Mental health problems in teens investigated by U.S. child welfare agencies

Amy Heneghan, Ruth E.K. Stein, Michael S. Hurlburt, Jinjin Zhang, Jennifer Rolls-Reutz, Emily Fisher, John Landsverk, Sarah Mc Cue Horwitz

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Purpose: To examine prevalence and correlates of five mental health (MH) problems among 12-17.5 year olds investigated by child welfare. Methods: Data from the National Survey on Child and Adolescent Well-being (NSCAW II) were analyzed to examine depression, anxiety, substance use/abuse, suicidality, and attention deficit hyperactivity disorder (ADHD) as reported by teens and their caregivers. In a sample of 815 adolescents, prevalence for each MH problem and correlates (e.g., age, placement location) were identified using bivariate and multivariable logistic analyses. Results: After investigation for maltreatment, 42.7% of teens reported at least one MH problem, regardless of placement. Nine percent reported depression, 13.9% reported suicidality, 23% had substance use/abuse, 13.5% reported anxiety, and 18.6% had ADHD. Of 332 teens with any MH problem, 52.1% reported only one problem, 28.3% had two problems, and 19.6% had ≥ three problems. Teens with prior out-of-home placement had odds 2.29 times higher of reporting a MH problem and odds 2.12 times higher of reporting substance use/abuse. Males were significantly less likely to report depression. Older teens were more likely to report substance use/abuse. Black teens were significantly less likely to report suicidality and ADHD and almost half as likely to report anxiety. Teens with a chronic health condition and teens whose caregiver reported depression had more than twice the odds of reporting anxiety. Conclusions: This study highlights high rates of MH problems in teens of all ages and placement locations and suggests that all teens involved with child welfare should be screened for MH problems, regardless of initial placement status.

Original languageEnglish (US)
Pages (from-to)634-640
Number of pages7
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 2013


  • Adolescent
  • Child welfare
  • Child welfare investigation
  • Foster care
  • Mental health
  • National Survey of Child and Adolescent Well-Being
  • Teens

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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