Foster Care Youth Facing Mental Health Crisis

Foster care youth are nearly 3x more likely to “reoffend” between adolescence and adulthood. There are several new initiatives underway to support the foster care system plagued by limited coordination and high cost treatment.

Many pediatricians knowingly treat a child within the foster care system for a severe mental illness but when the foster child goes into crisis- the kneejerk reaction is often to send the child to the emergency room. This stabilization process is essential, but doesn’t always meet the child’s needs. Residential treatment is generally too expensive for a foster parent. After several calls for outbursts- the police are often called.

This series of challenges is known as the “foster care to prison pipeline.”

By age 17, more than half of juveniles in foster care get into trouble with the law, says Tiona Praylow, MD, MPH, of Riverwoods Behavioral Health at the National Council on Behavioral Health’s annual conference NATCON this past April.

To address this, treatment revolves around focusing on ensuring the parent is the agent of change and that the young person has a positive caring person in their life.

In Oklahoma, Enhanced Foster Care addresses gaps in services and provides therapeutic care in traditional and kinship resource homes similar to what is provided in a contracted therapeutic foster care home. This enhanced level of care provides immediate services after a consult for the foster child, uses assessment tools and does continuous treatment team meetings that involve the child, parents, foster parents, case workers and service providers to take action.

“Being on the frontlines is hard but it’s rewarding and we’re seeing more children towards adoption and stabilization,” says Praylow. “651 total children were served in 2021, and 258 successfully exited care.”

Some states are taking action to help destigmatize severe mental illness.

A new program in Tacoma, Washington is designed to prevent people from going through the justice system with undiagnosed mental health issues. Starting in April ‘22, anyone charged with a misdemeanor or gross misdemeanor who also suffers from mood or thought disorders can be referred into the program. The program provides help from a team that includes a judge, therapeutic coordinator, case manager, and others.