Follow-Up Care After Maltreatment: Sociodemographic Associations With Timeliness in a Southern State

Abstract

Children who experience maltreatment are at elevated risk of developing mental health difficulties. Even so, they often do not receive timely, evidenced-based mental health treatment, which may exacerbate the risk of poor outcomes. This study aims to describe the receipt of timely follow-up care after maltreatment in a southern state with known treatment shortages and aims to identify factors associated with timely follow-up care. We utilized a retrospective cohort design using 2014 Mississippi Medicaid administrative claims data for youth 0–18 years. Prevalence estimates and associations with definite and probable maltreatment (based on recorded age/injury combinations) during inpatient and outpatient healthcare encounters were evaluated. Rates of 30-day maltreatment follow-up with any medical or behavioral health provider were also assessed. Prevalence estimates of definite and probable maltreatment in the eligible study population ( N = 324,752) were 0.53% and 3.8%, respectively. Only one-third of identified children received 30-day follow-up. Black and older children as well as children diagnosed with anxiety or depression were more likely to receive 30-day follow-up than younger children, white children, and children without anxiety or depression. Low rates of timely follow-up indicate the need for intentional workflow practices to increase the likelihood of follow-up.

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“…When their case is substantiated, children received CPS services disproportionately based on race. Calvert et al (2023) found only onethird of identified children received 30-day follow-up, with Black and older children and those with anxiety or depression being more likely to receive 30-day follow-up than were younger children, White children, and children without anxiety or depression. Metzger et al (2023) sought to better understand barriers and facilitators of service utilization for Black caregivers of youth referred to child advocacy centers (CACs), finding a lack of assistance and information in the referral and onboarding process, transportation issues, lack of childcare, restrictive employment hours, system mistrust, and stigma associated with the service system, as well as other parenting stressors.…”

“…When their case is substantiated, children received CPS services disproportionately based on race. Calvert et al (2023) found only one-third of identified children received 30-day follow-up, with Black and older children and those with anxiety or depression being more likely to receive 30-day follow-up than were younger children, White children, and children without anxiety or depression.…”