Plano EVA-TO: plano de enfrentamento à violência autoprovocada do Estado do Tocantins com ênfase na atenção integral à saúde / EVA-TO Plan: plan to face self-inflicted violence in the State of Tocantins with an emphasis on comprehensive health care

O Plano de Enfrentamento à Violência Autoprovocada do Estado do Tocantins com Ênfase na Atenção Integral à Saúde foi desenvolvido para fortalecer a rede de atenção psicossocial, em colaboração com o Sistema Único de Saúde (SUS) e o Sistema Único de Assistência Social (SUAS). Elaborado pelo Grupo de Trabalho "Flor de Pequi", o plano tem como objetivo qualificar a Rede de Atenção à Saúde, orientando gestores e profissionais de saúde na prevenção da violência autoprovocada, automutilação e suicídio, além de promover o acolhimento e compartilhamento do cuidado na rede de atenção à saúde. O documento foi elaborado em resposta a demandas relacionadas aos dados de violência autoprovocada, solicitações do Conselho Estadual de Defesa de Direitos da Criança e do Adolescente e do Conselho Regional de Psicologia. A metodologia, discussão, metas, ações e monitoramento também são abordados no plano.

The Plan for Confronting Self-Inflicted Violence in the State of Tocantins with an Emphasis on Comprehensive Health Care was developed to strengthen the psychosocial care network in collaboration with the Unified Health System (SUS) and the Unified Social Assistance System (SUAS). Elaborated by the "Flor de Pequi" Working Group, the plan aims to enhance the Health Care Network by providing guidance to managers and health professionals in the prevention of self-inflicted violence, self-harm, and suicide, while promoting care and support within the health care system. The document was created in response to demands related to self-inflicted violence data, requests from the State Council for the Defense of the Rights of Children and Adolescents, and the Regional Psychology Council. The plan also addresses methodology, discussion, goals, actions, and monitoring.

El Plan de Enfrentamiento a la Violencia Autoinfligida en el Estado de Tocantins con Énfasis en la Atención Integral de Salud fue desarrollado para fortalecer la red de atención psicosocial en colaboración con el Sistema Único de Salud (SUS) y el Sistema Único de Asistencia Social (SUAS). Elaborado por el Grupo de Trabajo "Flor de Pequi", el plan tiene como objetivo calificar la Red de Atención a la Salud, brindando orientación a los gestores y profesionales de la salud en la prevención de la violencia autoinfligida, la automutilación y el suicidio, además de promover el cuidado y apoyo dentro de la red de atención sanitaria. El documento fue elaborado en respuesta a demandas relacionadas con datos de violencia autoinfligida, solicitudes del Consejo Estatal para la Defensa de los Derechos de la Niñez y la Adolescencia y del Consejo Regional de Psicología. El plan también aborda la metodología, la discusión, las metas, las acciones y el monitoreo

Minding the complexities of psychotropic medication management for children and youth in the foster care system: Paper 1: The facilitators and barriers to learning about trauma-informed medication management.

