The Effects of Foster Care on Mental Health

The path to sound mental health is really quite simple. Over an extended period of time, a child needs a nurturing home that’s safe and secure, loving and responsive caregiver(s), and stability. In this environment, strong bonds are built, a sense of self worth is developed and a joyful life is possible. However, the complex trauma experienced by most youth in the foster care system often sets these children on quite a different path for their mental health.

Their mental and behavioral health is affected by what can often be a long history of abuse and neglect. And that’s before they even enter their first foster home. Broken family relationships, multiple transitions, and inconsistent access to mental health services along with poverty are all contributing factors.

Exacerbating the problem is the risk of unresponsive care once placed in a foster home. If physical needs are met, but caregivers are insensitive to attachment signals and emotional needs, the child is at a high risk for attachment disorders as well.

Young children removed from their home who experience attachment disorders are more likely to exhibit oppositional behavior, crying and clinging. As time goes on, severe disturbances in their relationships with caregivers can occur.Any of several disorders can manifest in adulthood.

In fact, up to 80 percent of children in foster care experience significant mental health issues. When compared to the general population of approximately 18-20 percent, it’s clear that children in foster suffer greatly in terms of mental health.

The chart below, taken from the Casey National Alumni Study, demonstrates clearly the differences between those with foster care experiences compared to the general population. As can be expected, the PTSD and panic disorder rates are especially high and disproportionate to the general population. Drug dependence and bulimia are also quite disproportionate.

Microsoft Word - Casey_Natl_Alumni_Study - Mental_Health_OutcomePlease Note: Chart republished from The Foster Care Alumni Studies Stories from the Past to Shape the Future. For more information on the mental health outcomes  in the Casey National Alumni Study visit (enter username: researchguest and password: caseyguest).

Another component of this complex issue is medication. The propensity to medicate is of particular concern in this population. Psychotropic medications treat behavioral and mental health problems. These medicines include anti-anxiety, stimulants, mood stabilizers and antipsychotics. It is estimated that youth in foster care use these medicines at significantly higher rates (13-52 percent) than the general population (4 percent). Often, multiple medications are prescribed without any conformity.

Finally, it appears that there is no significant delivery of mental health care services to these youth. The majority of services rendered are referrals to mental outpatient treatment centers.

Clearly, there is a lot of work to be done in this area. Is there any good news? There is some. That these mental health studies are now being performed, sheds light on the important issues facing foster care youth and foster care alumni with regards to their mental health. Other than PTSD, once in recovery, foster care alumni recover at the same rates as the general population. And, since 2011, over half of the states have enacted legislation regarding the use of psychotropic drugs. It’s a start.










Top 8 Ways To Help Your Foster Child In School

Top 8 Ways To Help Your Foster Child In School

By Dr. John DeGarmo Leading expert in Parenting and Foster Care Field.

Published in The Huffington Post 08/19/2016 04:35 pm ET | Updated Aug 19, 2016


School. For so many children, it is a place of learning, of laughter, and a place to make friends and form relationships.

Not so for children in foster care. It is a very difficult place, where academic failure and behavior problems are the norm.


For your child from foster care to truly have a chance to succeed, you as a foster parent must lead the charge and blaze a path as an advocate, fighting for your child’s every chance. Most likely, you will be the only one fighting for your child, as the caseworker and teacher are overwhelmed with all they have to do. Therefore, it is up to you. You need to become as involved as possible. The more active foster parents are in school and activities, the more likely children will succeed. Here are the top eight things you can do to help your child from foster care succeed in school.


1. Keep in Contact.
Reach out to school employees and form a positive working relationship with them. Let school counselors, teachers and administrators know that they can always call or email you if needed. Also obtain contact information from your child’s teachers. Attempt to remain in regular contact with them. Use all forms and means of communication. Through text messages, email, cell phones, Facebook, Twitter, and other social media platforms, there are numerous ways to reach out to teachers and school employees. It is essential that you remain up to date with your child’s progress, both with academics and behavior.
2. Update Teachers
Not only should you as a foster parent request regular behavior updates from the child’s school, but a responsible foster parent will provide such information to the school as well. If your foster child is having a particularly difficult time at home, let the teachers and counselors know, allowing these educators to be prepared and equipped to handle any difficulties that might come their way.
3. Let School Know About Visitation Day
Visitation day can be hard sometimes. It is likely that your child from foster care will have a difficult time concentrating and focusing on school work the day of a visitation, and many times the day after, as well. When your child is having a emotional or challenging time with visitations, you can help your child by informing the teachers beforehand, giving them some notice in advance. A note in your child’s school agenda, an email, a text message, or a phone call are all means that you can use to notify teachers and school counselors. Along with this, you can suggest to the child’s caseworker that visitations and medical appointments be made after school or on weekends, in order to not miss any more days of school, so the child doesn’t fall even further behind.


