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Background/Objectives: Most studies have linked mandatory homeschooling during COVID-19 to mental health harm in parents and children, while a minority have found non-significant or beneficial effects. Past studies have not measured mandatory homeschooling continuously over an extended period; consequently, they could not capture compounding mental health effects, which may explain conflicting results. We asked whether children's cumulative time spent homeschooled during COVID-19 school closure mandates caused compounding harm for parent and child mental health, and whether parent employment, child internet access and educational support from schools (live and pre-recorded online classes, home learning packs) impacted this relationship. We aimed to identify the families at greatest risk of mental health harm during mandatory homeschooling and the educational support that may have mitigated this risk. Methods: Couples completed retrospective, cross-sectional survey questionnaires assessing parent depression, anxiety and stress, child internalizing and externalizing symptoms, and the family's homeschooling experience. Data were analyzed using mediation analysis total effects, ordinary least squares regression and simple slopes analysis. Results: Both parents and children experienced compounding mental health harm during mandatory homeschooling. Live online classes protected parents and children, while home learning packs protected children. Unexpectedly, reliable internet access and the employment of both parents placed children at greater risk. Conclusions: Findings suggest that long-term mandatory homeschooling during COVID-19 placed families at greater risk of mental health harm. To protect family mental health during homeschooling mandates, schools should provide children with evidence-based educational support. [ABSTRACT FROM AUTHOR]

How Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism‐related stress on the well‐being of Black parents and children. Informed by Racism‐Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism‐related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy‐eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi‐structured interview. Meta‐inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism‐related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family‐centered programming that address the racism‐related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change. [ABSTRACT FROM AUTHOR]

Positive family relationships are important for child well-being. However, family relationships are unique for youth in out-of-home child welfare placements because they involve both biological and foster parents. The aim of this study was to test the interactive association between current caregiver involvement and contact with biological parents on youths' externalising symptoms using a sample representative of youth in out-of-home child welfare placements in the United States. Findings supported a significant interaction between current caregiver involvement and the amount of biological parent contact on youths' externalising symptoms, such that there was a more pronounced buffering effect of high caregiver involvement on youth externalising symptoms when there was more frequent youth contact with biological parents. Results can be used to support education initiatives about the importance of visitation for caseworkers and parents, and interventions aimed at promoting positive biological family and foster parent relationships focused on the best interests of the child. [ABSTRACT FROM AUTHOR]

Background: This study assessed the association between cardiovascular disease (CVD), the leading cause of death in the United States, among parents and child mental health. Methods: Our sample included 9076 children aged 6 to 17 years. Data were pooled from the 2016–2018 waves of the National Health Interview Survey. We fitted a logistic regression to obtain the odds ratios in favor of child mental health problems for parental CVD. We also fitted a multinomial logistic regression to obtain the odds in favor of the severity of mental health problems (i.e., minor, definite, and severe). Results: The adjusted odds of facing difficulties for a child of a parent with CVD were 1.64 (95% CI: 1.28–2.11) times that of their peers whose parents did not have CVD. The adjusted relative risk of facing minor and definite difficulties for a child of a parent with CVD were 1.48 (95% CI: 1.13–1.94) and 2.25 (95% CI: 1.47–3.46) times that of their peers of parents without CVD. Conclusions: The results suggest a strong association between child mental health and parental cardiovascular morbidity, demonstrating the need for the development or adaptation of existing public health interventions to facilitate mental health support for children of parents with CVD. [ABSTRACT FROM AUTHOR]

The Strengths and Difficulties Questionnaire (SDQ) is a widely used mental health screening instrument developed in the United Kingdom that measures five proposed factors. U.S. research, however, historically supports a slightly different three-factor solution. The present study reports results using both principal factor analysis (PFA) and confirmatory factor analysis (CFA) on data from multiple waves of an ongoing mental health project in middle school aged children. PFA analyses suggested three, five and six-factor solutions with substantial cross-loadings from items. CFAs showed alternative five and six-factor solutions fit well when items guided by the initial PFA were allowed to cross-load. Neither the original five-factor nor popular three-factor models fit well without allowing cross-loading items. These data suggest that popular SDQ three and five-factor model may have variable fit in certain U.S. populations. [ABSTRACT FROM AUTHOR]

