African American Parents' experience with early childhood mental health and child welfare services: Racism and seeking understanding

Background: Impacts of child maltreatment and child welfare involvement on young children are significant and early childhood mental health services are important to reduce risk factors for them. However, racial disparities limit access to mental health services. Objective: The purpose of this study is to understand the experience and perspective of birth parents accessing mental health services for their child welfare -involved toddlers and preschoolers aged 1.5 to 5 years. Specifically, this study seeks to examine racism and service disparities among African American parents. To our knowledge, there is no study examining birth parents' perspectives on mental health services for young children. Participants & Setting: This study collected original qualitative data using semi -structured interviews. Nine African American participants shared their experiences from February 2018 to November 2019. Methods: Qualitative data analysis used a pragmatic realist approach to understand the complex phenomenon of parents' experience accessing services. NVivo 12 was used for qualitative analysis to help condense themes for the study. Quantitative descriptive analysis using Stata 14.2 provided the sample description. Results: Equity and understanding was a main theme with three sub -themes; racism, child welfare understanding the family, and mental health provider understanding the family. Participants experienced racism, creating a mistrust of mental health providers and child welfare workers. Conclusion: Implications for policy and practice to improve equity and understanding of families in child welfare are discussed. Future research can build on this study by examining how racism impacts service use and how interventions can increase understanding of families using child welfare and mental health services.