Child safety decisions and parental mental health problems: A new analysis of mediating factors.
Decision-making
Mental health
Structural equation modeling
Substance abuse
Journal
Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
13
05
2020
revised:
01
04
2021
accepted:
06
07
2021
pubmed:
17
7
2021
medline:
19
3
2022
entrez:
16
7
2021
Statut:
ppublish
Résumé
Our previous study showed that parents with mental health problems or substance abuse are at increased risk of having children removed from the home, primarily due to caregiving deficits, neglect, and prenatal exposure to substances, not physical abuse. Using a larger sample and more rigorous analysis, the present study improves and expand upon the previous study, yielding more robust explanations for why these children are at increased risk of removal. The study uses a sample of 4070 Structured Decision Making® assessments conducted by San Francisco's Child Welfare provider involving parents reported for the first time from 2007 to 2015. Using structural equation modeling, mediation models were constructed to test the indirect effects of thirteen child safety threats on safety decision. Four threats explained 95% of the effect of mental health problems on safety decision, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.26, p ≤ 0.01) and Previous Maltreatment (OR = 1.24, p ≤ 0.05). Seven safety threats explained 91% of the effect of co-occurring mental health problems and substance abuse, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.78, p ≤ 0.001) and Physical Harm (Drug-Exposed Infant; OR = 1.57, p ≤ 0.001). As previously shown, parental mental health problems and substance abuse are not ipso facto safety threats. Rather, unmet child needs account for much of the increased risk of child removal in this population, underscoring the importance of timely resource referrals.
Sections du résumé
BACKGROUND
Our previous study showed that parents with mental health problems or substance abuse are at increased risk of having children removed from the home, primarily due to caregiving deficits, neglect, and prenatal exposure to substances, not physical abuse.
OBJECTIVE
Using a larger sample and more rigorous analysis, the present study improves and expand upon the previous study, yielding more robust explanations for why these children are at increased risk of removal.
PARTICIPANTS AND SETTING
The study uses a sample of 4070 Structured Decision Making® assessments conducted by San Francisco's Child Welfare provider involving parents reported for the first time from 2007 to 2015.
METHODS
Using structural equation modeling, mediation models were constructed to test the indirect effects of thirteen child safety threats on safety decision.
RESULTS
Four threats explained 95% of the effect of mental health problems on safety decision, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.26, p ≤ 0.01) and Previous Maltreatment (OR = 1.24, p ≤ 0.05). Seven safety threats explained 91% of the effect of co-occurring mental health problems and substance abuse, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.78, p ≤ 0.001) and Physical Harm (Drug-Exposed Infant; OR = 1.57, p ≤ 0.001).
CONCLUSIONS
As previously shown, parental mental health problems and substance abuse are not ipso facto safety threats. Rather, unmet child needs account for much of the increased risk of child removal in this population, underscoring the importance of timely resource referrals.
Identifiants
pubmed: 34271340
pii: S0145-2134(21)00275-1
doi: 10.1016/j.chiabu.2021.105202
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
105202Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.