4. Help with School Work
School work will likely not come easy. Foster children, in general, tend to perform below level in regard to both academic performance and positive behavior. And most children in foster care are behind in math and reading skills. It is important that you and the child’s teachers set realistic goals for the child. Find out where the child’s learning ability and level of knowledge is, and work with him at this level. Talk to your child’s teachers about his/her abilities and if any accommodations need to be made. You should encourage your child to set goals and expectations, and celebrate every success, no matter how big or small they may be.


5. Be Involved
You can help your foster student in his development by encouraging your child to participate in activities outside of the classroom. Many schools have extracurricular organizations and activities with various school sports, music, and clubs. Along with this, community sports and organizations also allow kids the opportunity to not only participate and develop these skills, but to learn new skills, develop talents and to exercise.


6. Be Ready
It is going to be tough for your child. A child in foster care often has a very hard time exhibiting proper school behavior during the school day, as school is simply a constant reminder that they are, indeed, foster children without a true home. The continuous reminder that their peers are living with biological family members, while they are not, is a difficult reality for them and can be manifested in several ways. Some foster children simply withdraw and become antisocial in an attempt to escape their current environment. Others may lash out in violent behavior.


7. Take A Tour
This is yet another unfamiliar place for your child from foster care. Before his very first day in class, take some time to go on a tour with your child through the building. Ask an administrator or school counselor to guide you and your child through the school. This will allow your child to feel more comfortable once he begins class.
8. Understand This Is Probably Not Fun
School is the last place your foster child wants to be at. He wants to go back to his home, his famiyl, and is simply trying to survive each day. Foster children often have a difficult time exhibiting proper school behavior during the school day. For many, school is a constant reminder that they are, indeed, foster children without a true home. The continuous reminder that their peers are living with biological family members, while they are not, is a difficult reality for them and can be manifested in several ways. Some foster children simply withdraw and become antisocial in an attempt to escape their current environment. For many foster children, violent behavior becomes the norm, as they not only act out in a negative and disruptive fashion in school, but in their foster home as well. This can prompt yet another move to a new foster home and another school.

Your child from foster care is depending on you to help him, not just in your home, but at school, as well. Quite simply, if you don’t help him succeed, who will?


Substance Abuse — The Thief that Robs Parent from Child

What do we really want for our children? We want them to grow into kind, functioning adults who are joyful, find their purpose and ultimately contribute to society. Easy stuff right? Under the best of circumstances, that’s a pretty tall order.

sadchildParents will do whatever it takes to help their children reach these goals. It can be challenging. For starters, kids need safety and security and food and shelter. But also important are clothing, medical care, heat in cold climates, lessons in hygiene, boundary setting, emotional support, socializing. The list goes on and on. But love and consistency are at the center of developing a young child, born full of potential, into a healthy adult.

But what if, as a parent, you don’t have the all the tools you need? What if you realize the big job ahead of you? What if you get scared? Or you don’t have the best coping skills? What if drugs or alcohol gave you relief? Or, you thought it did.

Enter substance abuse into a family, and even a child’s most basic needs are at risk.

Though each child’s experience will vary, most children of parents who suffer from substance abuse face a myriad of issues that affect the child’s entire life:

A parent might not come home at night, leaving the children to fend for themselves;

Mom cannot keep promises and may not even remember a promise was made;

Dad may have trouble keeping a job and struggle with paying bills, providing food or medical care;

Mom cannot help with homework, prepare meals or provide lessons in personal hygiene.

Consider this child, a child of a parent who suffers from substance abuse and you can imagine him going to school hungry, perhaps unwashed, in unclean and poor fitting clothes with incomplete homework. He or she, most likely on top of all that they endure at home, will experience teasing and bullying at school. He or she, most likely, has no coping skills to deal with the day they’ve been given.

Add family fights, neglect and emotional or physical abuse, and that’s a recipe that can lead to a child or children being removed from their home and placed into foster care.

Foster care can isolate a child, preventing them from forming healthy relationships with their peers. We can hope their teacher offers kindness instead of a reprimand for incomplete homework. Hopefully, the cafeteria server sees a hungry child and gives an extra helping and offers a smile. But in spite of the kindness offered, the feeling of hopelessness is a natural response to being removed from their home, and even though it is through no fault of their own, the child feels responsible for tearing the family apart.

