Learn More – Well-Being

Foster youth often experience a myriad of challenges, from the time they enter foster care to when they’re aging out and beyond. As a result, they need access to constant health benefits, services, programs, resources, tools and advocates who can support their health and well-being needs.

  • Common health challenges while living in foster care include behavioral problems, lack of self-esteem, depression and apathy.
  • Victims of child abuse and neglect are 42% more likely to be abused and neglected again later in life as children, teens or adults.
  • Teen girls in foster care are 2.5 times more likely to become pregnant by age 19.
  • 45% experience emotional or behavioral problems while in foster care.

What is well-being?
kids running in park towards camera

Well-being is characterized by a state of health, happiness and prosperity. For foster youth, it’s a state in which their physical, developmental, cognitive, emotional and behavioral functioning are healthy. They are able to develop skills and capacities; grow and mature appropriately with age; and engage in positive social interactions. Well-being is measured in four basic domains:

  • Cognitive functioning
  • Physical health and development
  • Behavioral/emotional functioning
  • Social functioning

What necessitates a child being placed into enter the foster care system?

Children and youth are removed from environments that have been identified as high-risk. They are in dire need of mental health resources to help them find ways of coping. Many have already experienced a prolonged history of suffering, mental health or physical issues in their biological home including:

  • Parent neglect, abuse, abandonment, or exploitation
  • A history of complex trauma
  • Multiple exposures to trauma in early childhood

What are some negative factors that can impact a foster youth’s well-being during their time in foster care?

The average length of time a foster youth spends in foster care in Southern California today is 20.6 months or almost 2 years. During that time, the well-being of a foster youth can be negatively impacted due to a wide range of factors, including:

  • Frequently changing situations and transitions
  • Broken relationships foster families or kin
  • A lack of educational tools, resources and school opportunities
  • Depression or lack of self esteem
  • Poverty or economic hardship
  • Behavioral or mental health problems
  • Living in unsupportive or problematic group homes
  • Inconsistent and inadequate access to mental health services
  • Over-prescription of psychotropic medications

What do experts say about the overall well-being of foster youth today?

The children and teens in Southern California’s foster care system are of all ages and varying mental, emotional, behavioral, physical and psychological needs. While some youth stay in foster care for weeks, and others may stay for years, all foster youth can experience emotions of from the events that led to removal from their birth families.

According to the American Academy of Pediatrics today, mental and behavioral health is the greatest unmet need for children and teens in foster care. While there is overwhelming evidence demonstrating the significant mental health problems foster children experience, historically there have been limited legal statutes, policies and programs that focus on the psychological and emotional well-being of children in foster care.

How do foster youth view their own well-being?

Recent studies have shown when asking foster youth what’s important to their overall well-being, health and wellness, they noted the importance of their relationships with others including staff within foster agencies. Safety and economic security, physical health, control in various personal domains, and social and moral responsibility were all cited.

The American Psychological Association states that children entering foster care should be assessed for physical, developmental, and mental health problems so that interventions can begin early to improve well-being. Periodic assessment is also required to assess the child’s adaptation to their new surroundings and relationships since placements can unstable and sometimes unsuitable.

What percentage of foster youth in Southern California today are experiencing challenges which affect their well-being?

According to a national statistics report, of the foster youth in Southern California, nearly 50% have learning disabilities or developmental delays. The National Institute of Mental Health reports that 48% of children in foster care have been found to have emotional or behavior problems.

What is the well-being of foster youth leaving the foster care system?
foster youth girl after aging out of foster care

A wealth of evidence today indicates that young adults who age out of the foster care system (youth who are not reunified with their family or adopted) are at significant risk of poor outcomes. As services often end abruptly once youth turn 18, they face challenges such as inadequate housing or homelessness, low education and poor vocational functioning, early parenthood, substance abuse, physical and mental health problems, relationship instability and involvement with the criminal justice system.

In fact, here are some alarming stats about the well-being of foster youth who have exited the system:

  • In the initial four years following exit from care, roughly one in three LA County foster youth will receive food stamps through the CalFresh Program and more than half are covered by MediCal at some point.
  • In the initial two years following exit from care, 50% of former foster youth will be homeless.
  • Within the first few years after leaving care, 60% of girls will become pregnant.
  • On top of that, more than 50% of former foster youth develop disorders later as adults.

