Caseworker Perspectives on Mental Health Disparities Among Racial/Ethnic Minority Youth in Child Welfare

Disparities in mental health service use exist for children of color in the child welfare system. Studies exploring a theoretical link of provider racial bias to disparities in service use recommend further inquiry into this association. Since measuring caseworker racial bias may be difficult, examining language, particularly as to whether caseworkers attribute racial disparities to structural mechanisms or individual agency and beliefs, may illuminate unconscious racial bias that caseworkers have towards their clients. Therefore, this study employed discourse analysis to examine child welfare caseworker racial explanations of mental health disparities. Qualitative data derived from focus group transcripts of 36 caseworkers who discussed barriers and facilitators of mental health service use were used in this study. Results showed that caseworkers cited factors at the institutional, community, and organizational levels as causes of racial disparities, but also ascribed ultimate responsibility for service use on clients and on caseworkers to facilitate access to services. Integrating anti-racist perspectives into caseworker training and agency policies can challenge racial stereotypes and empower caseworkers and agencies to address structural-level racial disparities. Future research should examine the impact of caseworker referrals on mental health disparities and evaluate the effectiveness of anti-racist training in reducing caseworker racial bias.