The main objective of the proposed research is to examine the effect of feedback of mental health screening information to case management social workers in a foster care system. It is expected that feedback will affect recognition of mental health problems, referral for assessment and treatment, use of services, cost of services, and child outcomes. This research extends the research tradition regarding the mental health role of primary care physicians to another professional gatekeeper group working in the context of an abused and neglected child population at high risk for severe emotional illness. The proposed research will be done as a fully collaborative project between researchers at San Diego State University, the San Diego County Departments of Social Services and Mental Health, and Childrens Hospital - San Diego. The experiment will consist of providing information from the Achenbach Child Behavior Checklist to social workers who will be randomized into an experimental and control group. The project will enroll 800 foster care children between the ages of 4 and 16 in the study. In addition to monitoring the impact of the feedback on the detection of mental health problems and referral behavior, the research will address the child outcomes of the experiment for psychopathology, adaptive functioning, depression symptoms, use and cost of mental health services. These foster child outcomes will be measured three times over an 18 month follow-up period. The significance of the proposed research is the potential for a simple and cost-effective strategy for early recognition and treatment of children at great risk of developing severe emotional-problems. A unique feature of the research is the combining standardized testing data with county and state data on the use and cost of mental health services. In addition, the proposed research will examine the use and interpretation of child mental health information from multiple sources.
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