Timely identification of mental health problems in two foster care medical homes

Despite known high rates of mental health problems among children in foster care, these problems are often not identified promptly by primary care or other systems. A novel delivery system is a centralized primary care practice for foster care. The purpose of this study was to examine the identification of mental health within two pediatric medical homes for foster care. We conducted a retrospective medical chart review of all children, aged 6–18 years, newly entering foster care, in two foster care clinics serving two county-wide populations. Our sample of 242 children describes demographics, rates for mental health problem identification, and length of time after entering foster care that mental health needs were identified. We used logistic regression analyses to examine variables associated with identification of mental health needs. Both centralized foster care medical homes had high rates for identification of mental health problems (> 70% in both sites), timely identification (the majority identified within two months after entry into care), and high mental health referral rates for children entering foster care (> 70%). Our findings suggest that attention to mental health needs for children in foster care within their primary care setting can impact identification rates and management of mental health.