Print Daily Journal Online Article

Daily Journal Newswire Articles
www.dailyjournal.com
© 2005 The Daily Journal Corporation. All rights reserved.

• select Print from the File menu above

FAMILY • Jul. 28, 2005
Foster Children Pay Price for Overworked, Inadequate System

Forum Column

By Miriam Aroni Krinsky

        Picture a soldier in battle, hunched over his rifle, grenades exploding on all sides and buddies wounded and dying before his eyes. That's probably the most anguishing scenario most of us can imagine. Yet a recent study found that the rate of post-traumatic stress disorder among former foster children is twice as high as that of U.S. war veterans.
        Children living in foster care, by definition, have undergone life-shattering upheaval. The psychological trauma inherent in being separated from their families without warning, often to be placed with strangers, when combined with the abuse or neglect that precipitated the removal, leaves these youth forever altered by their experiences.
        At a time when they desperately need a sense of consistency and stability, foster children are thrown into an uncertain world of multiple placements, unpredictable contact with their siblings and birth family, and the inability to control their own lives. Foster youth experience an often-debilitating void in their lives. Having been severed abruptly from their family and all that is familiar to them, and living a life thereafter commonly marked by perpetual motion, displacement and no stable anchor, many feel profoundly alone. They maintain little hope or expectation that things will ever be different.
        It is, therefore, unsurprising that the Child Welfare League estimates that between 40 percent and 85 percent of abused and neglected youngsters in foster care evidence major emotional and mental-health concerns.
        Exacerbating the problem is the lack of prompt and adequate attention to their emotional and mental condition. Early identification is key to the prevention or treatment of mental illness, yet half of the foster children who desperately need help receive appropriate or timely mental health services.
        Too often, foster children fail to receive psychiatric care until their situations reach a crisis and extreme or harmful behavior occurs. The lack of early, preventive attention may contribute to findings that 15 percent of foster youth attempted or contemplated suicide and 29 percent spent time in a psychiatric hospital.
        Even when care is provided, a lack of coordination among the child welfare system, mental health providers, schools and courts results in fragmented provision of services. A shortage of available providers, poor record-keeping and the absence of continuity of care diminish the odds for positive outcomes.
        Children who have the fewest defenses are paying the price for an inadequate system.
        The results of these failures are manifest. Mental-health problems make it less likely children will reunite with their birth families or be adopted and more likely they will experience multiple placement failures, spend a longer time in foster care or cross into the delinquency system.
        These difficulties outlast the child's time in foster care, as youth grow into adulthood. Half of former foster youth now in their 20s and early 30s reported clinical levels of major depression, post-traumatic stress disorder, social phobia, panic syndrome and anxiety or drug dependence within the past year.
        If we are to turn these disturbing trends around and respond effectively to the mental-health needs of the children who rely on us to help them heal, we must begin to develop better communication, collaboration and oversight among the multiple systems charged with caring for abused and neglected children.
        Child welfare workers, caregivers, attorneys, advocates, judges, educators and health care providers, regardless of differing mandates and differing values, must join the community of adults trained to understand the importance of rapid response to emerging mental-health issues in foster children.
        A recent report in the American Medical Association journal Archives of General Psychiatry demonstrated a strong link between coordination among agencies and enhanced services for children whose test scores indicated a need for treatment.
        This study coincides with the thoughtful recommendations issued last year by the nonpartisan Pew Commission on Children in Foster Care. The commission's report observed, "Assuring child safety, permanence and well-being is a shared responsibility, requiring collaboration and coordination across publicly-financed systems."
        Pew commissioners further emphasized the need for courts overseeing the foster care system to better track and manage their caseloads so that children receive the services they urgently need.
        The recent passage of Proposition 63 and the resulting enhancement of resources available to at-risk youth make it a particularly opportune time to engage our entire community with regard to these issues. We cannot afford to continue our "business-as-usual" approach.
        With the generous support of the California Endowment, the Children's Law Center of Los Angeles plans to develop ideas for new approaches to a sustainable collaboration that will create improved mental-health services for foster youth. Children's Law Center's newly created Foster Youth Mental Health Initiative will allow us to serve better the youth who most need our care and attention.
        This critically needed initiative will span three years. Efforts in the first year will focus on bringing together key players to identify barriers and begin to craft solutions. Children's Law Center will lead a collaborative, multiagency advisory group to work together and convene a summit focused on better meeting the mental-health needs of foster youth in Los Angeles County. We hope that this summit will forge relationships and identify areas where immediate changes can be implemented.
        The next step must be to develop practice guidelines regarding assessment protocols and identification of effective interventions. Under the current structure, for example, no systematic approach determines when a child should receive a mental-health assessment. Thus, improving responses for individual children will be futile unless we can change the system itself.
        Child welfare and child mental-health systems operate with somewhat different goals in the service of foster children. The primary goal of the child welfare system historically has been child safety, and the primary goal of the mental-health system is to improve overall well-being and functioning.
        These fundamental differences can make it difficult for the systems to work together. The Foster Youth Mental Health Initiative will create an interdisciplinary team structured to promote better collaboration and to develop proactive solutions.
        The initiative also will focus on the development of an improved approach to mental-health assessment, delivery of services, information sharing and outcome tracking. This will be accomplished through the creation of infrastructure, training materials and best-practice models as well as system change to further the mental-health interests of current and future foster youth.
        This is an ambitious undertaking, but we must begin now to bridge the gaps among the mental health, judicial and child welfare systems to ensure that all abused and neglected children have a meaningful chance to heal and move forward.
        We need to work together and break down the institutional silos that prevent our most vulnerable children from overcoming the emotional turmoil that foster youth encounter. We owe this to our youth, so they can begin to trust anew.
        Anyone interested in learning more about the Foster Youth Mental Health Initiative should contact the Children's Law Center at (323) 980-1700.

Miriam Aroni Krinsky is executive director of the Children's Law Center of Los Angeles, a nonprofit organization that represents abused and neglected children in the Los Angeles dependency court system.