Preventing the relinquishment of children with serious emotional disturbances

Background/Purpose.  Roughly 5% of children are classified as having a serious emotional disturbance (SED).  Anecdotal evidence suggests that some families seek and/or are advised to relinquish the custody of their children to the foster care system to obtain mental health care for their child.  This study was a legislatively mandated needs assessment of children with SED in Texas.

Methods/Approach. A mixed-methods study gathered information from multiple sources. Case studies were conducted with parents (n=5) and interviews were conducted with key stakeholders (n=10).  Online surveys were completed by parents (n=28) and stakeholders (n=31).  Qualitative analysis was conducted through content analysis and quantitative data was used to develop descriptive statistics. A cost analysis was also conducted to examine the cost of caring for children with SED in foster care.

Findings.  Findings suggest families feel services do exist, but are difficult to obtain. They first seek help from schools and their pediatricians followed by referrals for community mental health.  As behavior escalates, families often enter a cycle of calling the police for de-escalation and going to emergency rooms which result in inpatient commitments.  After families have experienced this cycle, they may consider or be directed towards foster care as an option.    Cost analysis suggests that serving a youth in the community rather than foster care saves the state approximately $60,000 a year.

Implications.  Treatment of serious emotional disturbance is a public health issue rather than a child protection issue.  Families want wraparound services, supportive case management, quality psychiatric services and in-home care.