The phenomenon of inappropriate polypharmacy among the foster care population arises in part due to the challenges related to integrating trauma-informed principles into service delivery. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate, including foster and biological parents, social service agencies, and advocates. Yet, there is limited research about trauma-informed psychotropic medication management interventions for child welfare staff. This pilot study was conducted to evaluate a trauma-informed psychotropic medication management intervention and is reported in two manuscripts, pertaining respectively to the facilitators and barriers to learning, and perceived individual and institutional trauma responsiveness. The intervention comprised of a 2-hour-long training session for child welfare staff and a 3-month web-based curriculum for leadership personnel, aiming to increase their understanding of trauma-informed psychotropic medication management. In the first paper, we report on the facilitators and barriers to learning, grouped into three categories: teacher attributes, learner attributes, and situational factors. In the second paper, in addition to trauma responsiveness ratings, we also provide a detailed account of one participant's life experience and perceptions of the intervention provided, as an exemplar of the psychosocial facets of resilience. The ABC Medication Scale scores that measured staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms showed a significant change in scores following training. Based on these findings, we provide practical solutions to address situational factors that are worth considering when providing training for child welfare staff. PAPER 1 ABSTRACT: THE FACILITATORS AND BARRIERS TO LEARNING ABOUT TRAUMA-INFORMED MEDICATION MANAGEMENT: Given that foster care children experience many challenges that threaten their well-being, their physical and mental health needs tend to be greater than those of their peers who are not in foster care. However, owing to the transient nature of the foster care placements, as well as continuous changes in medical providers and counselors, the screenings, supportive interventions, and treatments they receive may be fragmented. This is particularly problematic when considering that many of these children are medicated as a means of managing their behavior. Moreover, children in foster care are also more vulnerable to having the medications and diagnoses accumulate due to frequent placement changes and lack of treatment continuity. Our research was guided by the question "What are the facilitators and barriers to learning about trauma-informed psychotropic medication management?" We developed an intervention to address the issue of inappropriate polypharmacy and examined the facilitators and barriers to learning using a mixed methods design. The facilitators to learning were instructor-specific (e.g., reputation, teaching style, capacity for selecting and implementing relevant resources), learner-specific (altruism, capacity to see personal relevance in the learning situation, desire for knowledge/competence, career advancement/recognition-seeking), and situational (immediacy/on-demand resources, reinforcement of pleasant learning experience). Barriers were largely situational (workload and family demands). Based on these findings, we provide practical strategies for addressing situational factors that are worth considering when designing training curricula aimed at child welfare staff.

Minding the complexities of psychotropic medication management for children and youth in the foster care system: Paper 2: Levels of trauma responsiveness among child welfare staff.

BACKGROUND: Foster care children tend to have greater physical and mental health needs compared to those of their peers who are not in foster care due to many challenges that threaten their well-being. Yet, owing to frequent placement changes, their treatment may be fragmented. Moreover, if foster children are unable to provide important information about their own health status, and the same cannot be obtained from their families of origin, the resulting incomplete and/or inconsistent health history puts them at risk for unrecognized problems and conflicting diagnoses. Paradoxically, foster parents and resource providers often request psychotropic medications for children and youth in their care as a means of managing their behaviors. The phenomenon of inappropriate polypharmacy arises due in part to the difficulties related to integrating trauma-informed principles into the care process. It is further exacerbated by the complexity of intersecting systems in which child welfare case workers need to communicate including foster and biological parents, social service agencies, and advocates. In this second paper, we report on the same intervention as that discussed in the first paper, focusing on the effectiveness of the live 2-hour face-to-face training for child welfare staff and the 3-month web-based curriculum for leadership personnel in improving the participants' trauma responsiveness. RESEARCH QUESTIONS: 1. What are the child welfare staff's perceptions of their own knowledge, attitudes, and communication behaviors associated with medications used to treat mental health symptoms and monitoring for side-effects of psychotropic medication use in children? 2. What is the level of trauma responsiveness among child welfare staff? METHODOLOGY AND PARTICIPANTS: The ABC Medication Scale was employed to measure staff knowledge, attitudes, and behaviors associated with medications used to treat mental health symptoms before and after the intervention to determine if the training resulted in any improvements. Individual- and organizational-level trauma responsiveness was rated on a continuum of the Missouri Model: A Developmental Framework for Trauma-Informed Approaches. Artifacts of the web-based curriculum and qualitative interview data were analyzed by applying grounded theory methods. FINDINGS/RESULTS: There was a significant increase in The ABC Medication Scale scores following the training. The qualitative findings further revealed that majority of the participants rated themselves as "trauma aware" or "trauma responsive" on the Missouri Model, while indicating that their agencies could work harder to become more fully trauma-informed. As trauma-informed child welfare workforce that understands the complexity and advocacy requirements of psychotropic medication management is needed, further longitudinal research is required is to assess the training effects over time. In particular, the aim should be to establish (a) how knowledge and attitude shifts correlate with greater degrees of trauma responsiveness, and (b) if and how such trainings translate into improved systems of support.

