Perhaps the greatest challenge facing foster parents is finding help for our kids’ mental health challenges.  One study estimates that up to 80% of children in foster care have mental health issues.  The American Academy of Pediatrics says, “Mental and behavioral health is the largest unmet health need for children and teens in foster care.”

Agencies sometimes don’t provide for mental health care.  Even when we do have access what the government will pay for often is substandard.  The system needs to address this shortfall, but in the meantime, we need to find options to take care of our kids.

The Depth of the Problem

By definition, our foster children have suffered at least one Adverse Childhood Experience, namely being separated from their families. Recent studies have shown that compared with the general population, children in the system are far more likely to have experienced at least 4 ACES (42 percent v. 12.5 percent).

Furthermore, many of our children suffer from post-traumatic stress disorder (PTSD).  One survey of mental health research notes that  in one study, 20 percent of abused children in foster care experienced symptoms of PTSD versus the 11 percent that remained in their original home.  According to that same survey, another study conducted in 2005 reported 30 percent of foster youth alumni met the conditions for this disorder, compared to less than 8 percent of the normal population. Finally, the survey noted that up to 90% of foster youth have been exposed to trauma.

Most of our kids, then, have suffered some form of trauma that has left emotional scars.  Even if the kids seem to be doing fine, there may be a lot going on below the surface.  Sooner or later, we will have to help them deal with their trauma.  Whether it’s bad behavior or meltdowns or pushing boundaries, we eventually will see them wrestling with the emotional aftereffects of their trauma.

Finding Help

If you aren’t fortunate enough to be with an agency that provides good mental health care, you’ll have to search for other options.  Some of these options may work for you.

• Advocate Within the System.  Theoretically, your child has a right to adequate mental health services.  In practice, your agency and caseworker may not make those services a priority.  Know your child’s rights within your state, as well as your rights as a foster parent.  For example, federal law gives you the right “to be adequately prepared with appropriate knowledge and skills to care for a prospective foster child and to be provided continuing preparation after placement.” It would not be a stretch for you to agitate for quality family therapy as part of that “continuing preparation.”

It can be difficult to advocate to caseworkers, because if you become known as “that” foster parent, the system can retaliate against both you and your child.  To the extent you can, however, be persistent about getting whatever help the system has available for your kids.

Look Outside the System.  If the child welfare system in your state can’t help your kids, look for resources outside it.  Some health insurance policies, for example, will allow you to include foster kids, or at least pay for family therapy for all of you.  Low-cost clinics sometimes will help foster kids without counting the foster parents’ income.  Finally, when charitable or civic groups ask how they can help, tell them to fund a mental health scholarship for foster kids.  Your church or other place of worship may be interested in helping foster children; don’t hesitate to ask them to pay at least some of the cost for a good therapist.

• Learn How to Be a Therapeutic Foster Parent.  Even if you can find a good therapist for your child, spend time educating yourself.  After all, therapy only lasts for a few hours every month.  You are the people with your children most of the time, and you will be the most important influence on them.  Your learning how to be a trauma-informed parent may be far more helpful for your kids than finding even a brilliant therapist.

One positive development in the past few years has been an increased focus on specialized training for foster parents.   The goal is to have so-called “therapeutic” foster parents available as an option to specialized residential treatment.  If you find yourself parenting a child suffering from trauma, you can position yourself as a therapeutic foster parent and seek that advanced training.

If your government agency can’t or won’t provide extra training, look for a private agency that does.  Even if you don’t become a placement with that agency, it may be willing to provide the training or refer you to another group.  Talk to your state or national foster parent organization, or research online training. One positive benefit of the internet and social media is that it’s easier than ever before to educate yourself about how to help your child.

Being a foster parent has become much more challenging for any number of reasons.  Life is harder than it should be for our kids, and we need to find ways to help them.  Advocating for and finding good mental health services is more essential than ever.  Put it at the top of your list, and use these ideas to find help.  Send me other ideas that you have found helpful, and I’ll put them in a future post.


Debbie Ausburn

Helping foster parents and stepparents learn how to be the person who is not supposed to be there.