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Mental health, substance use, and child maltreatment

Mir M Ali1, Thanh T Lu2, Johanna Catherine Maclean3

  • 1Department of Health Policy and Management, University of Maryland, 4200 Valley Drive, College Park MD 20742, USA.

Journal of Health Economics
|July 7, 2026
PubMed

Insights

Improving access to mental health and substance use treatment centers is linked to fewer child maltreatment cases. Increased treatment availability may reduce child protective services referrals and injury deaths.

Area of Science:

  • Public Health
  • Social Science
  • Health Services Research

Background:

  • Child maltreatment is a significant public health issue in the U.S., with millions of children referred to child protective services annually.
  • Parental mental health issues and substance use disorders are recognized as major risk factors contributing to child maltreatment.
  • Existing research highlights the association between parental disorders and adverse child outcomes, underscoring the need for accessible support services.

Purpose of the Study:

  • To investigate the relationship between the availability of mental health and substance use treatment centers and the incidence of child maltreatment reports.
  • To quantify the impact of increased treatment center supply on child maltreatment rates and child injury deaths at the county level.
  • To provide evidence supporting the role of accessible treatment services in mitigating child maltreatment.

Main Methods:

  • Utilized administrative data spanning from 2004 to 2022 for U.S. counties.
  • Analyzed the correlation between the number of mental health and substance use treatment facilities per county and reported child maltreatment incidents.
  • Employed statistical methods to assess the impact of treatment center supply on child maltreatment reports and child injury-related fatalities.

Main Results:

  • A 9.6% increase in the supply of treatment centers per county was associated with a 0.7% reduction in child maltreatment reports.
  • The same increase in treatment center supply correlated with a 0.4% decrease in child injury deaths.
  • Findings indicate a statistically significant inverse relationship between treatment accessibility and child maltreatment indicators.

Conclusions:

  • Enhanced access to mental health and substance use treatment services can be an effective strategy for reducing child maltreatment.
  • Investing in and expanding treatment infrastructure may lead to improved child safety and well-being.
  • Policy implications suggest prioritizing the development of treatment centers to address and prevent child maltreatment.

Keywords:
Child maltreatmentHealthcareMental healthSubstance use

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