Background: Studies suggest increasing mental health care needs among children but limited capacity to meet those needs, potentially leaving some needs unmet. There are no recent national studies examining the receipt of mental health treatment among children. We sought to identify the correlates of treatment receipt in a nationally representative sample of children in the United States., Methods: We conducted a cross-sectional analysis of the 2019 National Health Interview Survey. Parents reported on their child's sociodemographic characteristics, general health care engagement, mental health using the Strengths and Difficulties Questionnaire, and whether their child received therapy or medication in the prior year. Weighted logistic regressions tested associations among child characteristics and receipt of mental health treatment while controlling for parental report of child mental health symptoms., Results: Among 7168 children surveyed, 1044 (15%) received mental health treatment, equating to over 7 million US children. Hispanic children (adjusted odds ratio [AOR]: 0.46 [95% confidence interval (CI): 0.34-0.62]) and non-Hispanic Black children (AOR: 0.35 [95% CI: 0.23-0.54]) had lower odds of receiving treatment compared to non-Hispanic White children, controlling for mental health symptoms. Children with a well-child visit in the last year (AOR: 2.05 [95% CI: 1.20-3.52]) and whose usual place of care was a doctor's office (AOR 2.10 [95% CI: 1.33-3.34]) had higher odds of treatment receipt., Conclusions: Racially and ethnically minoritized children and those without primary care access have disproportionately low levels of receipt of mental health treatment. Interventions to meet the needs of these groups should be prioritized to reduce mental health disparities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

This study examines the association between parent-reported family economic hardship (FEH) and child mental health conditions. We hypothesized a positive association between parent perceptions of FEH and child mental health conditions that would persist after controlling for underlying demographic and socioeconomic characteristics. Cross-sectional data came from the 2016 and 2017 National Surveys of Children's Health (NSCH), nationally representative surveys of non-institutionalized children in the United States, aged 0–17 years. We conducted chi-square as well as multivariable logistic regression analyses to investigate the relationships between FEH and internalizing disorders and behavioral/conduct problems among children ages 3–17 years. Overall, one in four children experienced FEH during their lifetime. FEH was statistically significantly (p < 0.0001) and positively correlated with each mental health condition, and the association remained after adjusting for covariates. Specifically, FEH was associated with 84% increased odds of having an internalizing disorder (OR = 1.84, 95%, CI: 1.54–2.20) and 53% increased odds of having behavioral/conduct problems (OR = 1.53, 95% CI: 1.25–1.87). Findings suggest that income alone may be an insufficient predictor of the health risks of economic hardship. Further research should examine FEH as a broader measure of disadvantage and its relationship with child health. [ABSTRACT FROM AUTHOR]

For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47%of the current U.S. labor force, only 16%of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks. [ABSTRACT FROM AUTHOR]

Parent engagement is a well-documented challenge when delivering child and adolescent mental health treatments. Therapists’ internal experiences, and how they respond to parents, may create a barrier to the parent engagement process. The current study developed the 13-item Therapist Barriers to Engaging Parents measure (TBEP) to assess providers’ internal and external experiences that operate as barriers to parent engagement. The TBEP was completed by 148 child and family therapists across the United States. The TBEP demonstrated strong internal reliability (Cronbach α = .86), and was negatively correlated with counselor efficacy, and significantly positively correlated with burnout, indicating convergent validity. Incremental validity of the subscales of the TBEP was also demonstrated. The TBEP appears to be a psychometrically sound measure of the internal barriers mental health providers experience when trying to engage parents. [ABSTRACT FROM AUTHOR]

Surveys suggest that between 4.3% and 11.5% of children living in the United States have a serious emotional disturbance (SED). SED is defined in the Federal Register, and federal block grants are allocated to states based on the prevalence of SED. Accurate measurement of SED is critical, yet surveys have used different methodologies and instrumentation to obtain prevalence estimates. Two expert panels were convened by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the fall of 2014 to discuss the current state of the field in operationalizing and measuring SED. The aims of this article are to (a) provide an update on SED prevalence rates from survey research, (b) summarize key discussion points that emerged during the SAMHSA expert panel meetings, and (c) make specific recommendations for next steps in measuring the prevalence of SED. Issues addressed in this article are important not only for federal allocation of service dollars to meet the needs of children with SED, but also for broader mental health surveillance efforts within the context of large national research surveys. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. METHODS Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement. RESULTS Eight studies show a significant risk of mental health disorders and poor academic achievement when exposed to childhood trauma. Seven studies found significant disparities in pediatric mental health care in the US. Nine studies reviewed SBHC mental health service access, utilization, quality, funding, and impact on school achievement. CONCLUSION Exposure to chronic childhood trauma negatively impacts school achievement when mediated by mental health disorders. Disparities are common in pediatric mental health care in the United States. SBHC mental health services have some showed evidence of their ability to reduce, though not eradicate, mental health care disparities. [ABSTRACT FROM AUTHOR]

