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Children Affected by Parental Substance Use or Mental Health Conditions

This series of fact sheets uses data collected by several agencies within the U.S. Department of Health and Human Services to illustrate cross-cutting issues with respect to families with substance use or mental health conditions, including the health and well-being of their children, and their likelihood of child welfare system involvement. The fact sheets were produced by the HHS Office of the Assistant Secretary for Planning and Evaluation in cooperation with the Department’s Behavioral Health Coordinating Committee, Subcommittee on Children and Youth.

Parental Behavioral Health and Child Maltreatment

Millions of American children have lived with people affected by substance use and mental health challenges. Parental behavioral health issues are common risk factors for child welfare involvement. But most children who have lived with people affected by these issues do not encounter the child welfare system and could benefit from supportive services through other service systems.

This fact sheet, using 2019 data collected by several HHS agencies, reviews:

  • The number and proportion of children in the U.S. living with someone with a substance use disorder and the number and proportion living with someone with a mental health challenge
  • The number of children reported to the child welfare system and the number entering foster care for whom parental substance use is identified as a risk factor
  • Recognizes that only a small percentage of children who have lived with someone with a substance use problem encounter the child welfare system

Parental Behavioral Health, Adverse Childhood Experiences, and Family Resilience

An Adverse Childhood Experience (ACE) is an event that occurs in childhood that is either potentially traumatic or may undermine a child’s sense of safety, stability, and bonding with parents or other caring adults. ACEs can negatively impact a child’s health and well-being and experts view cumulative ACEs as particularly harmful to a child’s long term health and well-being. Living with someone with a substance use or mental health issue are two possible ACEs that are frequently measured in studies.

This fact sheet, using 2019 data collected by several agencies within the U.S. Department of Health and Human Services, reviews:

  • The proportion of U.S. children who have lived with someone with a substance use challenge and the co-occurrence of that ACE with other ACEs
  • The proportion of U.S. children living with someone with a mental health challenge and the co-occurrence of that ACE with other ACEs
  • Examines how family resilience interacts with ACEs:
    • About three-quarters of children who lived with someone with a substance use issue and two-thirds of those who lived with someone with a mental health challenge live in households that nonetheless demonstrate high family resilience
    • Those children living with someone with a substance use or mental health challenge who are also living in resilient families were less likely to have experienced additional co-occurring ACEs

Parental Substance Use and Child Welfare System Involvement

Children who enter the child welfare system and whose maltreatment report or foster care entry are associated with parental substance use have varying experiences and characteristics. Further, families’ experiences with the child welfare system differ depending on whether parental substance use was associated with their maltreatment report or foster care placement.

This fact sheet, using 2019 data collected in the Adoption and Foster Care Analysis and Reporting System, describes:

  • The proportion of children reported for maltreatment and entering foster care with parental substance use identified as a risk factor
  • Data on differences in these factors by child age and the urbanicity of the county in which they live
  • Patterns of co-occurring reasons for children’s placement in foster care for those with and without identified parental substance use
  • Foster care lengths of stay by age and whether substance use was a factor in the child’s out of home placement