Beyond Child Abuse: The Array of Family Problems brought to the Child Welfare System.

The majority of children who encounter the child protective services (CPS) system are referred for reasons other than suspected physical or sexual abuse. Yet, specific concerns or risks, typically falling under the umbrella of neglect, remain poorly documented in academic and public debate. Using population-based data for 145,745 children referred to the Pennsylvania child welfare system in 2021 for reasons other than physical or sexual abuse, this study describes the types and overlap of family concerns documented. Parental substance use was the most frequent allegation (28% of referrals), followed by child behavioral concerns (24%) and unmet material needs (23%). There was a high degree of comorbidity, with half of referrals including allegations in multiple categories. Yet, only 34% were found valid, indicating service intervention. Of all allegation types, child's behavioral health was most likely to appear alone, with 14% of referrals reporting a concern about the child's behavior with no co-occurring allegations. Findings suggest that there is no single driver of the high volume of CPS referrals. However, a focus on increasing access to effective mental health and substance use treatment for parents and adolescents may reduce reliance on CPS to address these crises.