Based on 9 months of ethnographic fieldwork in a U.S. mental health clinic focused on the treatment of preschool-aged children who exhibited extremely disruptive behavior, this article examines the contradictions clinicians faced when trying to identify and attribute "intentionality" to very young children. Disruptive, aggressive behavior is one of the central symptoms involved in a wide-range of childhood psychopathology and the number one reason young children are referred to mental health clinics in the United States. In the clinic where I conducted my research, clinicians were especially interested in diagnosing these children with oppositional defiant disorder (ODD), in order to identify those at risk for more serious mental illness later in the lifecourse. In this article, I look at the different strategies clinicians used in interpreting whether aggressive, defiant behavior was a part of the child's "self," a biologically driven symptom of a disease, or a legitimate reaction to problematic social environments. I argue that conceptualizing intentionality as a developmental, interpersonal process may help to make sense of the multiple discourses and practices clinicians used to try to reconcile the contradictions inherent in diagnosing ODD. [ABSTRACT FROM AUTHOR]

The article presents the study on the perspectives of advocates and leaders on children's mental health policies in the U.S. The analysis of data from the national survey was designed to understand the groups' perspective in various theme such as empowerment of youth and family in policy and practice, financial support, and challenges on health policy improvement. Results were outlined and conclude the lack of awareness and information among policymakers and advocates in filling their roles.

A large body of literature suggests that children living with two married, biological parents on average have fewer behavior problems than those who do not. What is less clear is why this occurs. Competing theories suggest that resource deficiencies and parental selectivity play a part. We suggest that examining different contexts can help adjudicate among different theoretical explanations as to how family structure relates to child behavior problems. In this paper, we use data from the Growing Up in Australia: Longitudinal Study of Australian Children (LSAC), the UK Millennium Cohort Study (MCS), and the US Early Childhood Longitudinal Study (ECLS-K) to examine the relationship between family structure and child behavior problems. Specifically, we look at how living in several configurations of biological and social parents may relate to child behavior problems. Findings suggest both similarities and differences across the three settings, with explanations in the UK results favoring selectivity theories, US patterns suggesting that there is a unique quality to family structure that can explain outcomes, and the Australian results favoring resource theories.

This study examined perceived challenges to implementation of an empirically supported mental health treatment for youth (Trauma-Focused Cognitive Behavioral Therapy; TF-CBT) and explored the potential use of technology-based resources in treatment delivery. Thematic interviews were conducted with 19 approved national TF-CBT trainers to assess their perspectives about challenges to implementation of TF-CBT and to explore their perceptions about the potential value of innovative, technology-based solutions to enhance provider fidelity and improve quality of care. These data offer some important insights and implications for training in evidence-based treatments, provider fidelity and competence, and patient engagement, particularly for those interventions targeting trauma-related symptoms among youth. [ABSTRACT FROM AUTHOR]

Citizen-children born in the United States to undocumented immigrants have become collateral damage of immigration enforcement. These children suffer the effects of immigration laws designed to deport large numbers of people. In removal proceedings, parents often must decide to either leave their citizen-children behind in the care of others or take them to a country the child may have never known. Accordingly, immigration policy frequently creates two de facto classes of children: exiles and orphans. In discussing these classes, the authors offer a summary of how U.S. citizen-children come into contact with the immigration enforcement system. The article explores the impact of detention and deportation on the health, mental health, and developmental trajectories of citizen-children and argues for reforms in policy and practice that will adhere to the highest standards of child welfare practice. By integrating these children into the immigration discourse, practitioners and policy-makers will be better able to understand the effects of immigration enforcement, reduce harm to children, and provide for the protection of their rights. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe Fortalezas Familiares ( FF; Family Strengths), a community-based prevention program designed to address relational family processes and promote well-being among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children's outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community-based 12-week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother's vulnerability to depression and the family's response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine changes in child emergency department (ED) discharges and hospitalizations for primary general medical (GM) and primary psychiatric disorders; prevalence of psychiatric disorders among acute care encounters; and change in acute mental health (MH) care encounters by disorder type and, within these categories, by child sociodemographic characteristics before and after statewide COVID-19–related school closure orders., Methods: This retrospective, cross-sectional cohort study used the Pediatric Health Information System database to assess percent changes in ED discharges and hospitalizations (N=2,658,474 total encounters) among children ages 3–17 years in 44 U.S. children’s hospitals in 2020 compared with 2019, by using matched data for 36- and 12-calendar-week intervals., Results: Decline in MH ED discharges accounted for about half of the decline in ED discharges and hospitalizations for primary GM disorders (−24.8% vs. −49.1%), and MH hospitalizations declined 3.4 times less (−8.0% vs. −26.8%) in 2020. Suicide attempt or self-injury and depressive disorders accounted for &gt;50% of acute MH care encounters before and after the statewide school closures. The increase in both ED discharges and hospitalizations for suicide attempt or self-injury was 5.1 percentage points (p&lt;0.001). By fall 2020, MH hospitalizations for suicide attempt or self-injury rose by 41.7%, with a 43.8% and 49.2% rise among adolescents and girls, respectively., Conclusions: Suicide or self-injury and depressive disorders drove acute MH care encounters in 44 U.S. children’s hospitals after COVID-19–related school closures. Research is needed to identify continuing risk indicators (e.g., sociodemographic characteristics, psychiatric disorder types, and social determinants of health) of acute child MH care.