Trauma Exposure and Mental Health Needs Among Adolescents Involved With the Juvenile Justice System.

Justice-involved adolescents typically report high levels of lifetime trauma exposure, although research on juvenile justice system-wide screenings is limited. Further, there is little evidence from research on the psychological and substance abuse treatment related needs of youth relative to the trauma levels or types of trauma experienced by justice-involved adolescents. We documented lifetime exposure to traumatic events and its relation to psychological and substance use concerns in a sample of adolescents admitted to custody in the New Jersey Juvenile Justice Commission. This study examined lifetime exposure to traumatic events experienced by justice-involved adolescents (N = 627) using negative binomial regression modeling and zero-inflated negative binomial regression modeling to identify which adolescents have the greatest trauma exposure, and determine how cumulative types of trauma relate to youths' mental health and substance use needs. Adolescents reported experiencing an average of 4 of 17 traumatic exposures on the Life Events Checklist. The most common traumas experienced directly and indirectly were physical assault and assault with a weapon. Considering particular traumas, there were differences in exposures based on race and ethnicity, sex, child welfare involvement, and gang affiliation. Higher levels of some types of traumatic exposure were consistently related to higher levels of mental health needs. Results indicate that adolescents enter the juvenile justice system with high levels of polytraumatization. These adverse events are associated with elevated mental health and substance use needs that should be considered in case planning.

Experiencias comunitarias, crianzas compartidas y políticas de cuidado / Experiências comunitárias, políticas compartilhadas de pais e cuidados / Community experiences, shared upbringing and care policies

RESUMEN En el presente artículo, escrito en el contexto de la pandemia 2020-2021 y en el marco del cumplimento del Aislamiento Social Preventivo y Obligatorio (ASPO), analizamos dos experiencias comunitarias vinculadas al cuidado de las infancias y adolescencias que se desarrollan en las provincias de Neuquén y Río Negro (Patagonia Argentina). Dicho análisis es resultado de una investigación cualitativa realizada desde la perspectiva de la Psicología Social Crítica y las Políticas Públicas en la que buscamos recuperar los saberes sociales que estas iniciativas comunitarias pueden aportar al diseño y reformulación de las políticas públicas de cuidado. Específicamente, las experiencias que aquí presentamos son: la Asociación Civil GAIA-Nueva Crianza, conformada por familias de niñes y adolescentes trans; y la Asociación Civil Lazos Azules, integrada por familias de niños y adolescentes con TEA (Trastorno del Espectro Autista). Si bien las dos asociaciones son muy diferentes entre sí, ambas coinciden en estar protagonizadas por familias que, a partir de haber escuchado y prestado atención a las necesidades de sus hijo/a/es, se organizaron colectivamente para visibilizar la realidad de sus niño/a/es y adolescentes generando distintas acciones. Dichas acciones tienden no sólo a hacer efectivos los derechos de las infancias y adolescencias, especialmente aquellos vinculados a la identidad, la educación y la salud, sino que están orientadas a incidir en las políticas públicas de cuidado a nivel local desde lo que Boaventura de Sousa Santos denomina la sociología de las emergencias y desde lo que Rita Segato designa como una politicidad en clave femenina anfibia.

