UNLOCKING: Mental Health Services for Youth in Care

By Austin, Lisette | Children's Voice, May/June 2005 | Go to article overview
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UNLOCKING: Mental Health Services for Youth in Care


Austin, Lisette, Children's Voice


From national innovations to local collaborations to the one-on-one efforts of volunteers, child- and youth-serving systems are employing different strategies to meet the mental health needs of youth in foster care.

I went to my first therapist at age 12. At the time, my life was filled with chaos, and I didn't know who to talk to or how to handle it. My dad was in jail, my mother and I weren't talking, and in a little more than a year, several family members had died. All the feelings I had began to build up inside, and I felt like I was drowning in my emotions. Sometimes I would cry like a baby. Other times I'd feel angry and confused.

I didn't trust anyone, especially my family, and I thought people were saying negative things about me. I started to disrespect my elders, steal, stay out late, and fail in school. Things got so bad I was sent to two different group homes. At the homes, I pretended to feel better about myself, but being there made me feel like more of a failure and like I didn't deserve to live.*

When life becomes chaotic and feels like it is falling apart, it's easy to feel alone and depressed. When you are an abused or neglected child who has been separated from family and shuttled from home to home, the feelings can become overwhelming and isolating-perhaps even spinning out of control.

For many in foster care, the result of this kind of emotional trauma is the development of a mental health disorder. They find themselves in a system that is ill-equipped to provide the services they need, and that can further impede their progress towards emotional well-being.

According to the World Health Organization, nearly 20% of children and adolescents worldwide suffer from some type of emotional or behavioral problem. The U.S. Surgeon General reports that roughly 1 in 10 American children experience a mental illness severe enough to cause significant impairment.

The prevalence of mental health problems of youth in foster care are even more staggering. "Anywhere from 40% to 85% of kids in foster care have mental health disorders, depending on which report you read," says Steve Hornberger, Director of Behavioral Health for CWLA.

The reasons for these numbers are understandable. Children in foster care are struggling to cope with the traumatic events that brought them into care, including parental abuse or neglect, homelessness, and exposure to domestic violence and substance abuse. While dealing with the tremendous loss of their family, they also frequently blame themselves for being removed. Many children long to return to their families, regardless of the history of mistreatment.

At a time when they desperately need a sense of consistency and stability, they are living in the uncertain world that is foster care-multiple placements, unpredictable contact with family, and the inability to control their own lives. These conditions can help breed serious emotional disturbances.

Although many children and youth in foster care clearly need mental health services, studies show that less than one-third receive them. One reason is the lack of experienced mental health professionals available to this population. "There's a shortage of well-trained providers who can deal specifically with loss issues," says Toni Heineman, clinical psychologist and Executive Director of A Home Within, a non-profit dedicated to helping meet the mental health needs of children in foster care.

Heineman adds that according to recent informal survey, only 3% of mental health providers work with children in foster care. Those who do are often inexperienced trainees unfamiliar with navigating the child welfare system, and only available for one year. "Being abused, neglected, and removed from their family are extraordinarily painful experiences for these kids," she says. "Put them with people who aren't well-trained, and it can be overwhelming for both parties."

Another challenge is a lack of mental health training for both child welfare staff and foster families.

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UNLOCKING: Mental Health Services for Youth in Care
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