Adopting a Cascade-of-Care Approach to Examine Mental Health Service Access for Youths in the Child Welfare System

Youths within the child welfare system have high rates of mental health needs and chronic barriers to service access. The cascade-of-care approach was used to explore this population's use of mental health services.

The mental health cascade was used with electronic medical record data to characterize service access among 97 youths served in a child welfare clinic.

Of the total sample, 82% of youths met criteria to identify those needing mental health services, 56% were referred for assessment and services, 33% completed an assessment, 24% had a treatment plan signed, and 17% received services. Time between steps averaged 64.52 days from screening to referral, 65.94 days from referral to assessment, 7.05 days from assessment to signed treatment plan, and 19.84 days from treatment plan to service initiation.

Significant gaps in the care cascade occurred, especially at earlier stages. Multilayered efforts to reduce service gaps in this population are needed.