May is National Foster Care Month, a time to bring awareness to the experiences of young people in foster care and the adults who have previously lived in the child welfare system. At Cottonwood, in Tucson, Arizona, we provide treatment for mental health and substance use disorders. People who have lived in foster care are at especially high risk for these disorders, for a variety of reasons.
Foster Youth and Behavioral Health Risks
When someone has lived in a foster care placement, they are more likely to:
- Have had difficult experiences with their birth family, which could have included abuse, neglect, death of a caregiver, parental rejection, and/or abandonment
- Have trauma from the removal process itself, which can include leaving behind not only their parents, but also siblings, grandparents, cousins, friends, teachers, and other community supports, sometimes many times, as they move from one placement to another
- Have inadequate support as they enter adulthood, causing them to be unable to get their basic needs met
- Carry a genetic predisposition toward mental illness and addiction
- Have a history of disrupted adoptions, which further fueled feelings of rejection
Any one of these experiences can increase a person’s risk for behavioral health issues later in life, but the risk is even higher when someone has experienced multiple of these struggles, as have many young people who have lived in the foster care system.
Diagnoses Foster Youth Frequently Experience
One study of foster youth found that up to 80 percent of this population experience one or more mental health disorders. The most common mental illnesses among foster youth 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, 2.6 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 at increased risk for substance misuse, compared to the general population.
Poor Outcomes Later in Life
The trauma foster youth experience, the insufficient support many have available as they enter adulthood, and the mental health and substance use disorders they may develop later in life, place them at higher risk for further adversity, including:
- Homelessness
- Incarceration
- Food insecurity
- Joblessness
- Unhealthy intimate relationships
- Unwanted pregnancies
- Early death
Reducing the Risk of Negative Outcomes
The American Academy of Pediatrics recommends the following interventions for helping young people from foster care to live happy, healthy lives:
- A pediatric mental health professional should evaluate all youth in care before they ever receive psychotropic medications, to prevent overprescription of these medications, which has been a significant issue for foster youth.
- The child’s history and symptoms should support the diagnosis that is made.
- The highest priority should be placed on treating symptoms that interfere with the child’s home life, schooling, or the ability of adults to keep them safe.
- Psychotropic medications, when necessary, should be a small part of a wider treatment plan that includes interventions like therapy and skill-building.
- If psychotropic medications are needed, they should be prescribed by a child psychiatrist or a psychiatrist with experience in treating children.
- Medications should always be provided at the lowest effective dose.
Some additional strategies that promote the well-being of foster youth include:
- Therapeutic interventions such as child-parent psychotherapy, parent-child interaction therapy, or cognitive behavioral therapy (CBT)
- Programs including Fostering Healthy Futures and Incredible Years
- Training and supporting foster parents to reduce turnover and retain skilled caregivers
The Power of Connection
As young people exit the foster care system, one of the most powerful resources they can have available is one or more stable, caring adults who can help them navigate early adulthood. This can occur through formal or informal channels, such as a permanency pact or an adult adoption. Additional resources that are available to help young people during and after placement include:
At Cottonwood, we provide trauma-informed, evidence-based treatment to people who are struggling with a range of behavioral health diagnoses. We treat the whole person – mental, emotional, physical, social, and spiritual.
