Parents’ Experiences and Perspectives of Early Childhood Mental Health Services and Child Welfare

Abstract

Children birth to five in the child welfare system often experience trauma and are at risk for mental health problems and developmental delays (Barth, Scarborough et al., 2007; Cooper, Banghart & Aratani, 2010; Painter & Scannapieco, 2013; Whitaker, 2015). However, despite the high need for services, few children in child welfare receive them (Horwitz et al., 2012; Stahmer et al., 2005). Qualitative studies have used interviews with service providers to identify themes related to mental health service barriers (Hoffman, 2016). However, a gap remains in understanding birth parents’ experience accessing mental health services for children birth to five involved in child welfare.

The purpose of this dissertation is to understand the experiences and perspectives of parents of toddlers and preschoolers in child welfare accessing mental health services. A mixed-methods study using qualitative methods as the primary method was conducted. Ten African American birth parents participated. Participants had children 1.5 to 5 years old and involved in child welfare when accessing mental health services. The qualitative data explored parents’ experiences and perspectives of mental health and child welfare services. The quantitative data provided descriptive statistics to assess child behavior, parent stress, parent psychological distress, and mental health service satisfaction compared to national norms. The qualitative data and the quantitative data were integrated to understand parents’ experience with early childhood mental health and child welfare services.

The qualitative results of this study showed three major qualitative themes; complex mental health needs, navigating systems: child welfare and mental health, and equity and understanding. Quantitative results suggested most participants had their children placed in foster care, a high level of mental health need for participants’ children, participants had lower psychological distress, but had elevated levels of parenting stress. The integrated data showed participants referred to early childhood mental health services did not immediately seek services, but when they did, they often navigated through several barriers before receiving services. Some participants did not seek services until a major traumatic incident. A conceptual model was developed for early childhood mental health service utilization. Implications for practice, policy, and future research are discussed.