With all that suffering placed on their small shoulders, the child begins to lose focus at school, they act out, they cannot see a future for themselves. All too often, they feel lost, confused and voiceless.

Fortunately, for a child living in foster care, their hope, their voice comes in the form of a CASA volunteer. A CASA volunteer may be the only compassionate, consistent adult in that child’s precarious life. One single bond from a caring adult can give hope to a child who deserves joy and the opportunity to reach their potential. One single bond can save a child’s life.

CASA volunteers are trained in the complicated issues of families dealing with substance abuse. A CASA volunteer can help guide families to the resources and the support they need to help break the cycle of substance abuse, get their family back together and ensure another child, another family, is given the opportunity to thrive.

Learn more at


When Families Reunite Everyone Wins

One day at school, a seven-year-old Jonas was found with an apple-sized bruise on the back of his neck. His teacher brought him to the school nurse, who found more bruises on the child’s back, sides, and arms. Most disconcerting were the long, thin, vertical marks that stretched from his neck to the middle of his back. The result of a belt, the nurse thought.

The nurse asked the boy how he got the bruises.

“I scratched myself,” he replied.

The next day, a worker from child services was called into the school to speak with the child. In addition to the linear, vertical bruises on his back, he also had similar horizontal marks across his rib cage. His ear was swollen, his legs were bruised and scabbed, and he had dark marks on his behind and his bicep.

When the division worker asked the child how this happened to him, he said he was not in pain and that he scratched himself.

“Is your mokids_drawingther nice to you?” The division worker then asked.

The boy was silent.

Back at home, Jonas lived with his infant sister Mia, his mother, and Mia’s father. As a child, the mother had been disciplined with a belt and used the same manner to discipline her son. But one day after the child had made a mess, she struck her son seven times with a belt creating the bruises that the teacher, nurse and case worker were looking at now.

A Notice of Emergency Removal was issued, and the siblings were placed under the custody and supervision of the Division. Fortunately, the children were able to stay with their grandmother during this time.

CASA Volunteer, Bill was assigned to the children’s case. During a visit to Jonas’ school, Bill learned that he was having difficulty interacting with his peers; he would act out aggressively if other students got too close. His ability to focus also needed improvement. Bill asked the teachers if there were opportunities for counseling or training that could help. They suggested interpersonal relationship or anger management training, and Bill put in a request to the courts for these services.

Bill also sought out the children’s medical records and visited them at their grandmother’s house. When Mia was diagnosed with medical problems that were not being corrected with medication, Bill recommended early intervention services for her, which were ordered by the courts.

While the children were doing well with the grandmother, the children’s mother and boyfriend received counseling and continued to see their children on a regular schedule. She was making progress, even being diagnosed and now treated for PSTD, which she suffered from because of her previous service in the armed forces.

While CASA Bill continued to monitor the children’s well being, he stayed on top of the mother’s progress as well. When she was involved in a domestic violence issue with her boyfriend, Bill recommended supervised visits and an anger management course for both adults.

After six months of living with their grandmother, both children were improving. Mia was reaching her development milestones and Jonas was doing well in school both with his grades and interactions and relationships with his peers. The children’s mother and her partner continued to attend counseling and were also improving their relationship with one another and with the children.

After a year, the mother and her boyfriend successfully completed all of the recommended course and were finally at a place to make a safe home for their young family. At this point, CASA Bill had seen the progress made by both adults and recommended that the children be reunited with their mother. A few months later, both children were happily reunited with their mother and her boyfriend, Mia’s father. Young Jonas now receives all  A’s and B’s on his report card and Mia is an active 18-month old and can point to her nose and ears when asked.

Had it not been for CASA Bill’s diligence and dedication to this family, Jonas and Mia may have never had the opportunity to grow up together with their parents in a safe, loving home. Jonas’ mother was grateful for CASA Bill’s investment in her family saying, “He believed in me and my ability to provide a home for my children, his dedication to my children and to our whole family allowed us to heal.”

Child Abuse Prevention Month – We all have a role to play in ending child abuse


I-can-t-STOP-IT-stop-child-abuse-31299494-500-440In the time it takes to read this, more than 30 cases of child abuse will have been reported to authorities nationwide.  By the end of today, that number will swell past 9,000. Four of those children will die at the hands of their abuser.  All in a single day.

When we take stock of these sobering statistics it is easy to become overwhelmed.  However, we all ask the question, “What can I possibly do to make a difference?”

