Disparities in Mental Health Service Referrals in Child Sexual Abuse Cases

Child sexual abuse increases risk for future negative mental health outcomes. However, the factors influencing the likelihood of receiving referrals for mental health services for victims of child sexual abuse are not well understood. The current study sought to determine such factors and disparities via a secondary analysis of the National Survey of Child and Adolescent Well-being (NSCAW), a national probability study of children and caregivers investigated by US child welfare agencies. The sample consisted of the subset of children from NSCAW residing in-home with confirmed sexual abuse cases (n = 225, weighted N = 58,635). Weighted multivariable logistic regression analyses were conducted to estimate the odds of receiving a mental health service referral while controlling for important demographic and clinical characteristics. Black children and children residing in non-urban counties were significantly less likely to receive mental health referrals, while child health insurance coverage type and symptoms of mental health concerns were non-significant predictors. These results highlight an urgent need for efforts to overcome systemic biases and increase access to mental health services for victims of child sexual abuse.