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.










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