MENTAL HEALTH IN FOSTER CARE

October 10 is World Mental Health Day - a day when so many people and organizations highlight mental health issues and the need for supportive efforts....

Unfortunately, we know that there is a significantly higher risk for children growing up in foster care to experience mental health conditions such as depression, anxiety, ADD/ADHD, and thoughts of suicide.

• ​According to the National Conference of State Legislatures, up to 80% of children in foster care have significant mental health issues.
• The American Academy of Pediatrics says that mental health is one of the “greatest unmet health needs for children and teens in foster care.”
• In 2005, a study out of Harvard University confirmed that children in the United States foster care system experienced trauma in the form of post-traumatic stress disorder (PTSD) - at a rate more than twice that of combat veterans.
• According to youth.gov, suicide is the second leading cause of death among youth ages 15-24 in the United States - and studies show that children in foster care are more likely to consider and attempt suicide than those who have never been in foster care, due to mental health risk factors such as family history of childhood maltreatment, history of mental disorders, feelings of hopelessness, loss, social isolation, and barriers to accessing mental health treatment.

What is the cause? Children in foster care are removed from their homes as a result of neglect or physical, emotional, or sexual abuse. This can often cause complex developmental trauma, which is the experience of multiple, chronic, prolonged developmental adverse traumatic events, most often of an interpersonal nature. Early trauma and stress can have long-lasting effects on the child’s brain chemistry and health, and trigger delays in developing proper social competence, coping behaviors, and certain brain chemistry. The National Angels organization looks at trauma in relation to the 5 B’s:

1. Brain: trauma impacts the brain by creating imbalances between the “downstairs brain” (basic bodily functions, fight/flight/freeze) and the “upstairs brain” (control over emotions, decision making, empathy, morality)
2. Biology: trauma impacts biology by altering epigenetic processes that can have long-lasting developmental effects, even throughout multiple generations
3. Behavior: because trauma impacts behavior in a number of ways, children and youth are often given multiple diagnoses, including: anxiety, depression, oppositional defiant disorder, reactive attachment disorder, ADHD, PTSD, etc
4. Body: trauma impacts the body by altering our sensory experience of the world and the body itself
5. Beliefs: trauma impacts beliefs about oneself, including: self-awareness, self-regulation, self-esteem and self-efficacy

We also know that children in foster care move between placements an average of 7 times in only 2 years - that is seven different homes, seven sets of parents and siblings, seven sets of schools, teachers and curriculum, seven sets of friends, and seven general environments to become acquainted with over a very short period of time. This extreme instability causes more anxiety and depression, which of course can worsen the effects of the existing trauma caused by the original abuse and neglect.

Unfortunately, a lot of instability is due to foster parents feeling unsupported or ill-equipped to handle a child's extensive health and behavioral issues. In fact, as many as 50% of foster parents close their doors to fostering altogether within their first year. It is a vicious cycle - for children in foster care, dysfunctional behaviors from their traumatic past create barriers to the development of healthy relationships in new environments. And without proper intervention, problem behaviors tend to persist and intensify over time, causing overwhelm within the foster home. When foster parents feel they cannot continue caring for the child, the child is placed with another family or in a group home, must adjust all over again, and completely restart the healing process.

It is important to build community around foster and kinship families who are caring for children that have been through trauma and struggle with mental health issues. Foster parents deserve support, and children need time to trust that their world is stable and safe again. Children and youth in foster care need to be surrounded by healthy adults that allow them to feel seen, heard, valued and protected, and be given ample space and time to fully heal from their past.

​To find out more about how Houston Angels' programs support the foster care community and address mental health issues for children growing up in foster care, please visit www.houangels.org.