In light of these staggering statistics, it’s critical for foster youth’s survival and well-being to have access to programs, services and community connections to help ease their transition out of the state’s foster care system and into managing their lives as an adult. National statistics indicate about 10% of youth “age out” of the foster system. This number is reported to be rising in California.

A successful transition to adulthood requires much support, skills and resources for all youth, but foster youth in particular, face significant hardships as a result of difficult experiences early in life without the guidance and support of family to guide them.

Can early childhood trauma affect a youth’s well-being later on as a young adult or adult?

Early trauma does have consistent and predictable consequences on a foster youth’s life and also affects many areas of functioning. As trauma often begins before foster youth are removed and often continues after they are placed out of the home, these experiences engender intense effects on their well-being, such as rage, betrayal, fear, resignation, defeat and shame. More importantly, trauma often negatively impacts their ability to be resilient in the face of long-term adversity. Recent advances in brain and developmental science report that trauma does infact impede a child’s short and long term functioning across all domains of well-being.

When multiple traumatic events begin at a very young age and are caused by adults who should have been caring for and protecting the child, it’s difficult to understand the myriad effects of these early traumas.

What are some health outcomes of foster youth who have faced trauma, in comparison non-foster youth?

Recent studies comparing mental health outcomes between foster care alumni and the general population found significant disparities. Foster care alumni experience post-traumatic stress disorder at a rate nearly five times higher than the general adult population due to the high level of complex traumas they faced as foster children.(Assessing the Effects of Foster Care: Mental Health Outcomes from the Casey National Alumni Study, 2004)

What is The Fostering Connections to Success Act?

It’s a federal law requiring states to develop a case plan for coordinating health care services for children in foster care. It also coordinates mental health services, including the use of psychotropic medication.

What is the Affordable Care Act (ACA)?

Recent federal statutes such as the Affordable Care Act (ACA) under Obama Care provides funding to states to expand their early childhood home visiting programs for at-risk families. It also provides newer benefits for older youth who are in, or have been in foster care.

What is The Child and Family Services Improvement and Innovation Act on the well-being of foster youth?”]
The Child and Family Services Improvement and Innovation Act (2011) reinforces the importance of discussing social-emotional mental health of children who have experienced abuse or neglect. This federal law states that family treatment plans must include how emotional trauma, as a result of child maltreatment and removal from the home, will be addressed.

What is the Adoption and Safe Families Act?

In 1997, the Adoption and Safe Families Act identified safety, permanency and well-being as equal goals, with legislation requiring action to address the mental health needs of children who are victims of maltreatment. While the child welfare system is designed to provide safety and permanency, well-being is an equally important component to the goals of child welfare. However, historically these goals have not been given equal emphasis in child welfare policy and practice. This is indisputable when considering the current facts and statistics that characterize the emotional and psychological well-being of children in foster care.

What is being done today to improve the well-being of foster youth?
Girl sitting in chair looking at clipboard

While measures of well-being focus on the presence of risk factors such as poverty, low education, depression, or behavior problems, there are many ongoing initiatives today that strive to protect and promote a foster youth’s well-being, health and welfare. Efforts include developing parenting skills, social connections, support networks, emotional competence in youth and much more.

Overall, the goal is to foster happy, healthy and prosperous conditions within the family. Services are designed to foster connections with positive peers, other caring adults and spiritual communities.

State and local child welfare agencies promise to reintegrate the goals of safety, permanency, and well-being with a much stronger, and more integrated well-being orientation. Enhancing inter-agency and cross-system collaboration through technology are just a few of the efforts being executed at the local, regional and state level. Tracking children over time and linking child welfare records with educational, health, parental employment, and criminal records is able to yield valuable information about children’s well-being and pave the way for new policy and practice innovations.

California Youth Connection, a non-profit organization guided and driven by current and former foster youth, is making great strides in improving social work practices and child welfare policies by participating in policy development and legislative change.

Evidence Based Treatments (EBT)are being utilized by policymakers, advocates and practitioners in California. Over the last 20 years, EBTs have shown marked progress. For example, Trauma Focused-Cognitive Behavioral Therapy (TB-CBT) targets emotional and behavioral problems of children age 3 through 18 who have been exposed to trauma as well as provides therapy and support for their caregivers.

Policymakers and legislators at the American Public Human Services Association (APHSA) have determined that the sustained well-being of children and youth is a necessary policy goal for transforming the human service system.