Mental health service utilization in children adopted from US foster care, US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization. As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17years old (N=1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse). For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services. •For boys mental health service: foster (52.4%), private (41%), foreign (40%)•Girls' corresponding rates were 36.3%, 24.8%, and 30.9% respectively.•Foster care adoptees had a higher risk for mental health services.•No difference between private and foreign adoptees in using mental health services•Demographic risks increased odds for receiving mental health services.