Mental Health Effects of Foster Care Placement on Children - Article Example

Mental Health Effects of Foster Care Placement on Children Each year, a large number of children are being placed in foster care in the United s of America (USA) and elsewhere. These children often come from homes where they have been abused or neglected and are hence pre-disposed to mental health conditions. While some children do, in fact, get the assistance they require from the agencies responsible for mental health, not all cases of children needing treatment are identified and some children fall through the cracks in the system. This paper will take an intensive look at three papers which deal with this topic and make some conclusions based on the results of these papers. The first study being looked into is by Calusen et al, 1998 and was carried out across three counties in California, USA. The counties were Santa Cruz, Monterey and San Diego and were heterogeneous in their populations, density and the percentage of minorities present. Children considered for the study were registered under ‘Foster Children’s Health Project’ which had the aim of promoting the health on children in foster homes. Children were eligible to be considered in the study if four criteria were fulfilled: 1) the child had just been placed into a new instalment of care, 2) the child was under 18 years, 3) the child had been placed in care with a non-family caretaker and 4) the child had been in the foster home for a minimum of two months. The aim if the study was to compare the rates of mental health issues in children who had been placed in foster care with the use of standardised tests. The sample size was 267 children. Three primary data collection methods were employed: a behavioural screening checklist, a measure of self concept and an adaptive behaviours survey in one county. All this testing was carried out within the third and fourth month of being placed in a specific foster home and the tests done were dependant on age of the child. The Parent Report Form (PRF) on the Child Behaviour Checklist (CBCL) was used to give an indication of any behavioural issues and social competence (Achenbach, 1991). The PRF was completed by the primary licensed foster care parent. In addition, children were asked to complete the Piers-Harris Self-Concept Scale (SCS) which provided scores on how children view themselves (Piers, 1984). Also, in San Diego, the foster parent also completed the completed the Survey Form of the Vineland Adaptive Behaviour Scales (VABS) (Sparrow et al, 1984). This was indicative of adaptive behaviour in communication, daily living skills, socialisation and motor skills. Results from this study indicated that children in foster care have a much higher incidence of mental problems than the general population. The CBCL results showed that 75-80% scored within a range that was borderline or clinical problems. Almost two third of school age children also scored above the clinical threshold for behavioural problems and half scored above the borderline threshold. Social competence was another area in which children were seen to have difficulties with above 50% scoring within the clinically diagnosed range of problems. There were no significant differences observed within the different counties studies suggesting that children placed in foster care throughout California are indeed at a higher risk for mental and behavioural disorders and this is an issue which needs to be addressed. The second study that will be considered in this paper is a newer study that was also done in the United States but was at a national level. It was carried out by Leslie et al, 2005. The study encompassed 3592 children who were a part of the ‘National Survey of Child and Adolescent Well-Being. This represented a representative sample nationally of children between th ages of 2-14 who were under investigation for abuse or/neglect. It must be noted that not all of these children had been placed in foster care, they were under investigation for this. The aim of this study was to take a look at the relationship between the start of outpatient mental health services by children who were receiving in-home care, had no interaction with child welfare officials beyond the complaint and after placement in a foster home. Individual event histories detailing maltreatment and socio-demographics (age, gender, and ethnicity) of each child were obtained from child welfare workers and examined to identify pre-dispositions to the use of mental health services. The children were broken up into three categories based on whether they were receiving in home care, had an investigation carried out due to complains of abuse or had been placed in foster care. The CBCL was also employed as in the study by Calusen et al, 1998. This was the primary indication of whether or not a child is suffering from behavioural problems and has a need for mental health services. Two forms of the CBCL were made use of namely one for children between 2-3 years and another for children between4 and 18 years. For this particular study, the clinical range was considered as the cut off point rather than the borderline range as well as was done in Calusen et al, 1998. Of the children looked at, only 8.1% were placed in foster care. 53.4% of this group were seen to being need of mental health assistance and this was the group which had the highest need as compared to the other two groups. The level of assistance provided for mental health services appeared to be influenced by ethnicity with African-Americans being more likely to receive help than other ethnic groups. It must be noted that help for mental health issues was increased following involvement by child welfare officials and suggest that children who are actually placed in foster care tend to receive more help than children who are left at home. This findings, overall suggest that the child welfare and mental health systems do in fact interact though many children are possibly falling through loopholes due to the high percentages that are placed in foster care. The key element is identifying that a child needs help with mental issues after being placed in foster care and having access to the services required. The third and final paper that will be considered in this paper is quite different from the other too. It is by Richardson and Lelliot, 2003. It is based in the United Kingdom and provides a review of mental health in children placed in foster care in the UK. Several mental health issues have been identified in children from foster care and this undoubtedly holds true regardless of what country is being talked about. A report by the Department of Health in 1999 reported many young women who had been in foster car had long-term mental illnesses or disorders and phobias (Saunders and Broad, 1997). 