The answer is this: everybody can play a role in preventing child abuse and neglect by becoming advocates for children.  You can donate money, offer pro-bono support or become a mentor or advocate with organizations that help children and families, such as Court Appointed Special Advocates (CASA) for Children.

CASA advocates stand up for abused and neglected children who are now living in foster care. CASA volunteers are people just like you – teachers, business people, retirees, grandparents, young professionals – anyone who is willing to help a child in need.  These advocates give children a voice in an overburdened child welfare system and can help break the cycle of abuse and neglect by helping children find safe, permanent homes as quickly as possible.

Children with a CASA are half as likely to re-enter the foster care system, have improved educational achievement and are less likely to end up homeless, be involved in crime or become drug addicted.  CASA volunteers are making a profound difference in the lives of hundreds of thousands of abused and neglected children not only across the country, but serve nearly 500 children right here in Atlantic and Cape May Counties.  But because of the increased number of children in care coupled with the challenge of recruiting advocates, many children are left without a voice to fight for their rights.

While not everyone can be a CASA volunteer, everyone can be a child advocate.

Here are some steps you can take to make our community safer for our children:

Keep the child abuse hotline number close at hand, 1-800 NJ Abuse.  If you suspect a child is being abused or neglected, you can report your suspicions confidentially.  Volunteer for a social service agency that helps children who have been abused or neglected.  Educate yourself – and others – about the devastating toll that abuse and neglect take on children and on our society as a whole.

We must all take proactive steps to eradicate this problem.  Children need to be protected from abuse and neglect, and we all have the ability to make a difference now.  Please, spread the word and let us all work together to protect our most vulnerable children…it literally saves lives.

We all have a role to play. What will yours be?

David Hieb, Board President CASA of Atlantic and Cape May Counties


Foster Youth Sandy Tells Her Story

My name is Sandy. I am eighteen years old and I have an almost four year son named Angel. I have been in and out of foster homes for about fifteen years of my life. Some of my foster homes were great while others were not.

I was a very angry person, had a bad temper and was always moved from foster home to foster home. I was about three years old when I went into my first foster home with my brother who was about five. We were together for a couple of years and then we were separated. I never knew the actual reason why I only got to see my mother and my brother about every two weeks instead of everyday until I was about almost nine years old years old. That was when I started understanding that I was a foster child because my real mother told me. My mother was not a very stable person once my brother and I got taken away from her. At about six or seven years old I moved with my grandmother who is my father’s mother. I lived with her for about three years until I got fed up of her letting my father physically abuse me. My grandmother barely let me see my mother and I used to always complain. My grandmother got tired of hearing me, so she finally let me have weekend visits with my mother. That did not last very long because my mother got tired of hearing me complain about my father beating me every Saturday night, which was when I arrived from visiting with my mothers.  My mother and my father disliked each other and they still do till this day. My mother decided one Saturday that she was not letting me go back to my grandmother’s house. We ran off to Florida, came back about six months later I believe and then we were caught. I was at least eleven at this point.

I don’t remember the foster homes that I was in before seven years old, which is when I moved with my grandmother. After eleven I was again in foster homes. At eleven I lived in a foster home with Mrs. Renee. At twelve I lived in a building where there were many kids, I think it was some kind of shelter and then with Ms. Lynne. At thirteen I lived with Mr. George and his wife and then I finally moved back with my mother. I was super excited to be living with her. I lived with her for about three or four months and then I became pregnant at fourteen. I had decided at fourteen that I would keep the baby, which is something that my mother should have tried to convince me not to do. I went nine, almost ten months without anyone finding out that I was pregnant by a man who was 15 years older than me. Throughout my pregnancy I had gestational diabetes and I had to give myself insulin three times a day because my sugar was too high. We kept it from my caseworker, from family and from friends. I only went to doctor appointments and home. That was the worst thing that I have ever done.

I had my son, Angel. He was 7lbs 4oz and 21inches long. I was very excited when I had him. Angel’s father was there and we were trying to make him look as if he was one of our family members. The nurses bought that for like a couple days, but they got suspicious when my mother put his name on the papers that were to be used to make the birth certificate. I was questioned by police officers and some hospital therapists. I told them that he was the father of my child, they took him in and he was put in prison. He is still there till this day. I didn’t understand at fourteen why he was in jail because I knew I was not raped, but what I did not know was that there was a thing as statutory rape. Everyone explained it to me, but I still felt as though I was not raped.

