Mental Health and Child Welfare

For additional information, visit our Psychotropic and Prescription Medications webpage.

The following Hot Topics pages may also be of interest:

Guides Resources

Also see information about traumatic stress on our Disaster Relief and Emergency Preparedness page.

  • A Need to Know: Enhancing Adoption Competence Among Mental Health Professionals
    Published by the Donaldson Adoption Institute, this research-based report recommends that mental health professionals receive more and better training on adoption-related issues.  The report highlights that one of the most frequent issues of members of adoptive and birth/first families is an inability to find psychologists, psychiatrists, social workers and related practitioners who understand the unique, adoption-related issues that can affect their identities, their relationships and other important components of their lives. For a variety of reasons, mental health professionals typically do not receive the training required to fill adoption-related counseling needs and, too often, either do not fully understand why such training is necessary or mistakenly believe the knowledge they already have is sufficient. To address that reality, this report seeks to raise the level of professionals' awareness about the nature and importance of adoption clinical competence, heighten their desire to receive such training, and identify various means by which the relevant knowledge and skills can be obtained. (August 2013)

  • IRISS Insights, no. 21: Understanding Suicide and Self-Harm Amongst Children in Care and Care Leavers
    Self-harm and suicide are complex issues which arouse difficult and distressing emotions both within people who hurt themselves and those who love and care for them. When children hurt or try to kill themselves, adults responsible for them often feel confused, powerless and overwhelmed. If these children are looked after away from their families then all the professionals involved with them must be able to provide them with the understanding and support they require. Examining the research and literature about self-harm and suicide is an essential element in developing understanding. Many important studies reported in this paper are quantitative or have been undertaken from a medical perspective, but in reviewing them it is important to maintain a focus on the pain and emotional complexities for all involved. “Insights” evidence summaries are published by IRISS (Institute for Research and Innovation in Social Services) to support social services in Scotland. IRISS Insights no. 21 was written by Judy Furnivall. (June 2013)

  • The Relationship Between Youth Involvement in Bullying and Suicide
    The Journal of Adolescent Health has developed this online supplement containing nine articles examining the relationship between bullying and suicide among youth. This supplement reports on the findings of an expert panel that the Centers for Disease Control and Prevention convened on the latest research linking youth involvement in bullying—as victims, perpetrators, or both—with suicide-related behaviors. Three of the key findings were: (1) Bullying among youth is a significant public health problem. (2) There is a strong association between bullying and suicide-related behaviors, but this is often mediated by other factors, including depression and delinquency. (3) Public health strategies can be applied to the prevention of bullying and suicide. (July 2013)

  • National Children’s Mental Health Awareness Day 2013 Short Report
    This Substance Abuse and Mental Health Services Administration (SAMHSA) report discusses the prevalence of mental health and other related challenges among children and youth in the juvenile justice and child welfare systems, as well as trauma-informed SAMHSA programs, services, and initiatives that support their recovery and resilience. (May 2013)

  • CMCS Informational Bulletin on Prevention and Early Identification of Mental Health and Substance Use Conditions in Children
    The Medicaid program provides coverage to 27 million children under age 18 in the United States. A core component of this coverage is the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, which ensures that the health care needs of children and youth are addressed to maximize their growth and development. Prevention and early identification of health conditions, which is a key component of EPSDT, promotes positive health outcomes and can reduce health care costs across an individual’s lifespan. The Center for Medicaid and CHIP Services (CMCS) has issued this Informational Bulletin to help inform states about resources available to help them meet the needs of children under EPSDT, specifically with respect to mental health and substance use disorder services. (March 2013)

  • MMWR Supplement: Mental Health Surveillance among Children in the United States, 2005-2011
    The National Center on Birth Defects and Developmental Disabilities (NCBDDD) has developed this comprehensive report on children’s mental health in the United States. The Morbidity and Mortality Weekly Report (MMWR) supplement, Mental Health Surveillance among Children in the United States, 2005-2011, describes federal efforts to monitor childhood mental disorders, and presents estimates of the number of children ages 3 to 17 years who have specific mental disorders. This report is an important step towards better understanding these disorders and the impact they have on children’s mental health. Childhood mental disorders can be treated and managed, and CDC has been working with several Federal agencies to help children reach their full potential in life. CDC developed this report in collaboration with key federal partners – the Substance Abuse and Mental Health Services Administration, the National Institute of Mental Health, and the Health Resources and Services Administration – compiling data from a variety of data sources between the years 2005 and 2011. (2013)

