Publications by authors named "Amy S He"

11 Publications

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A Swedish national study: Immigrant-country of birth status and child welfare compulsory care among a sample of parents with risky substance use.

Child Abuse Negl 2020 03 17;101:104316. Epub 2019 Dec 17.

Graduate School of Social Work, University of Denver, Denver, CO, USA; Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden.

Background: Sweden has a high percentage of foreign-born residents (18.5 %) and one of the highest overdose death rates in Europe. For immigrant parents with risky substance use (RSU), risk factors associated with immigration status (e.g., economic strain and psychological stress) potentially heightening the risk of involvement with the child welfare system (CWS). Using Swedish registry national data, this study explored the relationship between immigration-country of birth status, psychosocial risk factors, and child compulsory care for parents with RSU.

Methods: Study sample consisted of 5932 parents from 65 Swedish municipalities assessed for psychosocial problems (including alcohol and drug use) using the Addiction Severity Index (2007-2017). Stepwise multinomial logistic regression models examined the relationship between immigration-country of birth status (Swedish born, Nordic-born, and non-Nordic born), psychosocial problems, and compulsory care in the CWS.

Results: Compared to Swedish-born parents, parents not born in Sweden, Norway, Denmark or Finland (non-Nordic born parents) had a lower probability of children living in compulsory care (family homes or institutions). However, after accounting for psychosocial problems, immigration status was no longer significantly associated with children's living arrangements.

Conclusions: Study findings indicate that parental immigrant status (even among parents dealing with RSU) in itself is not a risk factor for compulsory care in the CWS. Moreover, parental employment and health problems posed greater risk for children being in compulsory care. Receipt of targeted services for employment and health problems may help to maintain stable child living arrangements for immigrant parents dealing with RSU.
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http://dx.doi.org/10.1016/j.chiabu.2019.104316DOI Listing
March 2020

A Swedish national study: Immigrant-country of birth status and child welfare compulsory care among a sample of parents with risky substance use.

Child Abuse Negl 2020 03 17;101:104316. Epub 2019 Dec 17.

Graduate School of Social Work, University of Denver, Denver, CO, USA; Department of Social Work, Umeå University, SE-901 87 Umeå, Sweden.

Background: Sweden has a high percentage of foreign-born residents (18.5 %) and one of the highest overdose death rates in Europe. For immigrant parents with risky substance use (RSU), risk factors associated with immigration status (e.g., economic strain and psychological stress) potentially heightening the risk of involvement with the child welfare system (CWS). Using Swedish registry national data, this study explored the relationship between immigration-country of birth status, psychosocial risk factors, and child compulsory care for parents with RSU.

Methods: Study sample consisted of 5932 parents from 65 Swedish municipalities assessed for psychosocial problems (including alcohol and drug use) using the Addiction Severity Index (2007-2017). Stepwise multinomial logistic regression models examined the relationship between immigration-country of birth status (Swedish born, Nordic-born, and non-Nordic born), psychosocial problems, and compulsory care in the CWS.

Results: Compared to Swedish-born parents, parents not born in Sweden, Norway, Denmark or Finland (non-Nordic born parents) had a lower probability of children living in compulsory care (family homes or institutions). However, after accounting for psychosocial problems, immigration status was no longer significantly associated with children's living arrangements.

Conclusions: Study findings indicate that parental immigrant status (even among parents dealing with RSU) in itself is not a risk factor for compulsory care in the CWS. Moreover, parental employment and health problems posed greater risk for children being in compulsory care. Receipt of targeted services for employment and health problems may help to maintain stable child living arrangements for immigrant parents dealing with RSU.
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http://dx.doi.org/10.1016/j.chiabu.2019.104316DOI Listing
March 2020

Examining internal and external job resources in child welfare: Protecting against caseworker burnout.

Child Abuse Negl 2018 07 30;81:48-59. Epub 2018 Apr 30.

Butler Institute for Families, Graduate School of Social Work, University of Denver, Denver, CO 80208, USA.

