Unmet Mental Health Needs of Children in Foster Care

As a follow-up to a previous article on youth in the child welfare system and overuse of psychotropic medications, Imagine Giving an Infant A Psychiatric Drug, here are some highlights from the December 2012 Government Accountability Office’s Congressional report on Children’s Mental Health: Concerns Remain About Appropriate Services for Children in Medicaid and Foster Care.

The Nation Institute of Health spent approximately $1.2 billion dollars on children’s mental health research between 2008-2011.  The most commonly studied mental health issues were ADHD, major depression, and bi-polar disorder.  Of funded research, the largest portion of expenditures went to studies did not look at treatments, whether medication or psychosocial.  Of the 482 funded research projects which looked at treatments, 137 looked at medications, and 352 looked at psychosocial therapies.  66 projects were also funded which looked at combined treatments, whether multiple medications, or a combination of medication and therapeutic psychosocial interventions.

The most troubling findings reveal that more than 80% of youth with identified mental health needs received no psychosocial therapeutic interventions, and between 65% – 88% depending on age grouping had no mental health office visits, despite 9% of children in Child Welfare and 18% of children in Foster Care being prescribed psychotropic medications, and often multiple medications.

9% of children 0-5 years old receive medication interventions. 88% of youth in that age group had no reported mental health office visits, and 90% had no psychosocial interventions.

For the 6-11 age group, over 80% had no psychosocial therapeutic interventions, and 65% of Medicaid and 75% of privately insured youth had no mental health office visits. While medication may be helpful, studies have long shown that a combination of psychosocial interventions and mediation is more effective than medication alone, and often, psychosocial interventions are most effective.

The report also revealed 58% of Medicaid insured youth in this age group and 70% percent of privately insured youth with identified mental health needs received no medication or mental health office visits and no psychosocial interventions.  Clearly, this means we can identify youth with mental health needs, but they are receiving no treatment or interventions of any kind. These fragile, at-risk youth, who can show amazing long-term positive outcomes and benefit tremendously from early intervention, are receiving no help.

We know early treatment works best, and children can benefit greatly from psychosocial therapeutic interventions which could have marked impact on long-term positive life outcomes, especially when mental health issues stem from incidents relating to trauma. Stating the obvious, children in the child welfare and foster care system have undergone some type of traumatic event and more often than not, have been impacted by numerous traumatic events.

The report has found a lack of knowledge regarding mental health among child welfare and foster care providers, lack of qualified mental health providers for youth, and poor service coordination.  It is hoped that through continued quality improvement efforts,  better inter agency data sharing and reporting, and coordination of services , more  treatments that work will not only be made available to at-risk youth, but at-risk youth will be able to access needed services.

Press this link to access the full 60 page report.

Written by, Michelle Sicignano, LMSW – Staff Writer, SJS