LJWorld.com weblogs Notes from John

The mental health needs of foster children.

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46% to 49% of Kansas children entering foster care are receiving mental health services within six months. This eventually became 56%. This is according to a study done at the University of Kansas by Terry Moore and Becci Akin (http://www.socwel.ku.edu/occ/viewProject.asp?ID=75).These findings are consistent with national studies (i.e. Leslie, Hurlburt, James, Landsverk, Slymen & Zhang, 2005). It is not surprising that foster children need mental health services given that they enter care from a variety of troubled backgrounds including child abuse, neglect and their own troubling behavior which may be early onset of serious mental illness. Let’s hope that this is not an area for budget cuts in these dismal fiscal times. Our foster parents need all of the help that they can get in parenting our children. Another finding is that it is about 40 days on average from entry into foster care and first mental health contact. This is a concern given that the American Academy of Pediatrics recommends mental health screening for all children entering foster care within 24 hours and a comprehensive assessment within 30 days. Children entering care may not be screened for mental health needs using the best instrument. The report found that if a child under the age of 6 enters care and is screened for mental health needs, they are screened by a well regarded instrument. However this is not true for children over that age of 5.Finally (only in terms of this entry, the report’s 145 pages contains lots more information) 75% of foster children receiving mental health services are receiving only 1 or 2 different services. This is distressing given that one of the two services is assessment. More distressing is that only 5% of these services are family based. Most Kansas foster children need mental health services. However, it takes 40 days to get the process started. If the child is over the age of 5 the screening instrument may not be the best. The services provided may not go beyond a mental health assessment and only 5% of services are family based. So foster parents are not receiving the help they need to care for our children where it will do the most good, in the foster home. Certainly we can do better than this.

Comments

Ronda Miller 6 years, 3 months ago

John, the points you make about foster children needing immediate assessment and in some cases treatment is a good one. Sadly, it is a statement of our society that there is not a priority as such set in seeing the children are getting the mental, and sometimes physical, care, they so desperately need. It is no wonder the foster parenting system is stressed to the point of breaking. As a side, however, it is not just foster children who are neglected by a lack of mental health needs - we have children and adults of all ages who do not have the means to attain evaluation and treatment. Thanks for bringing this topic to light, John...

Alia Ahmed 6 years, 3 months ago

John,I used to work in mental health quality improvement for one the organizations that have foster care and adoption contracts for the State of Kansas . Foster children's frequent placement disruptions made it more difficult for foster children to get the services they needed. By the time of the first intake at a local community mental health center, the placement may have disrupted because of the unmet mental health needs of the child. So rapid identification and provision of mental health services, especially in the context of family foster care, might actually prevent unnecessary disruptions which may only reinforce or exacerbate mental health symptoms.

coolmom 6 years, 3 months ago

we adopted a child who continues to see 2 different councilors with us. in foster care according to court paperwork she was seeing a councilor but the fact was that they were writing her more and more scrips until and she says i couldnt feel anything and she was not attending counciling because of how hard it was to fit into the foster parents schedules and they said she was missing to much school. over the course of a year she had 4 real counciling sessions.

denak 6 years, 3 months ago

Wow, is this a topic that needs to be explored. I wholeheartedly agree that foster children need to be screened earlier and have more consistant counseling.Unfortunately, this isn't the reality for a lot of children who live in big cities. From what I am to understand, the waiting list for children in Kansas City Kansas is just enormous.I feel very fortunate to live in Lawrence because my foster kids usually get their mental health services within 30 days. However, I have had three foster kids who needed services WAY before 30 days. Especially if a child is entering foster care. There is so much anger, confusion, guilt and terror running through their little bodies that waiting 30 days to get services isn't going to cut it. I think one thing that foster parents should be allowed to do is make the first appointment especially if you live in a small town like Lawrence. Most social workers want to make the the first appointment and I understand why they want to do that but sometimes between all the rest of their duties, that kind of gets put on the back burner. I think there are a lot of foster parents who would like to make the first appointment and save time. There are, of course, drawbacks to that. Some foster parents won't do that and some won't grasps the severity of the child's needs and not make an appointment soon enough. And social workers tend to have more authority but I would like to at least see that as an option especially for foster parents who live in bigger cities and who might have the time to hound a particular mental health facility.Both what Alia and "coolmom" say is true. I had a child who had a total meltdown a few weeks after I got him because of all the guilt he felt because he told "the secret." I can't help but think had he gotten the services he needed beforehand, he wouldn't have had to go through what he did. And as for scheduling, that is a pain in the butt. The reality is that most foster parents have to work. It is not only a requirement but a neccessity. And trying to fit therapy in is hard to do sometimes. It takes a toll on both the children and the parents because there is not a lot of downtime some days. I had one foster child who had therapy three times a week. So I would get of work at 5, pick her up from the afterschool program and then hurry to take her to therapy which lasted an hour. So, on certain days, she was away from home, from roughly 7:45 to 6:45 and then we would have to go home, eat dinner and do homeowork. The only other option to insane days like that is to pick the child up from school and have therapy during the day, which means the child misses school. Which should be the subject for the next article by John. ..just how much school foster kids miss.Dena

