For children who grow up in foster care, life is unpredictable. They have to struggle with the instability that comes with moving from family to family, while trying to cope with the reasons why they are unable to stay with their biological family. Because of these challenges and others, children in foster care are more at risk for mental health issues than children in the general population. In fact, the American Academy of Pediatrics calls mental health issues the “largest unmet health need for children and teens in foster care.”
According to the Psychiatric Times:
- almost 50% of children in foster care ages 2 to 14 were diagnosed with a clinically significant mental health issues
- 42% of adolescents in foster care have at least one mental health disorder
- a number of adolescents experience two or three disorders
To put that into perspective, that’s more than double the one in five rate we expect to see in the typical population, based on figures reported by the Child Mind Institute.
Prevalence of Mental Health Challenges in Foster Care Children
The National Conference of State Legislature (NCSL) confirms that children in foster care have higher rates of mental illness than the general population. For example:
- 5% of adults who were in the foster care system were diagnosed with Post Traumatic Stress Disorder (PTSD), compared to 4.5% of the general adult population
- While only 3.6% of the general adult population experiences Panic Disorder, that number climbs to 11.4% for adults who grew up in foster care
- While 0.5% of the general adult population struggles with drug dependence, 3.6% of adults who grew up in foster care have drug dependence
The NCSL also reports that foster care children are prescribed medication for their mental illness at a higher rate than non-foster care youth.
The Risk Factors for Kids in Foster Care
According to the NCSL, contributing factors for mental illness among these children include a history of exposure to complex trauma, lack of stability, difficult family relationships, and inconsistent access to mental health services. Because children in foster care are more likely to be exposed to these risk factors, they are understandably at a greater risk for developing mental health issues than their peers in the general population.
These risk factors can exacerbate the stress a child in foster care experiences and can contribute to mental health issues such as anxiety, depression, and post-traumatic stress. For example, if a child is moved from a unstable home that included drug use and is placed in foster care with a new family, not only must he or she cope with the loss of living away from their biological family, he or she must also start at a new school (starting in the middle of an academic year is even more stressful), make new friends, and adjust to a whole new environment. That would be a significant adjustment for anyone, let alone a child. The child may struggle with leaving his or her biological family, at the same time trying to adjust to the new routines and rules in the family. And if the child does not have an adequate support system and coping skills, he or she may be at an increased risk for developing mental health issues.
Why trauma is so prevalent for children in foster care
Children who grow up in foster care are more likely than their peers to be exposed to traumatic events. This trauma might include experiencing or witnessing abuse or violence both inside and outside the home, repeated separation from their primary caregiver, exposure to substance abuse, experiencing homelessness and poverty, frequent moving, undergoing or witnessing emotional abuse, or experiencing or being exposed to chronic health problems.
When a child experiences traumas like these, their emotional, cognitive, and physical health can be impaired and that can contribute to the development of a mental health issue. For example, if a child lived with a caregiver who had a substance abuse problem and often became physically and emotionally abusive, the child may find themselves experiencing intense anxiety or panic attacks when encountering something that reminds them of that parent. It could be something as innocuous as a song playing on the radio that was playing one time when their caregiver came home drunk. It could be the smell of the perfume or cologne their caregiver wore, or even seeing a similar car. Because children in foster homes are at a higher for experiencing trauma, it is critical that be screened, and treated as appropriate, for its effects.
Unstable family relationships, changing environments, and exposure to trauma all contribute to the increased risk of mental illness for these kids. Children in foster care deserve special attention when it comes to coping with life’s challenges and managing their mental health. A helpful resource for foster parents and adults working with foster children, is our Children’s Mental Health guide. This handbook helps answer questions like, what mental illness is and what it looks like in a child.