Bai Yu, Wells Rebecca, Hillemeier Marianne M
Department of Health Policy and Administration, Pennsylvania State University, 604 Ford Building, University Park, PA 16802, USA.
Child Abuse Negl. 2009 Jun;33(6):372-81. doi: 10.1016/j.chiabu.2008.10.004. Epub 2009 May 26.
Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by the child welfare system.
This was a longitudinal analysis of data from a 36-month period in the National Survey of Child and Adolescent Well-Being (NSCAW). The sample consisted of 1,613 children within 75 child welfare agencies who were 2 years or older and had mental health problems at baseline. IOR intensity was measured as the number of coordination approaches between each child welfare agency and mental health service providers. Separate weighted multilevel logistic regression models tested associations between IORs and service use and outcomes, respectively.
Agency-level factors accounted for 9% of the variance in the probability of service use and 12% of mental health improvement. Greater intensity of IORs was associated with higher likelihood of both service use and mental health improvement.
Having greater numbers of ties with mental health providers may help child welfare agencies improve children's mental health service access and outcomes.
Policymakers should develop policies and initiatives to encourage a combination of different types of organizational ties between child welfare and mental health systems. For instance, information sharing at the agency level in addition to coordination at the case level may improve the coordination necessary to serve these vulnerable children.
儿童福利机构与心理健康服务提供者之间的组织间关系（IORs）可能有助于弱势儿童获得心理健康治疗。本研究调查了IORs是否与儿童福利系统所服务儿童更多地使用心理健康服务以及心理健康状况改善相关。
这是一项对《全国儿童和青少年幸福调查》（NSCAW）中36个月期间数据的纵向分析。样本包括75个儿童福利机构中1613名2岁及以上且在基线时存在心理健康问题的儿童。IOR强度通过每个儿童福利机构与心理健康服务提供者之间的协调方式数量来衡量。分别采用加权多级逻辑回归模型测试IORs与服务使用及结果之间的关联。
机构层面因素占服务使用概率方差的9%，占心理健康改善方差的12%。IOR强度越大，服务使用和心理健康改善的可能性越高。
与心理健康提供者建立更多联系可能有助于儿童福利机构改善儿童获得心理健康服务的机会和结果。
政策制定者应制定政策和举措，鼓励儿童福利和心理健康系统之间建立不同类型组织联系的组合。例如，除了在个案层面进行协调外，在机构层面进行信息共享可能会改善为这些弱势儿童提供服务所需的协调。
