Psychiatry and children in the child welfare system

The child welfare system is, for better or worse, an unavoidable associate of the child and adolescent psychiatrist. Although the child psychiatrist rarely plays an integral role in decision making about the children who are involved with the system, the authors point out that a large percentage of children maintained in and involved with the system have psychiatric and developmental disorders. When these children's difficulties are either minimized or unrecognized by child welfare workers, the interventions and treatment that the children receive may be inappropriate. Worse still, when the children's difficulties are improperly addressed, the vicissitudes of the system may further harm them. The authors propose several ways in which the child and adolescent psychiatrist can have an important reparative role and voice in child welfare systems.