Purpose: To examine prevalence and correlates of five mental health (MH) problems among
12e17.5 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.
2013 Society for Adolescent Health and Medicine. All rights reserved