RESUMO. Neste artigo, escrito no contexto da pandemia 2020-2021 e no quadro do cumprimento do Isolamento Social Preventivo e Obrigatório (ASPO), analisamos duas experiências comunitárias relacionadas com o cuidado de crianças e adolescentes que ocorrem nas províncias de Neuquén e Río Negro (Patagônia Argentina). Esta análise é resultado de uma pesquisa qualitativa realizada na perspectiva da Psicologia Social Crítica e das Políticas Públicas, na qual buscamos resgatar o conhecimento social de que essas iniciativas comunitárias podem contribuir para o desenho e reformulação das políticas públicas de atenção. Especificamente, as experiências que aqui apresentamos são: a Associação Civil GAIA-Nueva Crianza, formada por famílias de crianças e adolescentes trans; e a Associação Civil Lazos Azules, formada por famílias de crianças e adolescentes com TEA (Transtorno do Espectro do Autismo). Embora as duas associações sejam muito diferentes entre si, ambas coincidem no fato de serem lideradas por famílias que, depois de ouvir e atentar para as necessidades dos filhos, se organizam coletivamente para tornar visível a realidade dos filhos. a / es e adolescentes gerando diferentes ações. Essas ações tendem não só a efetivar os direitos da criança e do adolescente, especialmente aqueles vinculados à identidade, educação e saúde, mas visam influenciar as políticas públicas de atenção em nível local a partir do que Boaventura de Sousa Santos denomina a sociologia das emergências e do que Rita Segato designa como feminilidade anfíbia chave de politicidade.

ABSTRACT In this article, written in the context of the 2020-2021 pandemic and in compliance with the Preventive and Compulsory Social Isolation (ASPO), we analyze two community experiences related to the care of children and adolescents that take place in the provinces of Neuquén and Río Negro (Argentinian Patagonia). This analysis is the result of a qualitative study carried out from the perspective of Critical Social Psychology and Public Policy, in which we seek to recover the social knowledge that these community initiatives can contribute to the design and reformulation of public care policies. Specifically, the experiences we present here are the GAIA-Nueva Crianza Civil Association, made up of families of trans children and adolescents; and the Lazos Azules civil association, made up of families of children and adolescents with ASD (autism spectrum disorder). Although the two associations are very different from each other, they both coincide in being led by families who, after having listened and paid attention to the needs of their children, they organized collectively to make visible the reality of their children and adolescents by generating different actions. These actions tend not only to make effective the rights of children and adolescents, especially those linked to identity, education and health, but are also aimed at influencing public care policies at the local level, from what Boaventura de Sousa Santos calls the sociology of emergencies and from what Rita Segato designates amphibious feminine key politicity.

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.

Understanding trauma experiences and needs through a comprehensive assessment of transition age youth in child welfare.

BACKGROUND: In the context of child welfare, Transition Age Youth (TAY) have high rates of trauma experiences (TEs) and are more likely to exhibit negative outcomes as they transition into adulthood. OBJECTIVE: This study describes the frequency and distribution of TEs among TAY in child welfare, as a whole and across sex and race/ethnicity. This study also examines the relationship between TEs and Child and Adolescent Needs and Strengths (CANS) needs. PARTICIPANTS AND SETTING: Participants included 3324 TAY (14.5 to 21-year-olds) who were under the care of the Illinois Department of Child and Family Services (IDCFS) and in out-of-home care for at least one year. METHODS: The CANS was the primary measure for this study. Administrative and clinical data were examined for youth who met the identified criteria. Pearson's chi-square tests of association were conducted to determine differences in TEs across race/ethnicity and sex. Negative binomial regressions were used to determine the association between TEs and needs. RESULTS: Most TAY had at least one TE (91%) and the majority had four or more TEs (52%). Significant differences occurred in relation to sex and race/ethnicity. Furthermore, TEs were significantly associated with needs across all CANS domains examined (e.g., behavioral/emotional needs, life domain functioning). CONCLUSIONS: This is one of the few empirical studies to examine TEs and related functional, behavioral, and emotional needs of TAY in child welfare. Overall, findings suggest a need for improving trauma-informed approaches and interventions that serve TAY.

Who Is Caring for Health Care Workers' Families Amid COVID-19?

