The Intersection of Foster Care and Mental Health

Stephanie Orlando, speaking from a podium, wearing a red suit.

By Stephanie Orlando, Member, National Council on Disability (NCD) with the assistance of Robyn Powell, NCD Attorney Advisor

May is recognized as both National Foster Care Awareness Month and Mental Health Awareness Month. What most people do not realize is the overlap that often comes with membership in these populations.

In the United States, there are more than 400,000 children and teens in foster care.  Research reveals that children and teens in the foster care system have disproportionately high rates of psychiatric disability. 

One study by the National Institute of Mental Health found that nearly half (47.9 percent) of youth in foster care were determined to have clinically significant emotional or behavioral problems. Likewise, researchers at the Casey Family Programs estimate that between one-half and three-fourths of children entering foster care exhibit behavioral or social competency problems that warrant mental health services.

Youth who have “aged out” of foster care also show high rates of psychiatric disability.  According to a study by the Casey Family Programs and Harvard Medical School, a high number of former foster children have psychiatric disabilities as adults. Over half of foster care alumni had diagnoses compared to 22 percent of the comparison group.  

The disproportionate level of diagnoses is perhaps most evident with post-traumatic stress disorder (PTSD).  Thirty percent of foster alumni are diagnosed with PTSD, which is about twice the rate of U.S. combat veterans.

In 2008, the National Council on Disability (NCD), an independent federal agency that advises the President, Congress, and other federal agencies on disability policy, issued a comprehensive report Youth with Disabilities in the Foster Care System: Barriers to Success and Proposed Policy Solutions.

In that report, NCD found: “While the federal investment in the multiple systems with which these youth come in contact is significant, the disconnectedness and lack of coordination across programs and agencies call into question the effectiveness of government efforts.” 

Five years later, the problems remain. The mental health needs of children and teens in foster care continue to be overlooked and inadequately addressed, often with detrimental consequences.

A significant number of the estimated 20,000 young people who leave foster care each year face inordinately bleak futures. According to researchers, just over half of these young people – 54 percent – earn a high-school diploma and a quarter of them become homeless.  On average youth aging out of the foster care system with psychiatric disabilities fare even worse.

In 2003, researchers at Georgetown University estimated that only 42 percent of students with mental health diagnoses graduate from high school. As such, foster care youth with psychiatric disabilities find themselves at a double disadvantage.

As we acknowledge both National Foster Care Awareness Month and Mental Health Awareness Month, NCD renews its call to action. We urge legislators, policymakers, and service providers to direct significant attention to the needs of children and teens with psychiatric disabilities in the foster care system by making these recommendations:   

  • Increased flexibility to states and communities so programs and services can be most effectively structured to meet the needs of children and teens with disabilities in foster care;
  • More federal support for research and demonstrations to identify effective policies and practices that lead to positive outcomes for children and teens with disabilities in foster care;
  • Improvements in the quality, availability, and affordability of mental health services and supports;
  • Better training for foster care parents and increased recruitment of individuals willing to foster children and teens with disabilities;
  • Greater access to individualized, comprehensive transition services, including mental health care, for children and teens with disabilities aging out of foster care; and increased collaboration among the education, juvenile justice, child welfare, labor, dependency court, health, and mental health systems.

Further, NCD applauds the President’s new budget proposal to fund mental health initiatives. The proposed $205 million to help identify mental health problems, improve access to mental health services, and support safer school environments, if adopted, will fill an important void for many children and teens in foster care with psychiatric disabilities.

The goal for America’s foster youth to live healthy, happy lives and to become self-sufficient, contributing members of society is achievable, but we should not -- and cannot -- forget those young people who face significant barriers to reaching these goals. 

Our nation must make a strong commitment to support children and teens with psychiatric disabilities throughout their time in foster care and take the steps necessary to ensure that a safe, healthy and positive transition to adulthood is planned for as the end goal.

This can only happen if we include youth with psychiatric disabilities in the planning process and in our communities going forward. The foundation we, as a society, build for children and teens in foster care during their formative years will likely become the basis for the future they create. Let’s build it on solid ground.

 

National Council on Disability • 1331 F Street, NW, Suite 850 • Washington, DC 20004