Study Finds Foster Care May Foster Lifelong Ills

By Michelle Roberts

Summary: Adults who had been children in foster care later suffer post-traumatic stress disorder twice as often as U.S. war veterans

Former foster children in Oregon and Washington are twice as likely to be depressed or suffer from anxiety as the general population, according to study released Wednesday.

The study, by Casey Family Programs and Harvard Medical School, also found that they struggle with education, employment and money once they leave the foster system at age 18.

A third of former foster children live at or below the poverty line, three times the national poverty rate. More than one in five foster care alumni was homeless sometime during the year after leaving foster care. All but 2 percent fail to complete college.

About 220 teens "age out" of Oregon's foster-care system each year. Most of them, the study found, are not ready to be on their own.

"We are alarmed that in too many cases, these young adults aren't doing as well as we anticipated," said Ruth Massinga, president and CEO of Seattle-based Casey Family Programs. "Many leave the system without any lasting personal connections, support or life skills."

Only about 20 percent of adults formerly in foster-care placement through either private or public agencies were found to be doing well, the study said.

Researchers from Harvard Medical School, the University of Michigan and Casey Family Programs reviewed case files of 659 adults, ages 20 to 33, who had lived in foster care between 1988 and 1998. They interviewed 479 of them. It is the first significant study of how former foster children fare over a long period of time.

Most of those studied entered foster care because they had been abused or neglected. More than half reported clinical levels of mental illness, compared with less than a quarter of the general population. Foster children, the study said, are especially vulnerable to post-traumatic stress disorder.

Peter Pecora, director of research for Casey Family Programs, said a fourth of those studied reported symptoms of the disorder -- twice the rate of U.S. war veterans.

"It is a dramatic finding," he said, adding that national studies show that 12 percent to 13 percent of Iraq war veterans and 15 percent of Vietnam war veterans suffer from the disorder.

Post-traumatic stress disorder occurs in some people who experience or witness life-threatening events, such as violent personal assaults, military combat or serious accidents. They often relive the trauma through nightmares and flashbacks, and feel detached or estranged.

Foster children are traumatized by living with abusive or neglectful parents, by being removed from their homes, and by being moved repeatedly while in foster care, the study said.

"The very act of removal from their parents is often traumatic," researchers wrote, "potentially resulting in post-traumatic stress disorder and creating a sense of hypervigilance because their lives become unpredictable."

Nearly 14 percent of children in Oregon's foster care system experience three or more changes in foster placements as they grow up, according to the Department of Human Services. Some counties have placement instability rates of 20 percent and higher, despite a national standard of 13 percent or less.

Brian Gardner, 17, has been in Oregon's foster care system since he was 3 and has experienced "at least a dozen different moves."

Gardner, who recently moved into his own state-subsidized apartment in Portland, said the fear and reality of so many moves have made it difficult for him to bond with others.

The constant moving "was more difficult than anything I experienced with my birth mother," he said, adding that he was placed in foster care because his drug-addicted mother neglected him. Gardner said one move from a foster family he'd lived with for six years "almost made me lose my mind. It was like my whole life had crumbled. I still suffer the effects of that today."

Researchers looked for ways to improve outcomes for foster children. They created statistical simulations that found, for example, that increasing Medicaid mental health coverage and giving foster kids more stability by not moving them so much would reduce their chances of mental illness later in life.

The study identified several areas in which the states can improve, including reducing the number of times a child moves before being placed in a permanent home, and encouraging children to connect with foster parents and other adults in lifelong relationships. The study mirrors others that show that the resiliency of children can often hinge on one meaningful relationship with a caring adult.

Kevin George, the Oregon foster care program manager for Human Services, said the agency, which participated in the study, will take the findings to heart.

"This really validates many things that many of us had speculated," George said. "We will use it as a guide to where we're going to put our time, energy and resources."

Nationally, about 800,000 children a year enter foster care because of abuse or neglect in their homes. On a given day, Oregon supervises as many as 7,800 children in homes away from their parents. And, for the first time in years, more children are entering foster homes than leaving them.

The study focused on Oregon and Washington because they are home to some of the longest-running Casey Family Programs foster homes in the nation, and both states have large child welfare organizations.

RECOMMENDATIONS

* Reduce number of times a child moves before getting into a permanent home.

* Encourage lifelong connections with foster parents and other supportive adults.

* Increase access to effective medical and mental health treatment.

* Improve foster parent training with regard to addressing child mental health needs.

* Adopt measures to increase high school graduation rates with diplomas, not GEDs.

* Inform older youth about college-preparatory programs and help them enroll.

* Expand youth employment programs.

* Strengthen housing programs to prevent homelessness.

-- Northwest Foster Care Alumni Study

© 2005 Oregonian Publishing Co. All rights reserved. Used with permission of The Oregonian.