Despite the existing body of research examining the effects of imprisonment on incarcerated adults, as of yet, there is no solid empirical evidence for understanding the effects of parental involvement with the criminal justice system involvement (CJSI) on children and families. Accordingly, Columbia University-New York State's Child Psychiatric Epidemiology Group (CPEG), supported by a strong collaboration with The Bronx Defenders, a holistic public defender providing free legal representation, is conducting a longitudinal study examining the effects of parental involvement with the criminal justice system on this population. The study aims to understand, over time, the impact of parental CJSI on their children's mental health, including the effects of the collateral legal damage of CJSI (such as eviction and deportation), substance use, the development of risky behaviors leading to the child's potential involvement with the criminal justice system, as well as protective factors and identification of potential intervention points, which has the ability to inform public policy. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the trends in health care expenditures in children with autism spectrum disorders (ASDs) in Medicaid in the U.S. The study compared inflation-adjusted expenditures and Medicaid reimbursements from inpatient, outpatient, long-term care, and prescription drugs in 42 states from 2000 to 2003. Results show slight growth of per patient expenditures and large increase in treated prevalence due to the rise of total ASD-associated health care expenditures.

Abstract: This study builds upon existing research by examining whether risk indices for child psychological well-being behave in the same way in different types of neighborhoods. Specifically, we sought to determine if neighborhood characteristics acted to exacerbate or, alternatively, to buffer risk factors at the family and/or child level. Families with a child entering first grade in Fall 2002 were recruited from Baltimore City neighborhoods, defined as census block groups. This study included 405 children, and data came from an interview with the primary caregiver and an assessment of the first grader. The dependent variables were externalizing behavior and internalizing problems. A family risk index consisting of 13 measures, and a child risk index consisting of three measures were the main independent variables of interest. We examined the effects of these indices on child psychological well-being and behavior across two neighborhood characteristics: neighborhood potential for community involvement with children and neighborhood negative social climate. Results of multivariate analyses indicated that cumulative family risk was associated with an increase in both internalizing and externalizing behavior problems. Perceived negative social climate moderated the effect of family risks on behavior problems such that more risk was associated with a larger increment in both externalizing behavior problems and psychological problems for children living in high versus low risk neighborhoods. These findings further emphasize the importance of considering neighborhood context in the study of child psychological well-being. [ABSTRACT FROM AUTHOR]

The article presents a study on serious emotional disturbance (SED) among youths who are exposed to hurricane Katrina. It says that more than 1,000 persons were killed by the hurricane and caused property damage of 100 billion dollars. It states that 80% of individuals in hurricane-affected areas are experiencing psychological problems effect among children and adolescents. It mentions that traumatic stress disorder and aggressive behavior among children and adolescents were found.

