Foster Care

May is National Foster Care Month. In Kentucky alone, there are more than 8,500 children in the foster care system. More than 3,000 of these children are placed in foster homes, while others are placed with relatives, or in medical or other residential settings.

Children and teenagers in the foster care system, no matter where they are placed, are more likely to experience mental health challenges. According to the Children’s Bureau and Child Welfare Information Gateway, up to 80 percent of kids in foster care have mental health challenges, compared to 18 to 22 percent of the general population.

Below are problems that can hinder the mental health of children and teens in the foster care system.

Life and Family Transitions

Some children and teens in foster care have many different placements, bouncing around from home to home. This can lead to a lack of structure or routine and cause youth to never feel sure of what will happen next. Youth in the foster care system may frequently go through periods of grief and loss when they lose their old lives during a transition. Also, due to the disruption youth in foster care have faced in their family lives, they may not have a concept of what a healthy family relationship is. As a result, it may take time for them to learn about respecting themselves and others, solving problems, and cooperating and communicating effectively.

Life transitions include more than just adjusting to life with a new family or in a new setting. If a child or teen in foster care has visitation with a biological parent or another biological relative, they may have to focus on trying to build an appropriate relationship with that family member. This can be an adjustment for everyone involved.

Additionally, youth in foster care may go through multiple caseworkers, teachers, schools, friend groups, etc. Some youth in foster care constantly must lose and rebuild important relationships. These transitions are also hard on people interacting with foster youth. A positive relationship may be formed, and then the child or teen may have to go to a new placement. Sometimes the child or teen returns to a parent or other family member who had caused them to experience abuse or neglect.

It is important to note that in some cases life transitions can be positive, such as when a child or teen in foster care is leaving an abusive person or environment. While not all changes are negative, if life transitions are frequent, it can have negative impacts on children and teens’ mental and physical health, due to the resulting chaos and instability.

Medical Care Issues

Youth in foster care may often switch medical care providers, including mental health providers. When switching providers, a foster parent or other adult responsible for the child usually needs to give the providers a comprehensive history of the child’s health needs. If the child or teen has only been with the adult for a short time, the adult may have a hard time providing this history.

Also, youth in foster care may have a hard time accessing needed services if the adult caring for them cannot or will not provide consent, if the adult caring for them does not have health insurance or cannot afford the services, or if there is a lack of mental health providers in the community.

If the child or teen has had different mental health providers, the child or teen may have multiple diagnoses that may sometimes be unnecessary or inaccurate. This may result in the child or teen taking unnecessary medications or too much medication, or not receiving the appropriate care they need.


Life transitions, family issues, medical care issues, and other problems youth in foster care may experience can result in trauma. Many youth in foster care have post-traumatic stress disorder (PTSD) resulting from their experiences – in fact, they experience PTSD nearly five times more than the general population. The trauma these children and teens experience can affect their health in every way.

Addressing the Mental Health Needs of Foster Youth

It is important for foster youth to have the opportunity to work with mental health professionals who holistically address the youth’s mental health concerns, examining them as they relate to the youth’s lives at home, with their families, at school, at work, and in their communities. If mental health professionals work with an integrated approach, services are more effective and foster youth can experience positive outcomes.

Also, mental health professionals should allow foster youth to be involved in and make decisions regarding their own care. Foster youth know themselves better than anyone else knows them. When foster youth can make informed decisions about their mental health care, they are able to develop stronger relationships with their mental health providers and experience positive outcomes in their lives.

Additionally, it is important for youth in foster care to receive trauma-informed care. According to the Trauma-Informed Care Implementation Resource Center, trauma-informed care examines the impact of trauma and options for recovery, helps patients learn about symptoms of trauma, and helps patients and mental health providers work to avoid re-traumatization.

Foster youth also need some form of stability in their lives, such as having someone they can talk with whenever needed, a virtual or in-person group they can participate in, or a hobby they can engage in. Stability can help reduce trauma and help foster youth develop or maintain a sense of self and community.

UofL Health – Peace Hospital has inpatient and outpatient services available for foster youth and caregivers. You can call Peace Hospital at 502-451-3330. In a crisis, you can dial 988.

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Stephanie Siegel, M.Ed.

Stephanie Siegel, M.Ed., is a behavioral health outreach coordinator at UofL Health – Peace Hospital. She obtained her master’s degree in educational and counseling psychology from University of Louisville and has worked in the mental health field for 25 years as a therapist and assessment clinician. Stephanie works to educate people in the community about Peace Hospital and is a resource to others about behavioral health services.

All posts by Stephanie Siegel, M.Ed.
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