Child-welfare agencies now have available an updated set of mental health
practice guidelines to direct their work. The initial guidelines were based on
a consensus conference held in October 2007 by three nonprofit
The guidelines were developed by the Annie E. Casey Foundation, Casey
Family Programs, and the REACH Institute (REsource for Advancing Children's
Health) under the auspices of the Child Welfare League of America. Their
findings were endorsed by several professional and advocacy organizations,
The guidelines mandate screening of children and adolescents within 72
hours after they enter the foster-care system to identify those at immediate
risk for harm to themselves or others; those in need of treatment for mental
illness, including substance abuse problems; and those at high risk for
running away from placement.
Children should be screened again within 30 days to assess overall function
and find any needs for longer-term services.
Children screening positive at either assessment should then be referred
for a comprehensive mental health evaluation. Agencies should also screen
these children at least once a year while in care to monitor their
Child-welfare agencies should ensure that evidence-based psychosocial
interventions, in collaboration with mental health services, are available to
the children who need them. If psychotropic medications are indicated,
informed consent must be obtained from the adults responsible for the child,
including birth parents whose rights have not been terminated. Adolescents
over age 18 must consent to treatment.
Once a drug is prescribed, the agency must ensure its availability to the
child, monitor his or her response, maintain a documentary record of
treatment, and review medication use.
Caseworkers should be trained to recognize child mental health disorders
and treatment options. Adequate planning must be provided before children
leave foster care to inform them about their condition, identify care
resources including prescribers, and provide for payment, if needed.
The guidelines also address ways to support and empower parents and
"Mental Health Practice Guidelines for Child Welfare" is