Mental health issues: foster kids vs. public

Do foster kids suffer more health issues than kids in the general public?

Many prospective foster parents hesitate from stepping up to become a foster parent. One of the concerns is the potential mental health issues of foster kids. The concern is valid because if you are a kid and are removed from your difficult biological family situation there are two sources of stress. The first is the maltreatment endured in the biological family and the second is the stress of moving and adjusting to a new foster family.

There is a segment of kids that grow up in biological families and have mental health issues. The question is whether foster care kids are any more likely to have mental health issues than the the general public where there is evidence of maltreatment.

The answer to this fascinating question has become available in a research paper from Montreal, Canada just this month. The paper is:

Dubois-Comtois, K., Bussières, E. L., Cyr, C., St-Onge, J., Baudry, C., Milot, T., & Labbé, A. P. (2021). Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis. Children and Youth Services Review, 106100.

Dubois-Comtois et. al. 2021

The authors conduct a meta-analysis or a summary of prior research on the topic by summarizing the data from 41 studies that did some comparison of mental health in foster kids and kids in the public. While 26 of these studies were in the U.S. other countries were also included. These were England (3) , Belgium (2) , and one in each of the following countries: Australia, Canada, Chile, Croatia, Ireland, the Netherlands, Norway, Serbia, Spain, and Turkey. According to the authors the studies were published between 1988 and 2017.

Here is an overview of how the authors identified the 41 studies:

Source: Dubois-Comtois et. al. 2021

The research is methodologically rigorous and includes unpublished studies like dissertations. Including unpublished studies is a neat technique because published studies tend to be only the ones that show strong effects. Ph.D. dissertations that are still being written up for journals might also get excluded if only published studies are reviewed. The authors use an interesting software to analyze the data from the 41 studies.

Here is what we take away from this excellent paper:

  • Maltreatment drives mental health issues: When compared to the general public foster care kids (by almost definition maltreated) seem to have a similar level of mental health issues like maltreated kids in functional families in the general public. In other words, maltreatment is a prime reason to move the kid to foster care. While in foster care these kids are no more likely to develop mental health challenges than maltreated kids in “normal” homes. To clarify, maltreatment need not be a necessary cause of mental illness. [Disclaimer: We are not mental health experts please consult a mental health professional].
  • Stability helps: Whether at a kinship or unrelated foster home a sense of stability at the new home helps foster kids cope better. This is a recurring theme at our meetings and its interesting that this is brought up in the context of mental health.
  • Professional support matters after placement: Once a kid is placed in foster care, professional support can make all the difference. This includes licensed social workers, psychologists,psychiatrists who are available for counselling. It is therefore important for prospective foster parents to know what type of support the foster care organization will be able to provide.


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