Children’s reactions after being exposed to mass violence may be influenced by a spectrum of factors. Relatively unexplored is the extent to which family exposure to mass violence may affect child mental health, even when these children have not been directly exposed. In a representative sample of NYC public school children assessed 6 months after the September 11, 2001 attack on the World Trade Center (WTC), seemingly elevated rates of psychopathology were recorded among children of WTC evacuees. Children of NYC First Responders (police officers, EMTs, and fire fighters) displayed a complex pattern of response to the WTC attack. Overall, the findings from this previous study support putative transmission of trauma to children whose parents were exposed to the WTC attack. The “Children of First Responder and WTC Evacuee Study”—a two-site longitudinal study—is currently underway in the United States (New York City) and in Israel (Tel Aviv area) in an effort to understand the impact of different patterns of mass violence. The NYC sample permits us to examine the impact of a rare instance of mass violence (e.g., WTC attack), while the Israeli sample provides information about repeated and frequent exposure to mass violence brought about by acts of terrorism. In addition, children’s exposure to mass violence is considered in the context of their exposure to other potentially traumatic events. This study aims to improve our general understanding of the impact of mass violence on children, especially the psychological effects on children whose parents’ work experiences are by nature stressful. Knowledge generated by this study has implications for guiding efforts to meet the needs of children who have, directly or through a family member, been subjected to rare or infrequent mass violent event as well as to children whose exposure to mass violence is part of daily life. [ABSTRACT FROM AUTHOR]

The state of child and adolescent overall health in the United States evidences the need for both prevention and treatment. Although much time and energy has been spent in recent years discussing and improving health benefit coverage and affordability for children, physical access to services has not kept pace with these changes. This article will introduce four major physical health issues (obesity, diabetes, asthma, and teen pregnancy/STD) and five key mental health issues (suicide, depression, ADHD, aggression, and violence) facing young people today. In an effort to answer the question, “What can be done?” school-based health clinics and their impact on health and educational outcomes are examined. [ABSTRACT FROM AUTHOR]

This study examined the sustainability of a learning collaborative to improve service use among nine outpatient mental health agencies in the New York City area. Questionnaires were sent to collaborative participants to determine whether key practices and interventions were sustained one year later, and whether aspects of the staff, leadership, agency, and new practices facilitated or hindered their sustainability. All the agencies continued at least one of the new interventions to varying degrees. Agency openness, interventions that were aligned with agency mission, and dedicated leadership were the most frequently cited facilitators to sustainability. In contrast, staff and agency factors (such as not seeing a need for change) and inadequate resources were the most commonly noted obstacles to adoption. Learning collaboratives appear to be successful for effecting enduring change in agency practice, although various staff-, leadership-, agency-, and practice-related factors can either hinder or facilitate their sustainability. [ABSTRACT FROM AUTHOR]

Childhood psychological morbidity places both short-term and long-term costs on families, health services, social services, voluntary organizations, and society as a whole. Internationally, there have been few economic evaluations alongside clinical trials of population-based interventions to improve child mental well-being. This paper sets out a number of trade-offs relevant to the evaluation of the costs and benefits of multisectoral interventions to improve child mental well-being. These trade-offs have relevance for those who fund research, those who conduct research, and those who make policy decisions. The paper sets out a conceptual model for the economic evaluation of population-based interventions to improve child mental health. Finally, the paper argues that with the advent of “joined up” public policy and the breakdown of traditional ring-fenced budgets for health and social care, there is now, more than ever before, an opportunity for the research community to generate guidance for multisectoral collaborative interventions to promote the mental well-being of children and their families. [ABSTRACT FROM AUTHOR]

This paper unpacks the legacy of racism and white supremacy in American child psychiatry, connecting them to current racist inequities, to reimagine an antiracist future for the profession, and to serve all children's mental health body and soul. History reveals how child psychiatry has neglected and even perpetuated the intergenerational trauma suffered by minoritized children and families. By refusing to confront racial injustice, it has centered on white children's protection and deleted their role in white supremacist violence. An antiracist future for the profession demands a profound historical reckoning and comprehensive reimagining, a process that this paper begins to unfold., Competing Interests: Disclosure The authors have no conflicts of interest to disclose. They collectively contributed hundreds of hours and centuries of lived experience. In the process, they endured retraumatization while confronting white supremacist violence and risking censure from their employers and institutions for their unapologetic, transparent approach. The emotional, intellectual, and physical toll of this labor on their bodies cannot be quantified. The only remuneration they received for their free labor was support from one another. While invaluable, this is also unacceptable. The motivation for their unpaid contribution is that it serves as an impetus and mandate to fund long overdue and desperately needed anti-racism initiatives in American child psychiatry., (Copyright © 2021 Elsevier Inc. All rights reserved.)

