Abstract
Background
Cross-sectional analyses have identified factors associated with the decision to provide continued child welfare services. Determinations that children are at risk of maltreatment have been found to influence investigative decision-making in Ontario, over and above all other family and case characteristics.
Purpose
This study uses longitudinal administrative data to assess the decision to transfer a family to ongoing child welfare services within twelve months of an initial investigation.
Methods
We developed an entry cohort from administrative data held in the Ontario Child Abuse and Neglect Data System (OCANDS), which included all families investigated during 2013 in participating agencies. We conducted descriptive comparative analyses and used results to generate a generalized linear model to determine predictors of transfer.
Results
Of the 34,397 families investigated in 2013 by participating agencies, 23% were transferred to ongoing child welfare services within 12 months. Rates of transfer were highest when the primary caregiver was under 25; caregiver-child conflict or caregiver capacity were the primary reason for the investigation; immediate safety was a concern; and future risk of maltreatment was high. In the multivariable model, families considered high or very high risk were more likely to be transferred (RR: 2.13; 95% CI: 2.04, 2.22, p < 0.001), as were families investigated for caregiver-child conflict (RR: 2.53; 95% CI: 2.34, 2.77; p < 0.001).
Conclusions
Concerns about risk of harm appear to drive decision-making from the point of referral through the decision to transfer to ongoing services in a sample of agencies in Ontario. It is unclear whether child welfare services are the appropriate mechanism for effectively addressing circumstances that may put children at risk, particularly when the structure and delivery of services have been designed to intervene when children have already been harmed.