster care, less is known about the mental health of children who live at home with their parents while receiving assistance from child welfare services. Lately there has been an increased focus on evidenced based practice in child welfare. Paradoxically little research have been carried out regarding the most frequently used home based interventions. Practitioners and researchers have however expressed concern for mental health problems among child welfare children. Consequently, in order to provide these children with appropriate help and support it is important to have more information about their mental health situation. There is particularly a need to have a better understanding of the children's own perception of their problems.

Purpose. The purpose of this study was to assess mental health difficulties among children aged between 10-13 years who received intervention from Child welfare service while living at home with their parents. Some of the results from the study have been published (Iversen et al. 2007).

Methods. The study uses a quantitative approach. Data stem from a survey carried out in 2006 as part of the Bergen child study. The Bergen Child Study is a longitudinal population based study among all children in public and private schools in the Bergen municipality.

The sample consisted of parent and child reports from 4.162 children, of which 82 children were child welfare clients living at home. Data was collected by questionnaires to children and parents. Mental health difficulties were assessed by the "Strength and difficulties symptom scales"; emotional, conduct, inattention/hyperactivity and peer problems. In addition, the total difficulty score was calculated. The 90th percentile was used as cut-off for identifying children with profound problems in the different domains.

 Key findings. As expected child welfare families were more often single parents, had poorer family economy, lower education and more often poor parental health than families of peers. Compared to their peers, child welfare children had significantly more emotional problems, hyperactivity, conduct problems, peer problems, and total difficulties. The largest difference between child welfare children and peers were on conduct problems and total difficulties.

Implications. The high level of mental health difficulties and the complexity of problems have important implications for practice, policy and research. Although the present findings underscore the need for increased competence on mental health issues among child welfare workers, the complex needs of these children and families cannot be solved by the child welfare system alone. Consequently, the results also point to the need for better cooperation and collaboration between the different services, especially between child welfare and child and adolescent mental health service.

Key references

Goodman, R., Ford, T., Corbin, T., & Meltzer, H. (2004). Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. European Child & Adolescent Psychiatry, 13, 25-31.

Iversen, A. C., Jakobsen, R., Havik, T., Hysing, M., & Stormark, K. M. (2007). Mental health problems among child welfare clients living at home. Child Care in Practice, 13(4), 387-399.

Statistics Norway. (2003). Social assistance, child welfare statistics and family counselling services 2001. [Electronic Version] from http://www.ssb.no/emner03 /04/30/nos_sosialhjelp/nos_d250/nos_d250.pdf.

SDQ, http://www.sdqinfo.com/.

Contacts: Anette Christine Iversen, Child Protection Research Unit, Unifob Health, University of Bergen, Norway, Christiesgate13, 5015 Bergen, Norway, E-mail: Anette.Iversen@bus.uib.no, Phone+4755589894.



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