Angel and I got moved into a foster home after two weeks of staying at the hospital. I had my fifteenth birthday there and I was there with Angel until Angel was about five months. Then we moved to another foster home. We were there for about 4 or five months. I felt as though I could not live there, so I decided to tell my caseworker that I did not want to live there anymore because I did not feel equal there. After that foster home we moved with Ms. Anitra, where I live now with my son and this is where we have been living for about three years now. Throughout the whole process of moving around I was able to live with my son, many kids aren’t lucky to stay in the same foster home. My brother and I were not. I was and am very appreciative of my caseworker for managing to find us homes where we are able to stay together. I don’t know what I would have done if we were to have been separated.

I am eighteen years old, still living with Ms. Anitra, a senior is High School, I am graduating from high school and going to Gloucester County College. I am going to college for early childhood development with special needs kids. I want to work with special needs children and children period.

Helping Children Find their Forever Family


From dedicated foster parents, to a biological grandmother single-handedly raising her grandchildren, it is a family’s love and support that makes them picture perfect. In Atlantic and Cape May counties, more than 1,000 children are living in foster care.

Thankfully, with the help of a CASA volunteer, a child lingering in the child welfare system is not an option.

Once a child is removed from their home due to abuse and neglect, three different outcomes can arise:  reunification, kinship legal guardianship, or adoption. Behind each court docket, a child is hoping for a forever family, and here are their stories, as told by their CASA volunteer.


When CASA volunteer, Anna met the little boy on her case, he was in a body cast to properly mend his broken bones. After being injured at home, he was removed from his mother and placed in care with a cousin. “When I first got involved with the case, he was delayed in speech, mobility, and potty training,” Anna said. Reunification with his biological mother did not seem to be a viable option.

CASA Anna ensured he received special services and was enrolled in special education classes. For the first time, he was not merely surviving but thriving. While he progressed, his biological mother was determined to have her child back home. “From parenting classes to counseling, she did everything she was advised to do,” Anna said. “She worked hard to get her boy back.”

Anna continued to visit with the case workers, foster parents, and the biological mother, and despite the obstacles, reunification with mother and child became more than a hope – it became a reality. After much work and support, the boy’s mother was ready to make a home again for her son and he finally returned to his mother’s arms and his forever family. “Reunification is a good option when the parent and child have a warm, comfortable relationship, and the parent will do whatever it takes to get the child back,” Anna said. “Luckily in this case, his mother was once again able to provide a safe, loving home and I could fully support him being returned to her care.”

Kinship Legal Guardianship

As a cockroach crawled across her foot, CASA volunteer Kathy knew this was not a safe home for children. Brother and sister, ages 5 and 3, were removed from the bug-infested apartment and safe from their father’s drinking, after neighbors called child services. When CASA Kathy took the case the children were delayed mentally, and although they were safe in their grandmother’s home, they were still swatting away invisible bugs as they struggled to sleep. “The parents were not emotionally capable of caring for their children, and they would show up in preschool with diapers that were days old,” Kathy said.

The children adored their grandmother, and the transition to their new home was smooth, but parental visitations proved to be problematic. “When the children had visited with their parents, the next day at school the boy would be agitated and crazy, and the daughter was nervous,” Kathy said. Finally, the biological parents abruptly decided to move out of the state, leaving their children’s court case unfinished and their grandmother with the responsibility of raising the children on her own.

“There was no question where these children should be; It was a no brainer, and I made clear in my reports that I supported the grandmother caring for the children,” Kathy said. Their grandmother happily became the children’s Kinship Legal Guardian (KLG). “This (KLG) is a great option. Why go into foster care if you have a caring family member who is willing to take on raising the children. In this case the grandmother was more than able, and the children adored her,” Kathy said.


Due to their biological mother’s severe history of substance abuse, two brothers were placed in a foster home. “The foster parents were trained as medical specialists and worked with special needs children,” CASA Joe said. “It was a smooth transition; they fell in love immediately.”

From the beginning, the biological mother said, “I will do anything to get them back,” but no matter how hard CASA Joe tried to help and support her, she delved further into drug use. “The drug use finally caught up with her,” said Joe. Before the case was closed, the boys’ young biological mother died of an overdose.

Before relinquishing his rights, the biological father, who had never known his sons, asked to hold his children for the last time. “When this happened, the boy looked over to his foster father and said, ‘Daddy hold me.’ At that moment, I knew this child and his brother had found their forever family.” Joe said. The boys were officially adopted the following year into a loving, happy home environment, and Joe was honored to help bring a forever family together. “Everyone has a chapter to play in the child’s life, but you can’t ever forget the reality that they endured on the road to finding a home. Even after you know they are safe, you will still think about them and are glad that you played a small role in their finding a forever family,” Joe said.