The Physical and Mental Health of Children in Foster Care
Ferrara, Pietro, Romani, Lorenza, Bottaro, Giorgia, Ianniello, Francesca, Fabrizio, Giovanna Carmela, Chiaretti, Antonio, Alvaro, Francesco, Iranian Journal of Public Health
Background: To evaluate physical and mental health in children in foster care and comparison with general population.
Methods: The study is carried out between September 2011 and April 2012 into nine group homes in Rome. It involved 112 children ranging in age 2-17 years, living in temporary care facilities or institutes. All data came out of clinical history and physical exams, validated by a pediatrician. Such data were being then compared with samples of general population.
Results: Significant themes were high percentage of children with psychiatric disorders in foster care (22.3%); high percentage of psychiatric disorders diagnosed immediately while arriving at the foster care (56%); no significant differences in weight, height and BMI between children in foster care and general population; significant differences (P<0.05) for allergy, gastrointestinal diseases and caries between children in foster care and general population.
Conclusion: The results suggest that the physical health of children in group homes is no worse than that of children living care in their own homes and that the foster care provides necessary conditions to support the growth of the children and their physical, mental and social needs.
Keywords: Foster care, Institutes, Health, Psychology, Italy
Foster care is a social system based on institutions, group homes or private homes for orphaned, abandoned and maltreated children. There are many epidemiological studies about this situation and all surveys show an increasing number of children in foster care (1). In the United States a recent report estimates that up to eight million children currently live in orphanages (2009 esti-mate by Save the Children UK)(2), and more than 400.000 children are in foster care (3). A 2010 Eurochild comprehensive survey reports approx-imately one million of children in the EU is living in alternative care, including residential, commu-nity and family-based care; Eurochild is a network of organizations and people working in and across Europe to promote children and youth's rights and improve their quality of life (4). In Italy 30900 children live outside their biological family, 15700 of this group live in residential home and other 15200 live with foster parents. These statistics come from a report of the Italian Ministry of La-bor and Social Policy in 2009 (5). All national and international surveys show a real difficulty in understanding the extension of this growing real-ity. In Italy the child welfare system is managed by each region; the lack of a close network among regions and among all the residential host children homes, creates inhomogeneous situations with different outcomes in all the Country (6).
Placement in foster care is now seen as a solution to the care problems of children whose parents are unable, unwilling, or judged by the legal sys-tem as unfit to care for them (7). The children for whom substitute parents are sought are likely to have complex physical, developmental, emotional and educational needs. Often they have been damaged by inadequate parenting, abuse and neg-lect (7). Studies about the health status of children in foster care detect that the health care needs are strongly dependent by the factors that determine foster placement (8). The placement is due to different reasons such as abandonment, poverty, neglect, physical or sexual abuse, drug use by biological parents, parental psychopathology and family breakdown; based on that, it is not surpris-ing the high prevalence of mental health problems (9).The particular experience of each child affects greatly his or her health from a physical, mental and social point of view.
In literature, the physical and psychosocial health of children in institutional care has been widely investigated for nearly 70 years. Children in foster care have mental health problems, anxiety, depres-sive symptoms or general mental difficulties (8-11) and the overall health care of children who have been established in care for more than six months is significantly worse than for those living in their own homes (12). …