Building Capacity for Youth Mental Wellness: Feasibility and Acceptability for a Mental Health Family Navigator Model for Foster Parents.

Goal: This R34 study will pilot the Family Navigator Plus (FN+) program for foster parents to increase access to mental health (MH) services for children in foster care aged 6-17. Background: Youth in care experience disparities in mental health symptoms and access to treatment. Compared to the general child population, children in foster care are 4-5 times more likely to attempt suicide, and about 3 times more likely to have experienced trauma or have a diagnosed depressive or anxiety disorder. About half of children in foster care exhibit clinically significant MH needs, but less than a quarter of those children receive MH services. Those who do – experience delays in seeking treatment. Significance: This project will pilot the FN+ program to promote treatment engagement by building foster parent capacity to 1) recognize their child’s specific MH needs and address any preliminary barriers to treatment; 2) work with the child’s caseworker to engage the child in mental health services; 3) manage the child’s difficult behaviors; 4) remove remaining barriers to treatment access and use digital mental health tools during long waits for treatment, and 5) support treatment goals at home. Innovation: The proposed project is innovative in five ways. First, we plan to conduct the first pilot of a family navigator program in one of the highest-risk populations for developing psychiatric disorders: children in foster care aged 6 – 17 years. Second, we will pilot the use of a trained Community Health Worker in the family navigator role as a sustainable and cost- effective method to promote early MH treatment access. Third, we will provide rapid feedback regarding MH assessment results to promote foster parent understanding of child functioning and early treatment engagement. Fourth, we will use telehealth to facilitate family navigator access in areas with less access to support services. Fifth, we will help parents to find digital mental health tools to use during long waits for treatment. Design: Human-centered design and an open trial will inform a subsequent small randomized controlled clinical pilot to test the feasibility of the study protocol in preparation for a larger randomized controlled trial (RCT). Population: Foster parents of youth in care aged 6 to 17-years. Outcomes: All aspects of the study protocol (e.g., condition allocation, treatment and control condition procedures, data collection, etc.) will be operationalized in preparation for the subsequent RCT. The primary outcome is increased foster parent activation in the foster child’s mental health care. Secondary outcomes include reduced barriers to treatment access and perceived change in child behavior.