Foster children are at particular risk for experiencing mental health conditions, not only because of the experiences that lead to their placement in the child welfare system, but also their experiences within the system and possibly even their genetics. National Foster Care Month is in May, so now seems like a great time to talk about this topic. At Palms Behavioral Health, in Harlingen, Texas, we want to equip young people from the foster care system and their caregivers with the knowledge they need to navigate mental illness concerns that could arise.
Risk Factors for Mental Illness
People who have lived in the foster care system are more likely than people who have not to have the following risk factors that put them at higher risk for developing mental health concerns, including:
- Painful, awful events with their birth families, which could include abuse, neglect, abandonment, rejection, or the death or incarceration of a parent
- The trauma of being removed from parents, siblings, extended family, teachers, friends, or faith community
- Being expected to live with strangers, potentially in a new town, where they may not know anyone and don’t understand the rules of the home.
- Frequent moves between different placements
- Lingering in the system for years without being able to find permanency and stability
- Aging out of foster care without a single loving, supportive, trustworthy adult in their corner, meaning that they don’t have support when they experience crises
- Loss of identity and not feeling like they belong in their birth family, if they return after years outside of it
- Failed adoptions leading to more feelings of rejection and abandonment
- Abuse at the hands of group home staff, foster, and adoptive parents
- Genetic predispositions toward mental illnesses
Common Mental Health Conditions Among Foster Youth
Foster youth are overrepresented in certain mental health disorders when compared to the rest of the population. This may be largely due to the factors listed above. The conditions that current and former foster youth are most frequently diagnosed with include:
- Post-traumatic stress disorder (PTSD): 21.5 percent of foster youth, 4.5 percent of the general population
- Major depression: 15.3 percent of foster youth, 10.6 percent of the general population
- Social phobias: 11.9 percent of foster youth, 8.9 percent of the general population
- Panic disorder: 11.4 percent of foster youth, 3.6 percent of the general population
- Generalized anxiety disorder: 9.4 percent of foster youth, 5.1 percent of the general population
- Bulimia: 2.9 percent of foster youth, 0.4 percent of the general population
People who have lived in foster care are also more likely to struggle with substance use disorders than the general population, which can make mental health struggles worse.
Poor Outcomes in Adulthood and Life After Foster Care
Ensuring the success of foster youth does not end when they reach the age of 18. As young people leave foster care and begin their adult lives, they continue to need help, just as any other person does. Without proper interventions, to help foster youth manage their early adverse experiences, and navigate early adulthood, they are at increased risk for a number of undesirable results, later in life, such as:
- Homelessness
- Incarceration
- Food insecurity
- Unhealthy intimate relationships
- Unwanted pregnancies
- Difficulty finding and maintaining jobs
- Repeating the cycle of child welfare involvement with their own children
Practices That Support Foster Youth Mental Health
The American Academy of Pediatrics recommends the following practices to improve mental health outcomes for current and former foster youth:
- All young people from the foster care system should be evaluated by a trained pediatric mental health specialist before they ever receive any psychotropic medications, to reduce the risk of over-prescribing. Psychotropic medications should be part of a wider treatment plan that also includes therapy, skill-building, and other non-medication options.
- History and symptoms should support any diagnoses that are made.
- Priority should be placed on addressing symptoms that impact their success at home, school, or in childcare settings.
- A child psychiatrist or general psychiatrist with experience in pediatrics is the best choice for prescribing medications for the mental health of foster care youth.
- Medications should always be started at a low dose and gradually increased until the lowest effective dose is reached.
After a young person exits foster care, they also need to have the support of one or more caring adults who will remain in their lives. This can be an informal or formal arrangement, such as legal adoption, a verbal agreement, or a permanency pact that outlines what specific supports adult caregivers will offer to a young person, such as:
- Help with applying for financial aid for college
- Assistance applying for employment and preparing for job interviews
- A place to spend breaks from college and holidays
- Teaching them how to drive, how to buy and maintain a car, and how to purchase car insurance
- Someone to call to talk through emergencies
- Permission to use a washer and dryer
- Grandparents for their future children
At Palms Behavioral Health in Harlingen, Texas, we want success for every person raised in the foster care system. We are here to help young people from foster care, foster and kinship families, raising foster youth, and people who have left care and are now trying to recover from the hardships they experienced in early life.
