American Indian Children in the Child Welfare System

Introduction: American Indian/Alaska Native (AI/AN) children appear to have an elevated risk for exposure to community and family violence, which places them at greater risk for the development of mental health problems. Exposure to trauma and violence, along with other family adversities, may also increase their likelihood for involvement with child welfare (CW) services following allegations of abuse and neglect. Yet, little is known about AI/AN children in the CW system. This study sought to answer the questions: (1) Among the CW population, does the mental health of AI/AN children differ from children of other race and ethnicities? and (2) How does violence exposure impact the mental health of AI/AN children in CW?

Methods: This study analyzed secondary data from the second cohort of the National Survey of Child and Adolescent Well-being (NSCAW II). The subset of NSCAW used to answer question 1 was children 7 years and older (n=1887). The sample was further restricted to only AI/AN children for question 2 (n=178). Witnessing violence was measured with the Violence Exposure Scale and CW worker assessment of domestic violence. Children’s mental health was measured with the Trauma Symptom Checklist, Children’s Depression Inventory, and the internalizing and externalizing subscales of the Child Behavior Checklist. Parenting was measured by two worker reported variables: poor parenting skills and excessive discipline. Variations in child mental health and violence exposure by race/ethnicity was examined with chi-square and t-tests. Multivariate regression was conducted to examine outcomes of interest when accounting for demographics, exposure to violence, and other case characteristics.

Results: AI/AN children comprise 11% of CW children over age 7. In the bivariate analysis, AI/AN children were more likely to enter CW depressed and reported witnessing more severe violence than their non-AI/AN peers. However, in the multivariate analysis race/ethnicity was no longer significant. Among AI/AN children witnessing violence was a robust predictor of depression, externalizing problems and internalizing problems 3-years after the initial maltreatment report. Worker assessment of poor parenting skills also predicted worse 3-year mental health outcomes.

Conclusions: AI/AN children are highly over-represented in CW. While they make-up 2% of the US child population, they represented 11% of the CW population studied here. Witnessing violence and poor parenting is highly correlated with poor mental health outcomes among AI/AN children. This suggests the need for effective, culturally relevant violence prevention interventions, as well as parenting interventions to enhance outcomes for this understudied, underserved vulnerable population.