  • Trauma-Informed Care Emerging as Proven Treatment for Children, Adults with Behavioral, Mental Health Problems
    Children who are physically or sexually abused, or who go through other trauma-inducing experiences, can develop mental health disorders and related problems. Indeed, trauma can fundamentally affect how a young person grows and develops. Trauma-informed care is a treatment approach that explicitly acknowledges the role trauma plays in people’s lives. That approach is increasingly being developed and refined as a method of treatment by professionals working in medicine, mental health, education, foster care, juvenile justice, and other areas.
    This brief article from Youth Law News, by Ta Lynn Mitchell, discusses: Exposure to Trauma; Trauma’s Effects; Trauma-Informed Care; Helping Native Youth; and Trauma-Informed Care in California, and Beyond. (2012)

  • Selecting and Working with a Therapist Skilled in Adoption
    Adoption has a lifelong impact on those it touches, and members of adoptive families may want professional help when concerns arise. Timely intervention by a professional skilled in adoption, attachment, and trauma issues often can prevent concerns from becoming more serious problems. This factsheet from the Child Welfare Information Gateway offers information on the different types of therapy and providers available to help, and it offers suggestions on how to find an appropriate therapist. Foster parents also may find definitions and descriptions in this factsheet useful.  (July 2012)

  • Supporting Parents with Mental Health Needs in Systems of Care Issue Brief
    This study of community-based system of care sites was conducted to learn about efforts to assess parents’ mental health needs, effectively engage and support them, and improve system coordination and access to services. This issue brief is intended to inform system reform in child welfare and mental health, as well the child and adult service systems. This project was conducted for the Technical Assistance Partnership for Child and Family Mental Health by Dr. Barbara Friesen, Portland State University, with the support of Dr. Joanne Nicholson, University of Massachusetts, and Ms. Judith Katz-Leavy, former policy advisor for Children’s Mental Health, Center for Mental Health Services.  The study was possible with support from the Children’s Bureau and the Child, Adolescent, and Family Branch of the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration through an interagency agreement. (2011)
  • Effects of Separation and Loss on Children's Development
    This brief reviews the short-term and long-term impact of separation from or loss of parents due to death, divorce, incarceration, or removal to foster care on children's psychological development. Sections describe the short-term effects for children experiencing separation and loss during their first year, during the toddler years of 1-3, during the preschool years of 3-6, during the grade school years, and during adolescence. Strategies for minimizing the effects of the loss are discussed for each age group, along with possible long-range effects of the loss.

  • Mental Health in Child Welfare
    From the previous National Child Welfare Resource Center for Family-Centered Practice, two issues of Best Practice/Next Practice discuss disorders diagnosed in childhood, foster families as partners in treatment, guidelines for foster families, services and supports, creating effective systems of care, supporting parents with mental illness, racial disparities in use of services, caregivers, workers and supervisors. Summer 2003 and Winter 2004

  • Helping Those Who Need It Most: Meeting the Mental Health Care Needs of Youth in the Foster Care and Juvenile Justice Systems
    Young people who are transitioning out of the foster care and juvenile justice systems often have serious mental health needs. They can have many strikes against them: families with histories of violence, mental illness, incarceration and/or substance abuse; learning disabilities or neurological conditions; and histories of abuse, neglect or trauma. Some have been driven into the juvenile justice system, or onto the streets, because of undiagnosed or inadequately treated psychiatric problems. These hard lives can result in mental health needs that the foster care and juvenile justice systems struggle to address, with limited success. Why do efforts to provide mental health services to these young people so often fall short? What can be done to improve the system? This report explores these questions and proposes some answers from young people who have experienced the system from the inside, and from practitioners who work with them.

  • The Impact of Traumatic Stress and Alcohol Exposure on Youth: Implications for Lawyers, Judges, and Courts
    This paper from the Michigan Child Welfare Law Journal explains the impact of traumatic events on a child's development and the number of children involved in the child welfare system that have been exposed to trauma and alcohol abuse. It explores the practical implications for representing clients in child welfare and juvenile justice cases given the impact of childhood trauma on children's functioning. Strategies are discussed for communicating with and counseling youth with receptive language deficits or who have developed inhibitions that have a negative impact on communication, as well as strategies attorneys should use for investigating a child's history of trauma, addressing system trauma, and for assessment and pre-trial motions.