Amid the COVID-19 pandemic, women in medicine, including faculty, residents, medical students, and other health care workers (HCWs), are facing unparalleled challenges. The burdens of pandemic-associated increases in domestic and caregiving responsibilities, professional demands, health risks associated with contracting COVID-19, and the resulting psychosocial distress have exacerbated existing gender disparities at home, at work, and in academia. School and day care closures have created additional childcare needs, primarily for women, yet little support exists for parents and families. These increased childcare and domestic responsibilities have forced women HCWs, who make up the overwhelming majority of the workforce, to adapt their schedules and, in some cases, leave their jobs entirely. In this article, the authors detail how COVID-19 has exacerbated existing childcare accessibility and affordability issues as well as gender disparities. They argue that unless government and health care organization support for childcare increases, families, specifically women and children, will continue to suffer. Lack of access to affordable childcare can prevent HCWs from doing their jobs, including conducting and publishing academic scholarship. This poses incalculable risks to families, science, and society. COVID-19 should serve as a call to action to all sectors, including the government and health care organizations, to prioritize childcare provision and increase support for women HCWs, both now during the pandemic and going forward.

Depoimento especial a partir de opiniões de psicólogos brasileiros atuantes nessa prática / Views of brazilian psychologists on children's testimony / Testimonio especial a partir de las opiniones de psicólogos brasileños que actúan en esta práctica

O Depoimento Especial (DE) é uma prática de oitiva de crianças e adolescentes no âmbito judiciário, normalmente acompanhado por psicólogos. Objetivou-se conhecer opiniões de psicólogos brasileiros que atuavam no DE sobre essa prática. Foi realizada uma pesquisa qualitativa exploratória transversal on-line, por meio de ferramentas digitais (e.g., Skype, Whatsapp). Dez psicólogos brasileiros, de seis diferentes estados, atuantes no DE, responderam a uma ficha de dados sociodemográficos e a uma entrevista semiestruturada. As entrevistas foram estudadas a partir da análise temática. Evidenciaram-se seis temas, sendo eles: papel profissional, trabalho interdisciplinar, sentimentos, agilidade, proteção e legislação. Tomados em conjunto, esses temas indicam o DE como ágil e protetivo para as crianças e adolescentes vítimas de violência sexual, salientando possíveis desafios à sua efetivação. Os resultados obtidos possibilitam maior conhecimento sobre a prática do DE e podem ser utilizados em futuras revisões dessa prática. (AU)

Special Testimony is a method of judicial hearing of children and adolescents in Brazil, usually accompanied by psychologists. The objective of the present study was to know the opinions of Brazilian psychologists who work with children's testimony about this practice. A cross-sectional exploratory qualitative research was conducted using digital tools such as Skype and Whatsapp. A total of 10 Brazilian psychologists, from six different states, working with Special Testimony completed a socio-demographic questionnaire and a semi-structured interview. The interviews were analyzed according to the Thematic Analysis. Six themes were highlighted: professional role, interdisciplinary work, feelings, swiftness, protection, and legislation. Taken together, these themes indicate that the Special Testimony is swift and protective for children and adolescents victims of sexual violence, highlighting possible challenges to its implementation. The results obtained provided more knowledge about the Special Testimony and can be used in future revisions of this practice. (AU)

El Testimonio Especial (DE) es una práctica de escucha de niños y adolescentes en el ámbito judicial, generalmente, acompañados por psicólogos. La finalidad fue conocer las opiniones de psicólogos brasileños, que trabajan con el Testimonio Especial sobre esta práctica. Se realizó una investigación cualitativa exploratoria transversal en línea utilizando herramientas digitales (e.g., Skype, WhatsApp). Diez psicólogos brasileños actuantes en el DE, provenientes de seis diferentes provincias, respondieron a una ficha de datos sociodemográficos y una entrevista semiestructurada. Las entrevistas se analizaron a partir del análisis temático, destacando seis temas: rol profesional, trabajo interdisciplinario, sentimientos, agilidad, protección y legislación. En conjunto, estos temas apuntaron el DE como ágil y protectivo para los niños y adolescentes víctimas de violencia sexual, evidenciando posibles retos para su implementación. Los resultados obtenidos posibilitan un mayor conocimiento sobre la práctica del Testimonio Especial y pueden ser utilizados en futuras revisiones de esta práctica. (AU)

A Child Development Fund Program, Emotional Development, and Poverty Reduction.

