Mental Health and Substance Use Problems of Parents Involved With Child Welfare: Are Services Offered and Provided?

Objectives: This study examined service delivery to parental caregivers with mental health problems, substance use problems, or both. The study sought to determine whether, once need is identified, suitable services are offered and then provided. Methods: The study was a secondary analysis of the 1994 National Study of Protective, Preventive, and Reuni- fication Services Delivered to Children and Their Families. The national study interviewed child welfare caseworkers about the problems of and services provided to 2,109 families. Results: Of parents with mental prob- lems, 77.9% were offered services and 84.0% of those were provided services. Of parents with substance use problems, 65.7% were offered treatment and 67.5% of those were provided it. Other problems included lack of parenting skills, lack of education and job skills, parent-child con- flict, and lack of income. Significant associations were found between caseworkers’ identifying problems and offering relevant services. Care- givers with substance use problems were less likely to be offered sub- stance treatment services than caregivers with both mental health and substance use problems. Conclusions: The child welfare system may fa- cilitate service use for caregivers. More research is needed to understand the process of service delivery to caregivers, including why services are not offered to some caregivers and why some services are not provided after being offered. Future research should examine why caregivers with substance use problems are vulnerable to not receiving treatment and whether and how service use varies for other problems not examined in this study. (Psychiatric Services 60:56–60, 2009)