Child welfare caseworkers' perspectives on the challenges of addressing mental health problems in early childhood

• We examine challenges in addressing ECMH concerns in child welfare contexts.
• Workers recognize the importance of early identification and intervention for ECMH.
• Differing parent and worker views on child development create challenges.
• Communities lack high-quality, developmentally appropriate ECMH services.
• Workers disagree on the scope of their work related to ECMH.

Although nearly half of child maltreatment victims are under the age of five and at high risk for developing serious emotional or behavioral problems, few young children involved in the child welfare system receive treatment. As the first point of service contact, child welfare caseworkers can play a key role in quickly identifying children with mental health problems and linking them to services. This study examines caseworkers' perspectives on the challenges of addressing mental health problems in early childhood. Based on five focus groups conducted with 50 caseworkers from an urban, public child welfare agency, results suggest that although workers acknowledge the importance of early intervention, difficulty identifying mental health needs in early childhood and workplace barriers impede linkage to services. Given the lasting impacts of early experiences on children's development, it is imperative that these challenges be addressed. Implications for systematic mental health screening and caseworker training are discussed.