  • Early Childhood Mental Health Consultation
    This monograph from the National Clearinghouse for Alcohol and Drug Information addresses young children's mental health by providing a blueprint for child care providers to use when hiring a mental health consultant.

  • The Mental Health of Adolescents: A National Profile, 2008
    This brief from the National Adolescent Health Information Center at the University of California, San Francisco, with support from the Maternal and Child Health Bureau, highlights existing national data about adolescent mental health status, assesses shortcomings of current data, and offers recommendations to address these shortcomings.

  • Caring for their Children's Children: Assessing the Mental Health Needs and Service Experiences of Grandparent Caregiver Families
    This report from Chapin Hall reveals that absent parents play an ongoing and under-recognized role in the well-being of grandparents and grandchildren, regardless of whether they are a consistent, sporadic, or rare presence in the home. With respect to mental health needs, one-third of grandparents reported symptoms of depression themselves, and two-thirds were caring for grandchildren whom they identified as having emotional or behavioral problems. However, half of the families had no involvement with a child welfare agency, and fewer than a third of the grandchildren and only a handful of the grandmothers were currently receiving mental health services. The unmet mental health needs of both grandparents and their grandchildren are discussed as well as the implications of these findings for practitioners and advocates interested in meeting the service needs of grandparent-caregiver families.

  • Child Trauma and Resource Families
    Information about trauma, post-traumatic stress, and resources for coping with terrorism.

  • Posttraumatic Stress Disorder
    The June 2005 issue of Practice Notes, from the North Carolina Division of Social Services and the Family and Children's Resource Program, focuses on posttraumatic stress disorder in children, and particularly children in the child welfare system.

  • Mental Health Assessments for Infants and Toddlers
    This paper from Child Law Practice defines mental health in infants and young children as the capacity of the child from birth to three to experience, regulate and express emotions; form close and secure interpersonal relationships; and explore the environment and learn. It discusses the goals of infant mental health assessments, kinds of cases in which such assessments are useful, and who should conduct the assessments. Qualifications of evaluators are described and include infant mental health training, experience with infants/toddlers, and skill in evaluating and diagnosing young children. Components of infant mental health assessments are then explained, as well as the tools that are typically used during the assessment, the types of information that assessments can offer the court and advocates, and pitfalls and challenges in conducting infant mental health assessments. A list of warning signs that may indicate mental health problems in infants is provided.

  • Youngsters' Mental Health And Psychosocial Problems: What Are the Data?
    This report from UCLA's Center for Mental Health in Schools details and evaluates the existing data from research on the prevalence and incidence of these problems and defines the research in this area that remains to be done. Includes some interesting data about children in foster care and kinship care including the information that preschoolers receiving mental health services were almost twice as likely as older children to be living with kin caregivers or foster parents – “a finding which means that caretakers who are not parents may need supportive services to ensure timely and appropriate help for the children in their care.”

  • Factors Influencing the Placement of Children Solely to Obtain Mental Health Services
    In this 2003 report from the General Accounting Office (GAO-03-865T), it is estimated that in fiscal year 2001, parents placed over 12,700 children in child welfare or juvenile justice systems so they could receive mental health services. Many are adolescents with multiple problems and behaviors that threaten the safety of themselves or others. Agencies say that reducing costs, improving access, and expanding the range of mental health services for teens could help reduce the need for some child welfare or juvenile justice placements.

  • Update: Latest Findings in Children's Mental Health, Vol. 2, No. 1
    According to findings of a 1997 survey conducted by the U.S. Center for Mental Health Services (CMHS), many teenagers with severe and complex emotional disturbances are found in residential care programs rather than psychiatric hospitals. Often, these are "system kids" who are shuttled in and out of temporary placements in various child-serving agencies. This publication is the result of a collaboration among Rutgers University, the U.S. Department of Health & Human Services, and the Annie E. Casey Foundation.