OBJECTIVES: We aim to examine the effects of the Child Development Fund (CDF) program on the long-term psychological, health, social, and financial development of children in poverty. METHODS: The current study was a 4-year follow-up survey study (the follow-up study) of a nonrandomized controlled trial (the first study), conducted in 2019 and 2015, respectively, in Hong Kong. Subjects were 902 young adults who were from families living in poverty and receiving financial assistance from the government and who had completed the first study. Approximately 61% of the subjects (N = 546) completed the current follow-up study. RESULTS: Of the 546 subjects (46% male), 335 (61%; CDF participants) completed the CDF program between 2011 and 2015, and 211 (39%; CDF nonparticipants) were matched controls in the first study. The mean age was 20.64 years (SD = 2.72). After adjustments of covariates, the CDF participants reported fewer behavioral problems, higher levels of study motivation, higher levels of hope, and more positive attitudes toward their future education. The CDF participants also perceived greater social support from significant others and reported greater amounts of money saved every month. After further adjustments, CDF participants showed greater improvements in health-related quality of life related to emotional functioning. A considerable number of families of the CDF participants who were working for a living were no longer reliant on financial assistance from the government. CONCLUSIONS: The positive effects of the CDF program on children in poverty could be sustained throughout adolescence to young adulthood. Findings warrant the promotion of the program to reach more children.

Racial disparities in child welfare in Ontario (Canada) and training on ethnocultural diversity: An innovative mixed-methods study.

BACKGROUND: Despite continuous reports showing the overrepresentation of Black children in the child welfare system in Ontario, Canada's most populous and ethnically diverse province, knowledge in the factors contributing to this issue remain scarce. OBJECTIVE: This study aimed to explore questions relating to caseworker's training on ethnocultural diversity in connection with racial disparities and overrepresentation of Black children in child welfare services. PARTICIPANTS AND SETTINGS: This two-fold mixed-methods study included (1) a qualitative methodology based on four focus groups with child welfare caseworkers from a Children's Aid Society (CAS) in Ontario and community facilitators (N = 24), and (2) an analysis of academic curriculums from all 36 Ontarian colleges and universities offering social work programs. METHODS: We used an innovative and complementary mixed-method design based on grounded theory. RESULTS: Results from categorical content analyses with NVivo revealed that community facilitators perceived a lack of ethnocultural competency amongst CAS caseworkers. Similarly, CAS caseworkers reported inadequate training on ethnocultural diversity during and following their post-secondary education (college or university). Corroborating these findings, results from documentary analyses of Ontarian university and college curriculums in social work revealed that barely one in two programs had a mandatory course on cultural issues. CONCLUSIONS: This study reveals a need for additional efforts to provide adequate training to child welfare caseworkers on ethnocultural diversity, starting with undergraduate training programs, in order to understand and tackle the overrepresentation of Black children in child welfare services. Implications for policy and practice are discussed.

Thirty years of the CRC: Child protection progress, challenges and opportunities.

The CRC has a challenging and ambitious agenda in relation to the protection of children from all forms of violence, particularly the large and increasing numbers of children affected by natural disasters, armed conflict, trafficking, poverty and increasing inequality, displacement and trafficking. In this article, we outline some of the issues in the implementation and understanding of the Convention and highlight three major international developments over the last decade: the adoption of General Comment No 13, the work of the Special Representative of the Secretary General on Violence Against Children, and the adoption of the 2030 Agenda for Sustainable Development by the UN General Assembly in 2005. We also identify four broad domains in which the Convention can and is being used to enhance efforts to ensure the protection of children based on a rights framework - advocacy and litigation, policy design, service delivery and research and monitoring methodology - rather than a welfare-based approach. The key to a rights-based approach in efforts to protect children is a focus on children's right to be involved in decision-making - and in research - that affect their lives.

