The following is a summary of “A Population-Based Study of Mental Health Diagnoses and Child Protection System Involvement Among Medicaid-Insured Children,” published in the JANUARY 2023 issue of Pediatrics by Hornstein, et al.
For a study, researchers sought to investigate the prevalence of mental health disorders among children under 18 who are enrolled in California’s Medicaid program and have a history of child protection system (CPS) involvement.
To conduct the study, they retrospectively examined the complete population of Medicaid-insured children who had at least one claim during 2014-2015 and were enrolled in the program for at least a month (n = 3,352,886). The team used International Classification of Diseases codes to categorize a primary or secondary mental health diagnosis and linked the records of these children with statewide CPS records of maltreatment and foster care placements since 1998.
The study showed that about 14% (n = 470,513) of all Medicaid-insured children had a documented mental health diagnosis. The percentage of children diagnosed with a mental health condition with CPS involvement (i.e., maltreatment report) was almost twice that of the overall Medicaid population (50.4% vs. 26.9%). It was observed across all diagnostic groups, but there were variations in the magnitude of the findings. The study found a graded relationship between the level of CPS involvement and the probability of having a mental health diagnosis. Children with a history of maltreatment were commonly diagnosed with mental health disorders, regardless of whether they were placed in foster care.
The research concluded that the study’s findings reveal high rates of mental health diagnoses and previous CPS involvement in Medicaid-insured children. In addition, the study highlighted the importance of ensuring that children who remain at home after being reported for maltreatment receive the appropriate range and coordination of services.