Understanding the Behavioral Health of Children in Child Protective Services: Prevalence, Community Context, and System Involvement Using Administrative Data

This dissertation investigates the behavioral health of children involved in the U.S. child welfare system through a three-paper approach. Amid rising concerns over youth mental health, suicide rates, and ADHD diagnoses, this study explores how these issues manifest among children reported for maltreatment – a population at elevated risk and often underserved. Paper 1 estimates the prevalence of behavioral health problems using national administrative datasets (NCANDS and AFCARS), providing insight into trends over time and disparities by age, race/ethnicity, sex, geographic context (urban vs. rural), and system involvement (CPS investigation vs. foster care). Paper 2 leverages county-level data to examine contextual factors on adolescent behavioral health. It describes how the prevalence of behavioral health concerns differs across racial and ethnic groups of children and geographic contexts, and explores how local socioeconomic conditions may be associated with the identification of these concerns. Paper 3 analyzes the associations between behavioral health concerns, prior maltreatment history, and system involvement, and examines whether behavioral health concerns are linked to report substantiation and foster care involvement. Stratified by developmental stage, the study offers nuanced insights into the trajectories of children experiencing maltreatment. Together, these papers provide evidence on the behavioral health of children in CPS at both the individual and county levels, aiming to inform policy and improve services for this vulnerable population. Findings contribute to both scientific literature and practice efforts addressing disparities in child behavioral health.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Social Work

Year dc:date.available

2025

Author dc:creator

• Huang, Tzu-Hsin

Contributors dc:contributor

• Brett Drake
• Maria Morrison; Melissa Jonson-Reid; Mike Strube; Wendy Auslander

• Administrative Data;Behavioral Health;Child Protective Services;Child Welfare;Mental Health;NCANDS

Language dc:language

English (en)

Identifier

https://openscholarship.wustl.edu/brown_etds/49

OAI identifier oai:identifier

oai:openscholarship.wustl.edu:brown_etds-1048