Foster Kids Face Mental Illnesses in Adulthood
April 06, 2005
New York Times Syndicate

WASHINGTON, D.C. -- Children placed in foster care have much higher rates of mental illness when they reach adulthood, according to a new study released Wednesday.

The study, based on a sampling of former foster care children in Washington state and Oregon, found that 54.4 percent had one or more mental health disorders in adulthood, as compared with 22 percent in the general population.

"These findings are a wake-up call for the nation to make foster care and the well being of hundreds of thousands of our most vulnerable children a national priority," said Ruth Massinga, president of Casey Family Programs, a Seattle-based foster care foundation that co-authored the study along with researchers from Harvard Medical School, the University of Michigan, the University of Washington and Washington and Oregon state agencies.

About 800,000 children are in foster care across the country, most of them placed due to maltreatment in their parents' home, according to government statistics.

The study underscores that foster children enter adulthood with "tremendous trauma . . . and are much less prepared (for adulthood) than their peers" in the general population, she said at a news conference here to release the report.

Researchers said they were particularly alarmed about the incidents of post-traumatic stress disorder in former foster care children -- 25.2 percent had the ailment as compared with 4 percent in the general population. Foster care alumni experience post traumatic stress at twice the rate of U.S. war veterans, the study said.

When a person experiences an emotional trauma, the symptoms of the trauma usually disappear over several weeks. With post-traumatic stress, however, the symptoms persist, become exaggerated and can be debilitating.

Symptoms including being highly reactive to sounds, an inability to concentrate, difficulty falling asleep, little desire to do activities that had been of interest, increased isolation, an avoidance of thinking or talking about the trauma, a belief that the future is unimportant, and intrusive dreams or recollections about the trauma.

In its extreme, the disorder can result in suicide or violent rages long after the trauma was suffered. The treatment typically is combination of medications and psychological therapy.

Most children enter foster care as a "last resort," the report said, because their own families were abusive or unstable.

But removing a child, even from an abusive family, can add to post-traumatic stress.

"The very act of removal from their parents is often traumatic for the youth," researchers wrote, "potentially resulting in post-traumatic stress disorder and creating a sense of hypervigilance because their lives become unpredictable."

Ron Kessler, a faculty member at Harvard Medical School and one of the study's lead researchers, said former foster children face potentially prolonged mental illness compared with the general population. "The scars of those experiences stay with these people throughout their lives," he said.

Aggravating the disorder is that many experience unstable upbringings while in foster care, moving from family to family about every 16 months.

The report sample comprised 659 adults between the ages of 20 and 33 who had been in foster care at least a year between 1988 and 1998. Researchers reviewed case records for the entire sample and followed up with interviews of 479 of the individuals.

In addition to post-traumatic stress, foster care children upon reaching adulthood experience high rates of other mental disorders, compared with the overall population.

For example, the study found that 20.1 percent of study respondents have depression (compared with 10.2 percent in population); 11.5 percent have anxiety disorder (compared with 3.2 percent); and 8 percent have a drug dependence (compared with 0.8 percent.)

The report also found that many foster care children "are in fragile economic situations" once they become 18 years old and leave the system, with one-third living at or below the poverty line -- three times the national poverty rate -- one-third with no health insurance -- twice the national rate -- and over 22 percent homeless at some point.

One reason for the poor economic outlook is that only 1.8 of former foster care children go on to receive a college degree as compared to 24 percent to the general population.