What we're asking in child welfare

What facilitates the introduction of a trauma-informed behavioral health screen within a child and family services agency and can it benefit children in state care?

Research has shown that youth in the child welfare system are at considerably greater risk of a multitude of mental, behavioral, and physical health disorders, compared to their counterparts in the general population. The American Academy of Pediatrics identifies a “history of complex or ongoing trauma” as a primary contributing factor to these adverse outcomes. In response to a growing awareness of the negative impact of trauma on child wellbeing, child placement, and adoption stability, there has been increased emphasis on understanding and addressing trauma within the child welfare system.  

Through a collaboration with state agencies and local universities, PRG’s research examines the complexities of and outcomes associated with implementing new trauma-informed screening and referral procedures within the Louisiana child welfare system.

Louisiana Child Welfare System Leader Perspectives on Trauma-Informed Screen

As part of a larger statewide project aimed at improving the social and emotional well-being of youth receiving foster care services, PRG interviewed administrators and leaders in the Louisiana child welfare system about the implementation of a trauma-informed screen. Interviewees generally saw promise in the screen and viewed it as a potentially valuable tool for case planning and assessing and responding to system-wide needs. It could, they believed, be used by caseworkers to systematically identify and plan for the mental and behavioral health needs of clients. In addition, at the systems-level, they believed that the data from the new screen could be a richer and more standardized way to understand child outcomes over time and identify and address gaps in the mental and behavioral health service array across the state

While leaders agreed that the screen had the potential to help realize systemic enhancements and improvements in the services provided to children, they found that the experience of integrating the screen into the child welfare system proved more challenging than expected. For several reasons, leaders found that caseworkers could be unwilling or unable to fully adopt the new screen as intended. Consequently, they discovered that they were not able to realize the promise of rich and standardized data.  Screening data were not consistently collected, nor were they incorporated into case planning. This also meant that systems-level enhancements were not achieved because the data on clients’ needs and outcomes were often incomplete.

In our discussions with leaders of the child welfare system, they identified several systemic factors that inhibited caseworkers’ ability to fully implement and use of the standardized screening tool as intended, including high caseload, high employee turnover, and inadequate service array available to clients.