Alia Ahmed 6 years, 3 months ago

Dena,You certainly point out the obstacles to getting needed services to foster children. Thank you for opening your heart and home to foster children. It takes a special person/couple/family to do that. Would in-home services help with some of the scheduling problems as foster parents often have more than one foster child or children of their own? It is more costly to provide, but if it helps prevent a disruption and helps the foster child adjust more quickly, it may be money well spent. I agree about foster children missing school, it happens frequently because of court dates, appointments, etc. Also when foster children get moved frequently, they lose out on their education as they constantly need to readjust to a new foster family as well as a new school setting. For children who remain in foster care for many years, their quality of education has suffered greatly by the constant upheaval in their lives and are not prepared to either work or go onto to college once they are aged out of the system.

Alia Ahmed 6 years, 3 months ago

Coolmom,Thanks to your family also for adopting a child. I hope she is doing well now that she is in a stable home.

Linda Hanney 6 years, 3 months ago

Are foster care services something that might get cut? If so, we need to start writing letters. Perhaps we need to just in case.

johnp 6 years, 3 months ago

Thanks to all of you for adding to this post. The real experiences of workers, foster parents and adoptive parents are very informative. Coolmon and Dena - thanks for taking care of some of these kids. We need more people like you.The study could not address the effectiveness of the services delivered. That is another whole study but your experiences document the difficulty of getting the right services at the right time.Linda and others - feel free to share this with your legislators. The combination of the study findings and direct experiences revealed by the comments are powerful.

coolmom 6 years, 3 months ago

i took her off all meds for a year and now she is just on a very low dose of adderall to help with the adhd symptoms. we got her at 13 and she will be 16 this week. when she came to us she was reading and decoding at a second grade level. and i held her back in 8th grade after fighting with everyone about it.(you know bad for the kid stuff but already foster kids are at risk for dropping out so they might as well be able to read) i teach a reading intervention group and as painful as it was for both of us she has dramatically improved. her dad is a eng. and does math stuff with her and she now maintains about a B average. she has issues with her past and guilt ptsd kind of stuff but you would not believe the kid she is today. this weekend she will have a sweet 16 and there will be 13 screaming girls here playing rock band and the hubby will be gone on a business trip. (feel free to pray for me lol)

Alia Ahmed 6 years, 3 months ago

Coolmom,Thanks for the update on your daughter's life and thanks for being such an advocate for her. She's blessed to have you and your husband as parents. You will be in my thoughts and prayers this weekend. :~ )

Mary Darst 6 years, 3 months ago

At the middle school I work at, we have a large number of foster children. Mostly from Wichita. It is heartbreaking. They usually come with nothing and leave with nothing. I am certainly not smart enough to even have a suggestion about how to fix this problem, but taking away funding would be a really bad deal. My daughter- in-law works in the mental health field. They are under staffed and underpaid. They receive up to 18 intakes a week and most are children. What do we do about the parents of all these children? I applaud all of you that foster them with loving care. Sadly some do it just for the money. Nothing like seeing a foster child in the home of someone that couldn't raise their own children.

StephanieD123 5 years, 9 months ago

Thank you for this post. This is where more CASA workers are needed. They are the voice of the children. Unfortunately there are outstanding numbers of foster children and far too few CASA's. Every foster child that has a CASA is given a gift. The CASA will get them any needed help immediately. They make sure they don't get lost in the system and their needs are met. Due to the failing economy there are more abused and neglected children than ever. There needs to be more CASA volunteers.

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