Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system

Antonio R. Garcia, Elizabeth Circo, Christina DeNard, Natalie Hernandez

Research output: Contribution to journalArticlepeer-review

34 Citations (SciVal)


While the gap between need for and access to mental health services is well documented among children of color in foster care, little is known about why they are sustained. To illuminate barriers of service delivery, thirty-six caseworkers participated in one of five focus group meetings in a large urban Mid-Atlantic City. Ground Theory Methods revealed that there are barriers and facilitators at the macro, meso, and micro practice orientations. At the macro-level, development of effective practice strategies and proximity to effective services are likely to influence dissemination of effective practices. Secondly, at the meso-level, job support is needed to facilitate awareness, but for case managers to feel supported, they need effective training and opportunities to facilitate interagency collaboration. Finally, at the micro-level, cultural competence largely impacts implementation of effective practices. However, increased awareness around the social ills of stigma and the salience of "insider work" are needed to increase cultural competence. A "downstream" effect in which there are numerous barriers identified at the macro level has a direct negative impact on organizational capacity and readiness to deliver and engage youth and families in mental health services served by the child welfare system. Findings underscore the need for child welfare agencies to build supports at the macro, meso, and micro practice levels to ameliorate mental health service disparities.

Original languageEnglish
Pages (from-to)110-122
Number of pages13
JournalChildren and Youth Services Review
StatePublished - May 1 2015

Bibliographical note

Funding Information:
We would like to thank the participants for taking the time to share their experiences and expertise, and the University of Pennsylvania Research Foundation (Grant ID 350-3510-000002-0026) for funding this study.

Publisher Copyright:
© 2015 Elsevier Ltd.


  • Child welfare
  • Community-based agencies
  • Disparities
  • Dissemination
  • Engagement
  • Ethnicity
  • Implementation
  • Mental health services
  • Privatization
  • Race

ASJC Scopus subject areas

  • Education
  • Developmental and Educational Psychology
  • Sociology and Political Science


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