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Objective: To understand obstetric provider perspectives on child protective services (CPS)-mandated reporting requirements and how they affect care for pregnant and postpartum patients with opioid use disorder (OUD). Methods: Key informant interviews were conducted virtually with obstetricians, nurse practitioners, and social workers caring for obstetric patients (n = 12). Providers were asked about their experience as mandated reporters working with patients with OUD. Transcripts were independently coded by two staff, and content analysis was used to identify themes. Results: Our analysis resulted in six thematic areas, including CPS-mandated strengths, concerns related to CPS reporting requirements, implementation of mandates, supporting patients after CPS report, communication between stakeholders, and the impact on care. Providers noted that the fear of CPS involvement causes some patients to delay or not engage in care. Other patients are hesitant to accept medications for OUD for fear of CPS involvement. The inconsistencies in how reporting mandates are applied and how CPS handles cases make communication about the policies challenging for providers and create anxiety for patients. Conclusions: The results of this study indicate that mandated reporting requirements and the potential for CPS involvement are perceived to have minimal positive effects on perinatal individuals with OUD and may negatively affect patients and their care. Clinicaltrials.gov number: NCT04240392. [ABSTRACT FROM AUTHOR]

Children with emotional and behavioral disturbance often have difficulties in multiple symptom domains. This study investigates the relationships between child symptoms and caregiver strain and parenting stress among 177 youth and their caregivers participating in a school-based system of care. Youth were grouped by symptom domain and included those with low scores on both internalizing and externalizing symptoms, those with only high internalizing symptoms, those with only high externalizing symptoms, and those with high symptoms levels in both internalizing and externalizing domains. Results revealed significant group differences on measures of caregiver strain and parenting stress. Caregivers of youth with symptoms in both internalizing and externalizing domains reported the highest levels of strain and stress; however, there was some variation in group differences by caregiver outcome. The results of this study emphasize the importance of providing not only services for youth but also support services for their caregivers. (Contains 4 tables)

The coronavirus disease pandemic has highlighted significant gaps in community mental health services, placing vulnerable individuals at greater risk for mental health and substance use difficulties via disrupting their wellness journey. Guided by a wellness framework, a needs assessment was conducted among adult consumers of behavioral health services to understand their needs during the pandemic and to help develop and strengthen service delivery strategies. A team of three university researchers and four Consumer Researchers, who receive services at a publicly funded community mental health center, engaged in a community‐based participatory project in which 13 focus groups were conducted with 51 consumers. Several themes emerged from a thematic analysis of transcripts regarding consumer well‐being and healthcare needs, coping strategies employed, and the accessibility, benefits, and perception of clinical and support services during the pandemic. Results highlighted strengths in service delivery and areas in need of enhancement. Findings may inform similar community services that seek to enhance delivery of care among vulnerable populations. [ABSTRACT FROM AUTHOR]

The present study examined how exposure to traumatic events affects children with severe emotional disturbance who are being served in a school-based system of care. Multilevel growth curve models were used to examine the relationships between a child's history of traumatic events (physical abuse, sexual abuse, or domestic violence) and behavioral and emotional strengths, internalizing problem behaviors, and externalizing problem behaviors over 18 months. Results indicate that children receiving services (N = 134) exhibited increased emotional and behavioral strengths and decreased internalizing and externalizing problem behaviors from enrollment to 18-month follow-up. Children with a history of traumatic events improved more slowly than children without such a history on both strengths and internalizing problem behaviors, even after controlling for dosage of services received and other characteristics previously found to predict outcomes. Gender was also related to improvement in internalizing symptoms. Results highlight the continued need to assess the impact of exposure to traumatic events for children served in a system of care. (Contains 4 tables and 3 figures.)s