• More frequent contact with biological mothers was associated with fewer cumulative days in out-of-home care. • Older child age was related to longer stays in out-of-home care. • Black youth experienced more cumulative days in foster care compared to white youth. • More frequent contact with both mothers and fathers was associated with lower mental health symptoms. Foster care is intended to be a temporary placement option. Viewing permanency as central to child well-being, current U.S. policies aim to limit the length of time a child spends in out-of-home foster placements. There is little recent research, however, on predictors of length of time in out-of-home care. The purposes of this study were to test if more frequent contact with biological parents predicted less time in out-of-home care, and determine if more frequent contact with biological parents was associated with better mental health outcomes using three waves of data from the National Survey on Child and Adolescent Well-Being II, a U.S. nationally representative dataset of youth involved with the child welfare system. Findings revealed that more frequent contact with biological mothers was associated with fewer cumulative days in out-of-home care. Among covariates, older child age was related to longer stays in out-of-home care, and Black youth experienced more cumulative days in out-of-home care compared to White youth. Links between frequency of contact and youth mental health outcomes also were tested, and more frequent contact with both mothers and fathers was associated with lower mental health symptoms. Being separated from siblings also was associated with more mental health problems, and compared with foster care, being in kinship care was negatively associated with mental health problems. A discussion of the findings in light of U.S. polices and best-practices is included. [ABSTRACT FROM AUTHOR]

In the United States, approximately 20% of children and adolescents meet diagnostic criteria for a mental health diagnosis, but few receive treatment. The purpose of the current study was to explore the factors that contribute to help-seeking among mothers from diverse ethnic groups (52.5% European American/White, 23% African American/Black, and 24.6% Latinx). Participants were 122 mothers recruited from 2014 to 2017 through a convenience sample in Central Texas. Using MANOVA, results indicated that mother with no history of therapy use reported more fears about seeking therapy for children. Additionally, there was a trend towards African American mothers reporting more fears about therapists' responsiveness and image concerns. Finally, therapy fears significantly predicted mother's intentions to delay seeking therapy in the future. Implications for research and practice are discussed.

Objective: To describe the development and evaluation of two integrated care models using a partnered formative evaluation approach across a private foundation, clinic leaders, providers and staff, and a university-based research center., Design: Retrospective cohort study using multiple data sources., Setting: Two federal qualified health care centers serving low-income children and families in Chicago., Participants: Private foundation, clinic and academic partners., Interventions: Development of two integrated care models and partnered evaluation design., Main Outcome Measures: Accomplishments and early lessons learned., Results: Together, the foundation-clinic-academic partners worked to include best practices in two integrated care models for children while developing the evaluation design. A shared data collection approach, which empowered the clinic partners to collect data using a web-based tool for a prospective longitudinal cohort study, was also created., Conclusion: Across three formative evaluation stages, the foundation, clinic, and academic partners continued to reach beyond their respective traditional roles of project oversight, clinical service, and research as adjustments were collectively made to accommodate barriers and unanticipated events. Together, an innovative shared data collection approach was developed that extends partnered research to include data collection being led by the clinic partners and supported by the technical resources of a university-based research center., Competing Interests: Competing Interests: None declared.

Background and Objectives: Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children's hospitals., Methods: We examined all discharges in 2009 for patients aged 3 to 20 years in the nationally representative Kids' Inpatient Database (KID) and in the Pediatric Health Information System (free-standing children's hospitals). Main outcomes were frequency of International Classification of Diseases, Ninth Revision, Clinical Modification-defined mental health diagnostic groupings (primary and nonprimary diagnosis) and, using KID, resource utilization (defined by diagnostic grouping aggregate annual charges)., Results: Nearly 10% of pediatric hospitalizations nationally were for a primary mental health diagnosis, compared with 3% of hospitalizations at free-standing children's hospitals. Predictors of hospitalizations for a primary mental health problem were older age, male gender, white race, and insurance type. Nationally, the most frequent and costly primary mental health diagnoses were depression (44.1% of all mental health admissions; $1.33 billion), bipolar disorder (18.1%; $702 million), and psychosis (12.1%; $540 million)., Conclusions: We identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis. These diagnoses can be used as priority conditions for pediatric mental health inpatient quality measurement.

Little research has examined the impact of having a parent with a disability on child mental health. This study used data from 7,116 families of children who participated in the 2006 National Health Interview Survey and propensity score matching (PSM) to investigate this question. Prior to PSM, differences in Child Mental Health Brief scores were significant with a moderate effect size. After PSM, differences in Child Mental Health Brief scores were still significant, but the effect size was small. Results indicate that much of the mental health risk for children of parents with disabilities is connected to related issues.