The Mental Health Effects of Living in Foster Care

Children in foster care are facing tremendous hardships. The simple act of leaving home is a traumatic experience, but this is just the beginning for children entering the welfare system. Many have been removed from their home due to abuse or neglect. Many are forced to adapt to constantly changing environments, as they are bounced from home to home. Some are returned to their biological family after a short-term placement, only to be reentered back into the system. 

Living in foster care is challenging, no matter the situation, and this experience can have a negative impact on a children's mental and behavioral health.

While the goal of foster care is to provide children with a safe and nurturing temporary home until they can be reunited with their biological family or given permanent placement, the reality is that more than 20,000 foster care children age out of the system on an annual basis before this happens.

The Effects of Early Childhood Trauma

In many foster care cases, children are removed from their biological home due to maltreatment, abuse, or neglect, which means the child has likely experienced physical, emotional, or psychological trauma.

Even if a child is taken out of their home for other reasons—a parent is sent to prison, both parents have died, a parent is battling a substance use disorder—they are still dealing with a traumatic event that can have serious mental health implications. 

"In foster care, children are often moved around a lot and have to interact with multiple people in their journey. With instability comes loss, and loss is always part of foster care starting with the removal or separation of the child from their first family," says Ebony E. White, PhD, LPC, NCC, ACS. Children endure a constant 'starting over' process in the system, which can cause problems with attachment and detachment, impacting the child’s ability to form and maintain healthy relationships. 

Without support or the proper treatment, children in foster care may have a hard time processing, understanding, and recovering from their circumstances, and this can cause physical, mental, and emotional symptoms that can extend into adulthood.

Mental Health Disorders Associated With Foster Care 

Foster care children are among the most vulnerable in the world, so it’s no surprise that the majority face mental and behavioral health problems. When you're taken out of your home by a stranger and placed in a new home or congregate setting with more strangers, you're bound to experience anger, confusion, fear, and distrust. 

When placed into another home, many children in foster care ask the following questions, according to John DeGarmo, EdD, founder of The Foster Care Institute: Why am I here? Did I do something wrong? Do my parents not love me anymore? How long will I be here?

Common mental health disorders seen among foster care youth include:

• Post-traumatic stress disorder 
• Reactive attachment disorder
• Anxiety disorder
• Depression
• Borderline personality disorder (BPD)
• Social phobia
• Oppositional defiant disorder 
• Conduct disorder 
• Attention deficit hyperactivity disorder (ADHD)
• Separation anxiety disorder
• Eating disorders

It's also common for foster care children to experience comorbid disorders and engage in high-risk behaviors such as violence, substance use, and delinquency.

They also face significant emotional difficulties, such as a lack of self-worth and the need to be in control, which can make it hard to establish healthy, loving relationships. 

Barriers Facing Long-Term Foster Care Youth

While some children are reunited with their biological family or adopted into a new family, many others age out of foster care and find themselves without the support they need to live independently. Youth leaving foster care, also called care leavers, suffer more with mental health and behavioral problems than non-fostered youth and are more likely to be incarcerated.

The transition to adulthood—and independent living—for foster care youth is extremely difficult, as many experience low levels of support, which leads to an increased risk of social exclusion, homelessness, unemployment, low education, financial difficulties and behavioral problems. This is especially true of LGBTQ+ youth, youth of color, and youth diagnosed with mental illnesses. 

In order to aid in this transition, we need to provide foster care youth with educational assistance, job training, housing placement, and financial support, as their biggest concerns often revolve around social drivers like housing, finances, employment, and access to health care.

Providing Mental and Behavioral Health Care and Support

Studies suggest that among the 40% of youth in foster care, up to about 80% exhibit a serious behavioral or mental health problem requiring intervention. The problem is that many mental health issues go unaddressed and untreated, and far too often, the children are blamed for their behavior rather than offered support and care. 

"Children need to have structure, boundaries, consistency, affection, and attention," Dr. Ebony White explains.

Simply living in foster care, for any period of time, puts a child at a high risk of developing medical, behavioral, and/or emotional difficulties.

Children in foster care don’t always get their basic human needs met. A child may be experiencing homelessness, housing instability, food insecurity, financial hardship, maltreatment, or neglect, which prevents them from addressing and meeting other human needs like connectedness, intimacy, love, independence, and self-actualization. 

"It is important that children in foster care receive professional therapy and counseling services," says Dr. DeGarmo. "Along with this, foster parents need to ensure that their child in care and in their home are provided security, safety, consistency, and feelings of being loved unconditionally. Foster parents must also be patient, understanding, compassionate, and non-judgmental in order for the child to heal and thrive."

Takeaways

Living in foster care can negatively impact a child’s health, but the system isn’t all bad. Many children are reunited with their biological parents or adopted by family members or foster care families—and one study shows that foster care youth who experienced maltreatment have increased levels of adaptive functioning.

Adverse childhood experiences can have long-term consequences, which is why it’s so important to address them as soon as possible. Mental health professionals are available at any time to discuss symptoms, diagnoses, and treatments or simply offer mental health support as you navigate life.