Given intense job demands, it is not surprising that job burnout is a consistent threat to the well-being and retention of the child welfare workforce. Guided by central postulates of the Job Demands and Resources (JD-R) model which suggests that job burnout develops because of experiences of high work demands coupled with low resources in the workplace, we applied a conceptual model of job burnout (client and work related) that accounts for both internal and external resources available to child welfare workers. Findings among child welfare caseworkers from three states (N = 1917) indicate that job demands (stress and time pressure) were positively related to client- and work-related burnout. Additionally, both internal and external resources moderated the relationships between job demands and client- and work-related burnout. Study findings have workforce management implications in the child welfare sector, including the role resources might play in mitigating the negative impact of job demands on burnout in the child welfare workforce.
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http://dx.doi.org/10.1016/j.chiabu.2018.04.013DOI Listing
July 2018

Interagency collaboration and receipt of substance abuse treatment services for child welfare-involved caregivers.

Authors:
Amy S He

J Subst Abuse Treat 2017 08 16;79:20-28. Epub 2017 May 16.

Graduate School of Social Work, University of Denver, Craig Hall, 2148 S. High St., Denver, CO, USA. Electronic address:

Caregivers dealing with problematic substance use pose persistent challenges for families involved with the child welfare (CW) system. Research has indicated that receipt of substance use disorder (SUD) services help improve family outcomes. However, there are many challenging stages of intervention in the SUD treatment process, including detection, assessment, referral, entry, and completion. Considerable work is needed to illuminate factors that strengthen the delivery of SUD-related services at various points in the treatment services continuum. Although a growing body of work has focused on individual-level correlates, few studies have examined organizational factors that potentially affect the delivery of SUD-related services. This study sought to further understanding of the relationship between CW organizational factors (interagency collaboration and organizational resources) and delivery of SUD-related services in a nationally representative sample of CW-involved caregivers. In this study sample, engagement in collaboration through a memorandum of understanding (MOU) and co-location supported caregiver receipt of a referral to SUD services. Caregivers were more likely to receive a formal assessment for SUD problems when their CW agencies reported the availability of a standardized SUD assessment tool. Also, having arrangements with SUD agencies so that CW-involved families had priority status to enter treatment was pertinent to caregiver receipt of SUD treatment services. These results provide evidence that engagement in collaboration activities and greater organizational resources can increase an organization's capacity to deliver services to clients.
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http://dx.doi.org/10.1016/j.jsat.2017.05.006DOI Listing
August 2017

Service Receipt and Mental Disorders in Child Welfare and Mental Health Systems in Los Angeles County.

Psychiatr Serv 2017 Aug 17;68(8):776-782. Epub 2017 Apr 17.

Dr. He is with the Graduate School of Social Work, University of Denver, Denver. Dr. Traube, Dr. Brimhall, and Ms. Lim are with the School of Social Work, University of Southern California, Los Angeles. Dr. Lecklitner is with the Child Welfare Division, Los Angeles County Department of Mental Health, Los Angeles. Ms. Olson is with the Los Angeles County Department of Children and Family Services, Los Angeles.

Objective: Use of administrative data from child welfare (CW) and mental health systems in Los Angeles County provided a unique opportunity to more closely examine mental health needs of children dually served by these systems. This study examined the presence of mental disorders and correlates of receipt of mental health services by diagnostic classification in this population.

Methods: Data were obtained for 3,191 children receiving services from Los Angeles County's Department of Children and Family Services and Department of Mental Health (DMH) between July 2011 and July 2012. Multivariate linear and logistic regression models examined the relationship between sociodemographic and CW-related characteristics and receipt of outpatient services by clinician-diagnosed mental disorder.

Results: Of the 3,191 referred children, 68% met criteria for one of the four diagnostic classifications. Mood disorders were the most common diagnosis (30%), followed by anxiety disorders (20%), behavior disorders (9%), and attention-deficit hyperactivity disorder (9%). Children with prior DMH involvement received more services regardless of diagnosis. Older children (ages ≥15) received more services than younger children, whereas younger children were more likely to receive family therapy. Race-ethnicity did not play a significant role in predicting service receipt.

Conclusions: The unique mental health needs of CW-involved children were exemplified by the differences found in the percentages of children with diagnoses of mental disorders between this sample and children in the general population. Because of family and placement disruptions among CW-involved children, it is important that the provision of individual therapy is not overlooked in favor of family therapy.
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http://dx.doi.org/10.1176/appi.ps.201600266DOI Listing
August 2017

Interagency collaboration: Strengthening substance abuse resources in child welfare.

Child Abuse Negl 2017 Feb;64:101-108

Graduate School of Social Work, University of Denver, Denver, CO 80208, USA.