  • Evidence-Based Practices in Mental Health Services for Foster Youth
    This report is a component of the California Institute for Mental Health Caring for Foster Youth initiative that has been funded and supported by the Zellerbach Family Fund. The project has focused on the promotion of mental health assessments and services for children in foster care throughout California, and has created two screening tools designed to support child and family service systems in these efforts. This report discusses some of the common myths and misperceptions about the mental health needs and best treatment options for children in foster care, and gives recommendations for improving the delivery of mental health services.

  • The Effect of Lifetime Victimization on the Mental Health of Children and Adolescents
    This paper examines the cumulative prevalence of victimization and its impact on mental health in a nationally representative sample of 2030 children aged 2-17 in the USA. Sexual assault, child maltreatment, witnessing family violence, and other major violence exposure each made independent contributions to levels of both depression and anger/aggression. Other non-victimization adversities also showed substantial independent effects, while in most cases, each victimization domain remained a significant predictor of mental health. Results suggest that cumulative exposure to multiple forms of victimization over a child's life-course represents a substantial source of mental health risk.

  • The Mental Health and Wellbeing of Children and Adolescents in Home-based Foster Care
    This research describes the nature and prevalence of mental health problems in children and adolescents living in home-based foster care in the Adelaide (Australia) metropolitan region. The authors found that children in home-based foster care experience high rates of mental health problems but only a minority receive professional help for their problems.

  • Making Reform Real: Addressing the Mental Health Needs of Children in the Dependency System
    In May 2006, the Children's Law Center of Los Angeles brought together mental health clinicians, social workers, foster parents, relative caregivers, advocates, community leaders, and youth to identify and develop concrete, workable solutions regarding the timely and appropriate provision of mental health services for children and youth in the child welfare system. This report summarizes the discussion and recommendations of the Summit participants in regard to the ten critical areas that were the topics of discussion at the Summit breakout sessions.

  • Youth Empowerment and Participation in Mental Health Care
    The Summer 2009 issue of Focal Point highlights a number of successful and innovative efforts to promote youth voice and youth empowerment. Many of the articles are authored by or include contributions from youth who are directly involved in the featured programs. Focal Point is produced by the Research and Training Center (RTC) on Family Support and Children’s Mental Health in Portland, Oregon.

  • Mental Health Needs of Foster Children and Children At-Risk for Removal
    This article from the Virginia Child Protection Newsletter focuses on the mental health needs of children entering foster care and children at risk of entering care. The article explores the range of mental health needs and ways to address those needs using evidence-based practices. The article discusses ways to work with children as well as methods for parent and foster parent training. (2009)

  • Hit on All Fronts: Parenting with Mental Illness
    Parents with mental illness face extraordinary obstacles to reuniting with children placed in foster care. Challenges include: Some State laws give parents with mental illness less time to reunify; few family supports are designed to help these parents; and, biases and misconceptions about mental illness can make reunification more difficult. In this issue of Rise Magazine, parents write about how they have struggled to overcome these obstacles and safely raise their children at home. Rise magazine is written by and for parents involved in the child welfare system. Its mission is to help parents advocate for themselves and their children. (Summer 2010)
  • Mental Health and Child Welfare Resources
    This NRCPFC resource handout provides a listing of resources on the topic of mental health and child welfare, including a description of each resource and a website address where it can be accessed online. (2010)

  • Meeting the Health Care Needs of Children in the Foster Care System
    In October of 2002, the Georgetown University Child Development Center completed a three-year study to identify and describe promising approaches for meeting the health care needs of children in the foster care system. In this study, the term health care encompassed physical, mental, emotional, developmental and dental health. The study was funded by the federal Maternal and Child Health Bureau, and supported in part by the Children's Bureau, Administration for Children and Families. In response to a national search for promising approaches, the study collected information on over 100 different approaches.

  • Being S.A.D.: Seasonal Affective Disorder
    In this YCteen article, Troy Shawn Welcome writes that, like many people, he feels a little depressed and disoriented during the winter months. It’s called Seasonal Affective Disorder, and he explains its symptoms and ways to deal with it.


  • Mental Health Service Utilization and Outcomes for Children and Youth in the Child Welfare System
    This empirically-based curriculum from the California Social Work Education Center focuses on a number of issues related to mental health service utilization and outcomes among children in the child welfare system. It focuses on five areas: (a) demographic and system-related characteristics of children involved in both the child welfare and mental health systems; (b) clinical need for services, service utilization patterns, and association between mental health service utilization and child welfare outcomes; (c) policies affecting mental health service utilization by children in the child welfare system; (d) collaboration between child welfare and mental health systems; and (e) resources for collaboration and service provision for children and youth in both the child welfare and mental health systems.