Differences and disparities over time: Black and White families investigated by Ontario's child welfare system.

BACKGROUND: Black-White disparities in child welfare involvement have been well-documented in the United States, but there is a significant knowledge gap in Ontario about how and when these disparities emerge. OBJECTIVE: This paper compares incidence data on Black and White families investigated by Ontario's child welfare system over a 20-year period. METHODS: Data from the first five cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993-2013) were used to examine trends in child maltreatment investigations involving Black and White families. Incidence rates were calculated. T-tests were conducted to assess statistically significant differences between and within cycles. Population and decision-based enumeration approaches were also used to examine child welfare disparities. RESULTS: The incidence of investigations involving White families almost doubled between 1998 and 2003, but for Black families the incidence increased almost fourfold during the same period. These increases and the difference between Black and White families in 2003 were statistically significant. The results further indicate that Black families experience disparate representation in Ontario's child welfare system over time for most service dispositions. CONCLUSIONS: Several possible explanations are offered for the study's outcome, including changes in risk related to social safety net, the threshold for risk of harm, and bias and racist institutional policies and practices. This study invites policy-makers and child welfare authorities to rethink service delivery in addressing the disparate representation of Black families in the child welfare system.

Preparing the child welfare workforce: Organizational commitment, identity, and desire to stay.

BACKGROUND: Since 1995, Colorado has had a Title IV-E child welfare Stipend Program, most recently involving four universities in partnership with the Colorado Department of Human Services. OBJECTIVE: A ten-year cohort study was conducted to understand program graduates' experiences with organizational commitment, the impact of stipends on child welfare professional identity and desire to remain in the child welfare field. PARTICIPANTS AND METHODS: The mixed methods evaluation involved 245 stipend graduates from 2006 to 2016 from Bachelor of Social Work (BSW) and Master of Social Work (MSW) programs and included an online survey and focus groups. RESULTS: Results indicate stipend graduates remained in the workforce beyond payback periods, felt prepared for the job, appreciated the skills and networks gained from their programs, and expressed gratitude for the financial assistance. Graduates identified workforce factors including peer support, supervisor support, and mobility in the agency as key retention sources for remaining in child welfare.

Professional quality of life and intent to leave the workforce: Gender disparities in child welfare.

BACKGROUND: Efforts to enhance professional quality of life (ProQOL) may prove a promising area for intervention to reducing workforce jettison and maintaining a healthy and resilient workforce necessary for supporting children and families in the child welfare system. OBJECTIVE: The current study aimed to describe the relative contributions of measures of ProQOL to intent on leaving the workforce among child welfare professionals. We also aimed to describe gender differences in ProQOL, intent to leave, and associated correlations among child welfare professionals. Such an investigation is a critical extension of earlier efforts as women constitute a markedly larger proportion of the workforce compared to men and evidence exists pointing to gender disparities in helping professionals' work experiences. PARTICIPANTS AND SETTING: Secondary data were used from a survey of child welfare professionals across five sites. METHODS: Univariate and bivariate statistics, hierarchical linear regression, and associated z-scores and p-values were used to meet the aforementioned aims. RESULTS: Burnout accounted for the greatest variation in intent to leave among all professionals. However, gender disparities were found for all ProQOL measures with the largest difference observed for burnout, an effect more pronounced in males. Compassion satisfaction was significantly higher among females. CONCLUSIONS: Burnout shapes intentions to leave for child welfare professionals; however, the effects of emotional exhaustion and hopelessness are stronger predictors of turnover among male than females in the current sample. Organizational strategies to reduce burnout and future research directions are discussed.

Inequalities in educational outcomes in individuals with childhood experience of out-of-home care: What are driving the differences?

