Hardship follows children after foster care

Many foster children apparently go on to have rocky young adulthoods: They're less educated and in much worse mental health than other adults the same age, and about one-third live at or below the poverty level — three times the national average, a study of former foster care children reported Wednesday. About 800,000 children a year in the USA spend time in foster care. But few studies have examined their lives beyond the teen years. It's a disturbing picture, says study leader Peter Pecora of the Casey Family Programs.

The 479 adults ages 20 to 33 in the study had spent at least a year in foster homes when they were ages 14 to 18.
Only about 1 out of 5 are mentally healthy and employed. More than half have at least one mental disorder, including 25% with post-traumatic stress disorder in the past year. That's more than six times the post-traumatic stress rate for adults the same age and even higher than war veterans' levels, Pecora says.
Just 2% have a college degree, compared with 24% for other adults the same age. And more than 1 out of 5 have been homeless.
Many leave foster care "without any lasting personal connections, support or life skills," says Casey Family Programs President Ruth Massinga.
The best-adjusted adults lived with the fewest foster families, had access to effective mental health treatment and benefited from a good education and work training, the report says. Much of the difference between grown-up foster kids and others "could be wiped out by very doable changes in the foster care system," says study co-author Ronald Kessler of Harvard Medical School.

Good care for mental disorders is key. But child welfare workers aren't adequately trained to recognize the problems, Pecora says. Also, some public agencies aren't up to speed on what treatments work best, so they're buying ineffective care for kids. More agencies should sign "performance-based" contracts that pay for results, he says.
A 7-year-old federal law requires every person leaving foster care to have a written transition plan so he can "be put on a path to a living-wage job," Pecora says. But counties and states are enforcing the law "on a hit-or-miss basis," he says, and the U.S. government has not monitored enforcement.
The law also allows states to extend foster kids' Medicaid coverage to age 21 so they can get health and mental health care during the transition to adulthood. But only nine states are doing this, the report says.
Often, workers in foster care, education, employment and mental health programs don't talk to one another, leading to kids falling through the cracks, Pecora says. San Diego and San Antonio have model programs that get all these professionals working together, he says.
Investing in the welfare of foster kids can be a hard sell politically, because there aren't immediate payoffs, Kessler says.

"But there are enormous downstream savings to society from this 'ounce of prevention,' " Kessler says; many more kids can become mentally healthy taxpayers rather than welfare recipients.

Marilyn Elias
6 April 2005

http://www.usatoday.com/news/health/2005-04-06-foster-challenges_x.htm

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