The effects of organizational culture and climate on the access to mental health care in child welfare and juvenile justice systems.

This study examined the effects of organizational culture and climate on the access to mental health care for 588 children referred to child welfare and juvenile justice systems in 21 Tennessee urban and rural counties. Cross-level, hierarchical linear models (HLM) analyses indicated that children served by child welfare and juvenile justice case management units with constructive organizational cultures were more likely to receive the needed mental health care. For example, controlling for the child's need for mental health care and other child and family characteristics, the odds of a child receiving mental health care in a case management unit with the most constructive culture were 11 times the odds of receiving mental health care in a unit with the least constructive culture. Constructive cultures were characterized by organizational norms and expectations that case managers would be mutually supportive, develop their individual abilities, maintain positive interpersonal relationships, and be motivated to succeed. These findings suggest that efforts to improve access to mental health care for children referred to child welfare and juvenile systems should include the development of constructive organizational cultures in case management units responsible for the children's care.