Increasing Mental Health Services for Child Welfare-Involved Children in Michigan

Project Context: 

• Children in foster care experience higher rates of mental health needs compared with their peers. For these children, the trauma of removal from their parent’s care can exacerbate existing mental health needs.  
• When children’s mental health needs are not met, it can lead to escalating behaviors, placement breakdown, and multiple moves to different foster homes or even residential treatment programs. 
• After reviewing several years of foster care cases, leaders in the Michigan Department of Health and Human Services realized that existing interventions designed to address children’s mental and behavioral health needs were not always being fully utilized early on. 
• Child welfare leaders in Michigan wanted to connect children to mental health services earlier to improve children’s well-being while in care and reduce mental health-related placement disruptions. 

How the GPL Supported: 

• Helped leaders review Medicaid claims data to identify trends in mental health service access and timelines for a cohort of children entering foster care.   
• Worked with a cohort of county leaders, foster care staff and local mental health service providers to identify and test strategies to improve the referral process. This included: 
• Increasing referrals made early on by setting clearer expectations for caseworkers to conduct a trauma screening at the start of every child’s placement, and if needed, make a referral for mental health services.  
• Proactively discussing a child’s trauma history and potential mental health needs during initial family-involved team meetings. 
• Tracking new data on referrals and service connections to better identify barriers to access or system bottlenecks to address.  
• Holding monthly meetings with caseworkers and service provider staff to ensure that cases did not fall through the cracks and create space to collaboratively troubleshoot challenges. 

Results: 

• In 2020, 50% more children were connected to community mental health services within their first month of entering care, and placement disruptions during children’s first six months in care declined by more than 20%, when compared with prior rates.