Objective-Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by the child welfare system.Methods-This was a longitudinal analysis of data from a 36 month period in the National Survey of Child and Adolescent Well-Being (NSCAW). The sample consisted of 1,613 children within 75 child welfare agencies who were 2 years or older and had mental health problems at baseline. IOR intensity was measured as the number of coordination approaches between each child welfare agency and mental health service providers. Separate weighted multilevel logistic regression models tested associations between IORs and service use and outcomes, respectively.Results-Agency level factors accounted for 9% of the variance in the probability of service use and 12% of mental health improvement. Greater intensity of IORs was associated with higher likelihood of both service use and mental health improvement.Conclusions-Having greater numbers of ties with mental health providers may help child welfare agencies improve children's mental health service access and outcomes.Practice Implications-Policymakers should develop policies and initiatives to encourage a combination of different types of organizational ties between child welfare and mental health systems. For instance, information sharing at the agency level in addition to coordination at the case level may improve the coordination necessary to serve these vulnerable children.The insufficient provision of mental health services to emotionally disturbed children in the child welfare system has been well documented (Burns et al., 2004;Glisson, 1996;Hurlburt et al., 2004;Trupin, Tarico, Benson, Jemelka, & McClellan, 1993 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Author ManuscriptChild Abuse Negl. Author manuscript; available in PMC 2010 June 1. system, for instance, one recent study found 42.4% of children to have mental health problems; however, only 28.3% received outpatient specialty mental health services (Hurlburt et al., 2004). Although many child welfare agencies provide mental health services, other agencies often provide at least some of the treatment children need. Inadequate interorganizational relationships (IORs) between child welfare and mental health providers thus may partly account for the substantial gap between needs and use ...