The Safe Start demonstration projects, funded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) under the first phase of the Safe Start initiative, are primarily designed to influence change at the systems or macrolevels to reduce the incidence of and impact of exposure to violence for children aged birth to 6 years; direct services are also provided to young children and their families who were exposed to violence. The data presented in this article come from 10 communities that submitted data regarding the characteristics of young children exposed to violence to OJJDP. These data represent families who are typically not represented in the databases of state child protective services programs but instead have been identified by domestic violence advocates, early care and education providers, family members, court personnel, police, and other social service personnel as families with young children in need of intervention due to violence exposure.The purpose of this article is to describe the characteristics of young children and their parents who seek help for psychosocial problems related to exposure to family and community violence. Results indicate that one quarter of the children and nearly half of their parents evidenced clinical levels of stress, suggesting the need to intervene at the family level as well as at the individual level when working with young children exposed to violence. The information presented, including the extent of exposure to violence, the multiple types of violence to which children are exposed, the impact of this exposure on young children and their families, and the multiple ways in which families exposed to violence come to the attention of service providers is useful for policy makers and service providers who are interested in breaking the cycle of violence by meeting the needs of the children exposed to violence and their families. (Contains 3 notes and 8 tables.)

Research supports that office referral data is useful in informing programmatic decisions and planning interventions such as Positive Behavior Supports (PBS). Knowledge of patterns of office referrals may facilitate development of interventions that target specific groups. This study examines patterns in office referrals within an urban district by gender, race/ ethnicity and grade. Findings reveal that there are differences by grade that appear to be related to developmental level, with more referrals for aggression in younger students (grades K-6), disrespectful behavior in middle school students (grades 7-8), and attendance problems in high school students. Gender differences in the rate and type of referrals were found, with significantly more referrals for boys' delinquent/aggressive behavior, which may relate to how schools define unacceptable behavior and the data collection method. Finally, there were significantly more referrals for African American/black students than Hispanic students, suggesting that schools consider racial differences when developing behavioral expectations. (Contains 1 note, 2 tables and 6 figures.)

Systems of care (SOCs) are comprehensive, community-based services for youth with emotional and behavioral disorders. For these youth, little is known about how trauma symptoms influence participation in SOC care coordination through the Child and Family Team (CFT) meeting. The current study assessed the extent to which exposure to potentially traumatic events (PTEs) and trauma symptoms were associated with participation in CFTs and youth and family outcomes. Participants were 464 youth (Mage = 11.02, SD = 3.72) and their caregivers. Families completed measures of youth and caregiver functioning, PTEs, and trauma symptoms at enrollment and 6-months follow-up. Care coordinators completed surveys assessing CFT characteristics following each meeting and assessments of youth functioning. Moderated multiple regression analyses tested the conditional effects of youth trauma symptoms on the relationships between CFT characteristics and youth and caregiver outcomes. Trauma symptoms moderated the relationship between the number of days to the first CFT meeting and youth impairment and the relationship between CFT meeting duration and youth impairment. Results suggest the presence of trauma and other contextual factors contributed to difficulty in initiating services and to changes in youth impairment. Implications for the provision of trauma-informed SOC services are discussed. [ABSTRACT FROM AUTHOR]

Families' positive health service-related views and experiences are associated with improvements in physical and psychological well-being. Research has elucidated key differences in the experiences of caregivers and their children. More work is needed to better understand how families experience enrollment in systems of care (SOCs), given their unique service delivery approach. We compared the service-related views and experiences of 77 youth (Mage = 13.5 years, SD = 2.09, Range = 8 to 18) with severe emotional challenges and their caregivers enrolled in a school-based SOC. Youth and their caregivers reported positive views of service characteristics and related youth outcomes. However, caregivers reported significantly higher levels of perceived cultural sensitivity of services, general satisfaction with services, and active participation in services. Qualitative findings indicated that youth primarily reported improvements in their own psychological and behavioral functioning as the most helpful aspect of services, whereas caregivers tended to emphasize specific youth and family services that they received, such as counseling and psychiatric treatment. We discuss limitations and implications for future research. [ABSTRACT FROM AUTHOR]