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This chapter reviews studies of mental health service need and use in children involved in the child welfare system. It presents two comprehensive views: one of the research literature leading up to the NSCAW study, and another that depicts mental health service use in this population over a full 36 months. It considers three distinct age groups of children: those aged 2 to 5 years, those 5 to 10 years, and those 11 years or older. In addition to offering the most detailed examination of the use of mental health care by the younger children involved in child welfare, the chapter is perhaps the first study that uses a measure of developmental functioning to examine need for care in the youngest group (2-5 year olds). The striking finding is the larger gap between need and use for this youngest segment of the NSCAW cohort. Meanwhile, the findings about the powerful role of race/ethnicity in use patterns confirms at the nationwide level major findings from all local studies that have examined this question.
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