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Children in foster care in the United States often require behavioral health services due to their high rates of mental health needs. Many children in foster care who need behavioral health treatment end up in hospitals and psychiatric institutions, even when not medically necessary. Home-based behavioral health services (HBHS) for children can result in similar or better clinical outcomes than in-patient care, often with higher family satisfaction and lower costs.

Using Medicaid data from 28 states, a research team lead by Johns Hopkins University and the Center for Child Health Services Research at Icahn School of Medicine examined mental health service utilization among children aged 3-18 with primary mental health diagnoses across three groups: children in foster care, children with disability, and children from low-income households. HBHS use was highest among children in foster care and was associated with lower odds of hospitalization and emergency department visits and higher odds of school-based mental health services use.