  • Helping Child Welfare Workers Support Families with Substance Use, Mental, and Co-Occurring Disorders: A Training Package for Child Welfare Workers
    This free online training toolkit from the National Center on Substance Abuse and Child Welfare is intended to provide learning opportunities and baseline knowledge on substance abuse and mental health problems and interventions; motivate and facilitate cross-systems work; and incorporate cultural awareness and facilitate cultural competency in child welfare practice. The toolkit covers six modules and provides a range of training materials that were developed to be adapted to meet the needs of child welfare trainers for in-person workshops and/or training sessions.


NRCPFC Information Packets

  • Emotional Well-Being of Children & Youth in Foster Care
    On September 20, 2005, the NRCPFC and CWLA hosted the first of a series of teleconferences for state foster care and adoption managers on mental health issues. To listen to the audio files and download the handouts, visit our archived teleconferences page.

  • Strategies for Meeting the Mental Health Needs of Youth in Care
    The second teleconference in the NRCPFC/CWLA series was held November 29, 2005. To listen to the audio files and download the handouts, visit our archived teleconferences page.

  • Promising Practices for Addressing the Mental Health Issues Impacting Parents of Children in Foster Care The third teleconference in the NRCPFC/CWLA series was held January 31, 2006. To listen to the audio files and download the handouts, visit our archived teleconferences page.


    Developed by the National Association of Broadcasters (NAB) and featured on, OK2TALK is a new campaign that aims to encourage young people struggling with mental health challenges to talk about their experiences, without fear of stigma, and to create opportunities for open conversations in schools, in the workplace, and among families about mental health.  The campaign includes TV and radio PSAs and an online community where youth can share their story by submitting creative content.

  • UCLA Center for Healthier Children, Families & Communities
    The UCLA Center for Healthier Children, Families and Communities has produced a number of materials, including several policy briefs, on health and mental health services for children in foster care.

  • Center for Health Care Strategies, Inc.
    CHCS is working with states, health plans, and community organizations to improve the physical and behavioral health outcomes for these children by increasing coordination of care, implementing electronic medical records, and identifying best practices in behavioral health pharmacy management.

  • Caring for Children in Child Welfare
    Children served in the child welfare system (CWS) are at greater risk of having psychological, social and developmental problems than children in the general population. However, little is known about which types of children in the CWS receive services and how services are delivered. This study will examine the mental health services received by children in the CWS, and the impact of placement types and changes over time within the context of state and regional policies regarding the use, organization and financing of mental health services. The website includes copies of the CCCW newsletter, a list of journal publications, and information about the progress of the study.

  • Centre of Knowledge on Health Child Development
    This Canadian web site is dedicated to providing the latest and best information on child mental health problems and the influences that shape the developmental health and well-being of children and youth.

  • Research and Training Center for Pathways to Positive Futures
    The RTC for Pathways to Positive Futures aims to improve the lives of youth and young adults with serious mental health conditions through rigorous research and effective training and dissemination. SPEAK OUT! is a monthly feature on the Pathways website. Each month a question relevant to transition-aged youth and young adults is answered by two members of their team of young writers. Discussion is encouraged.

  • StrengthsofUs
    StrengthofUs is a user-driven online social networking community developed by young adults and launched by The National Alliance on Mental Illness. Through this website, young adults living with mental health concerns can provide mutual support in navigating unique challenges and opportunities during the critical transition years from ages 18 to 25.  Members can connect with peers for support, encouragement, and advice; share personal stories, creativity, and helpful resources; write and respond to blog entries; engage in discussion groups; and share videos, photos, and other news.

  • Parental Mental Health and the Child Welfare System
    Research indicates that children with parents/caregivers with significant mental health needs are at greater risk of involvement in the child welfare system. The resources available on this new webpage of the child welfare section of the Technical Assistance Partnership for Child and Family Mental Health website describe promising practices for screening and treatment, and provide tools and training, fact sheets, links to websites, and research to better understand how mental health and child welfare systems can work together to support parents and caregivers with mental health needs.


Last updated 1/30/14