Emotional and behavioral problems of children in residential care: Screening detection and referrals to mental health services

Adverse family conditions, abuse and neglect during childhood present important risk factors for the appearance of emotional and behavioral problems. The main aim of this paper is to describe the presence of these kinds of disorders in children in residential child care and to explore individual, socio-family and care process factors associated with the use of mental health services. The sample consisted of 1216 children 6–18years old in residential care in several Spanish regions. Information about emotional and behavioral problems was gathered according to two criteria: receiving some kind of treatment services and/or being identified as within the clinical range in the Child Behavior Checklist (CBCL). Results showed that 49% of cases were receiving some kind of mental health treatment and 61% were identified as within the clinical range in some of the broad band scales of the CBCL. In terms of agreement between referral to treatment and CBCL scores, results showed that four out of ten cases identified as within the clinical range were not receiving any kind of treatment. Several factors related to the type of problems detected in the CBCL, personal variables, and child care arrangements are associated with greater use of mental health services. •49% of children in residential child care in Spain were receiving mental health treatment•61% reached the clinical range on the broad-band scales of the Child Behavior Checklist•Four out of ten cases identified as within the clinical range in the screening test were not receiving attention•Intellectual disability, unaccompanied migrant children and clinical range are associated with probability of treatment•Systematic detection tools of mental health needs are critical to ensure detection and early referral to treatment