Supporting child welfare (CW) workers' ability to accurately assess substance abuse needs and link families to appropriate services is critical given the high prevalence of parental substance use disorders (SUD) among CW-involved cases. Several barriers hinder this process, including CW workers' lack of expertise for identifying SUD needs and scarcity of treatment resources. Drawing from theories and emergent literature on interagency collaboration, this study examined the role of collaboration in increasing the availability of resources for identifying and treating SUDs in CW agencies. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, study findings highlight a lack of SUD resources available to CW workers. On the other hand, the availability of SUD resources was increased when CW agencies had a memorandum of understanding, co-location of staff, and more intense collaboration with drug and alcohol service (DAS) providers. These results provide evidence to support efforts to improve collaboration between CW and DAS providers and showcase specific collaboration strategies to implement in order to improve service delivery.
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http://dx.doi.org/10.1016/j.chiabu.2016.12.011DOI Listing
February 2017

Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

Child Welfare 2015 ;94(5):45-66

To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.
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March 2016

Examining intensity and types of interagency collaboration between child welfare and drug and alcohol service providers.

Authors:
Amy S He

Child Abuse Negl 2015 Aug 15;46:190-7. Epub 2015 Jul 15.

School of Social Work, University of Southern California, Los Angeles, CA 90089, USA.

The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs.
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http://dx.doi.org/10.1016/j.chiabu.2015.07.004DOI Listing
August 2015

Examining intensity and types of interagency collaboration between child welfare and drug and alcohol service providers.

Authors:
Amy S He

Child Abuse Negl 2015 Aug 15;46:190-7. Epub 2015 Jul 15.

School of Social Work, University of Southern California, Los Angeles, CA 90089, USA.

The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs.
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http://dx.doi.org/10.1016/j.chiabu.2015.07.004DOI Listing
August 2015

Alcohol outlet density and related use in an urban Black population in Philadelphia public housing communities.

Health Place 2015 Jan 15;31:31-8. Epub 2014 Nov 15.

University of Pennsylvania, School of Nursing, Center for Health Disparities Research, 18 Ci Blvd, Floor 2L, Philadelphia, PA 19104, USA.

Adolescent alcohol use behaviors are influenced by familial patterns and neighborhood factors. This work explored the influence of individual, family, and environment on alcohol use. Baseline data from a randomized controlled trial with Black mothers son dyads (n=382) were paired with census tract and alcohol control board data. Among mothers, younger age, along with neighborhood factors of alcohol outlet density, race, and education were significantly associated with use. Among sons, older age and alcohol outlet density in the neighborhood predicted use. Findings highlight neighborhood influence, beyond family qualities, as a significant determinant of disadvantaged Black mothers' alcohol use. Implications for public health policy are discussed.
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http://dx.doi.org/10.1016/j.healthplace.2014.10.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305475PMC
January 2015

Perceptions of parental substance use disorders in cross-system collaboration among child welfare, alcohol and other drugs, and dependency court organizations.

Child Abuse Negl 2014 May 21;38(5):939-51. Epub 2013 Nov 21.

Children and Family Futures, Lake Forest, CA 92630, USA.

Cross-system collaboration among child welfare (CW), alcohol and other drugs (AOD), and court organizations shows promise in addressing the many needs of CW-involved families experiencing parental substance use disorders (SUDs). Research has suggested that differing perceptions of parents with SUDs among staff in these organizations may hinder the collaborative process. Using a sequential explanatory mixed-method approach, this study explored staff perceptions of parental SUDs among CW, AOD, and court organizations. Logistic regression analyses indicated that, compared to CW respondents, AOD respondents were: (a) less likely to believe that parents could provide effective parenting; (b) more likely to believe that abstinence should be a criterion for reunification; (c) more likely to agree that parents should receive jail time as a consequence for noncompliance with court orders; and (d) more likely to believe that parents could succeed in treatment. Thematic analyses of these focal areas identified two core themes (focus on the primary client and mandated time frames for permanency), as well as multiple subthemes, that provided a nuanced understanding of differing perceptions on these matters. Suggestions for the development of anticipatory cross-system training and practices and implications for policy evaluation are discussed.
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http://dx.doi.org/10.1016/j.chiabu.2013.10.020DOI Listing
May 2014
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