60% of these females had contemplated suicide and suicide attempts had actually been made by 40% of this afore mentioned 60%. 35%were actively engaging in self-harm. 31% had attempted to get help of their own free will for mental health problems but 12% of this group did not find this useful. These figures are startling and more so is the fact that within the general population of people who had been in foster care as children, 67% suffered from psychiatric disorders while for the control group the prevalence was 15%. 96% of children in residential facilities had psychiatric disorders and specifically 57% who had been in foster homes. The most common disorders were conduct (behavioural) disorders followed by depressive disorders and a smaller percentage was seen to suffer from unspecified functional psychosis). Unfortunately several of these disorders were treatable but had not been detected while in foster care (McCann et al, 1996. The main reasons identified by Richardson and Lelliot, 2003 for being placed in foster care and the root cause of several of the above mentioned conditions are abuse and neglect , a dysfunctional family, the presence of a disability, parental illness or disability, low income, stressful situation in the family, socially unacceptable behaviour and absent parents. Children who face issues such as these early in life are pre-disposed to mental illness. Unfortunately, as seen by the staggering statistics of people who come out foster care with mental disorders, in most cases adequate help is not provided. The main reasons that are a barrier to improved mental health care for foster children are listed as follows. -The resistance to label a child as needing help with mental health issues. This carries a certain degree of stigma but may be the only way a child gets the help they need. -There is inadequate funding to help all the children in need. -There is a lack of collaboration between the different agencies that are responsible for the child once removed from the home. - Social workers and foster carers must have an open line of communication with their foster child. In some extremely stressful situations, they may feel threatened by the child in terms of claims of abuse or even their jobs. - The process of referral to the mental health services needs to be more efficient. It must be noted that while a lot of children from foster care suffer from mental health issues, there is a high percentage that do not. A study found that while children who had been in care were more at risk for been in care were significantly more at risk of psychological problems at age 16 and depression at 33 but 75% did not have psychological problems at the age of 16. Furthermore, 80% were not depressed at 33 (Buchanan, 1999). Factors such as living a good quality of life with the basic requirements and having enough discipline greatly contributes to this positive result. Continuity of care also seems to be an important thing to take into consideration as people who had received support from specialists and raised in stable foster homes were more likely to be well integrated into society (Dumaret et al, 1997). To conclude, a review of the three papers into mental illness in children who have been placed in foster care was very insightful. The main points that stand out from all three papers is that children who are placed in foster care, regardless of where it is are in dire need to access to mental health services. Most of these children come from homes where they have been exposed to factors that pre-dispose them to mental illness such as absent parents and abuse and neglect. The percentage of children who suffer from mental illness and who are in foster care is hugely more than children in the general population. Despite what is known on this topic, not all the children who require mental health assistance in foster care are actually getting the help they need. A staggering number appears to come out of foster care suffering from conditions that were easily treatable if diagnosed early on. Perhaps, surprisingly, the access to mental health services is actually increased when children who are abused or maltreated are placed in foster homes rather than being cared for in their own homes. There are several barriers to children receiving the mental health care they require and these can include a lack of inter-agency collaboration, a reluctance to label the child as mentally ill and a shortage of adequate funds amongst others. All this information must be taken into consideration to better the services towards mentally ill children in the foster care system as prolonged mental illness will affect their integration into society. There have been cases of children who have come from foster care turning into well-adjust adults even though they were at risk for mental health problems and these children have been linked with a stable foster family environment and continuity of care from specialists. It is these cases that need to be looked into more in detail so that these results can be emulated for all children going into foster care. Bibliography Clausen, J.M,; Landsverk, J. Ganger, W.; Chadwick, D. & Litrownik,A. (1998). Mental Health Problems of Children in Foster Care. Journal of Child and Family Studies, 7. 3, 283-296. Leslie,L.K. ; Hurlburt, M.S., James, S.; Landsverk, J.; Slymen, D.J. & Zhang, J. (2005). Relationship between Entry into Child Welfare and Mental Health Service Use. Psychiatric Services, 56, 981–987. Richardson,J. & Lelliott, P. (2003). Mental Health of Looked After Children. Advances in Psychiatric Treatment, 9, 249-256. Read More