BACKGROUND: Prior research has shown that individuals with experience of out-of-home care (foster family care or residential care) in childhood are educationally disadvantaged compared to their peers. In order to be better equipped to design interventions aimed at improving the educational outcomes of children for whom society has assumed responsibility, this study seeks to further our understanding about which factors that contribute to the educational disparities throughout the life course. METHODS: Using longitudinal data from a cohort of more than 13,000 Swedes, of which around 7% have childhood experience of out-of-home care, Peters-Belson decomposition is utilized to quantify the extent to which the gap in educational achievement in school (age 16) and midlife educational attainment (age 50) captures differences in the prevalence of factors influencing educational outcomes, and differences in the impacts between these factors. RESULTS: We find that the achievement and the attainment gap was around 13% and 9% respectively. These gaps were to a large extent explained by differences in the distribution of predictors. The major explanatory factor for placed children's lower achievement was a lower average cognitive ability. Yet there were some evidence that the rewards of cognitive ability in these children differed across the life course. While the lower returns of cognitive ability suggest that they were underperforming in compulsory school, the higher returns of cognitive ability on midlife attainment indicate that-given previous underperformance-their attainment at age 50 reflects their cognitive capacity more accurately than their achievement at age 16 do. CONCLUSION: The large influence of the unequal distribution of predictors suggests that policy efforts are needed to promote equity in the distribution of factors contributing to educational achievement and attainment. Since cognitive ability was found to be an important contributory factor, such efforts may include promoting cognitive and intellectual development among children in out-of-home care, preferably starting at a young age.

From Child Welfare to Jail: Mediating Effects of Juvenile Justice Placement and Other System Involvement.

This study examines the effects of child welfare, mental health, and drug/alcohol system experiences on jail involvement, as mediated by juvenile justice placement, for Black and White youth/young adults. The sample was comprised of individuals born between 1985 and 1994 with child welfare involvement in an urban Pennsylvania county (N = 37,079) and an out-of-home placement (OOHP) subsample (n = 8,317). Four path models were estimated (two full samples, two subsamples; separate models for Black and White youth). For all models, juvenile justice placement was positively related to jail involvement. For the full samples, out-of-home child welfare placement was associated with an increase in juvenile justice placement. Within the Black placement sample, child welfare placement experiences had complex relationships with juvenile justice placement. Providing drug/alcohol services may be a protective factor for Black youth prior to juvenile justice contact. Articulating these relationships helps identify youth most at risk of justice system involvement and better targets services, especially mental health and drug/alcohol services.

Translating and Implementing Evidence-Based Mental Health Services in Child Welfare.

Children in the child welfare system with mental health difficulties seldom receive evidence-based treatment (EBT) despite the abundance of validated interventions that exist. This manuscript describes two projects aimed at increasing access to EBTs. The first is a completed field trial of an adapted parent-child interaction therapy intervention with foster-parent child dyads. New findings are presented from variable- and person-centered analyses of impact on diverse symptom profiles. The second is an ongoing statewide initiative that is increasing access to multiple EBTs while navigating implementation barriers. Lessons learned for bridging gaps between children's mental health research, services, and policy are discussed.

Providing Health Care to Maltreated Children Receiving Child Welfare Services.

This study sought associations between maltreated children's receipt of needed health care and five other variables or sets of variables: medical need, social structural factors, access to care, demographic factors, and child welfare intervention. Data for this study came from longitudinal records derived for a sample of 1,465 children (extracted from all records in a national data set) for whom maltreatment had been substantiated. Children in the sample had, following substantiation, either remained in the home or been placed in kinship care or other out-of-home setting. Generalized estimating equations were applied to the data. The results supported a negative association between the sample's receipt of needed health care and three factors: general physical health, age, and remaining in the home after substantiation. Data analysis also supported a positive association between receiving needed care and Medicaid receipt, family income of between 100 percent and 200 percent of federal poverty level, family income above 200 percent of federal poverty level, needed health care services included in child welfare case plan, and wave 2 interview. The study's implications for social work practice include the necessity of accurately identifying children's health problems, of addressing health needs in the case plan, and of coordinating meaningfully with health professionals.