Children Grow Up Healthier in Enriched Foster Care
There are big, long-term health payoffs in mental and physical well-being when foster-care services to children are enhanced, a new study suggests.
Kids generally go into foster care as a last resort: when maltreatment or neglect at home is extreme and unremitting. Such abuse can have long-term consequences on the mental and physical health of children as they grow up.
A new study, published in the latest edition of the Archives of General Psychiatry, looked at whether more enriched and supportive foster care can help mitigate some of the long-term problems foster kids face.
The study compared two groups of adults from Oregon and Washington state who, as teenagers, had been placed in foster care because of abuse at home.
The social and economic backgrounds of the two groups were similar, but one group had been placed in the states' public foster-care systems. The other group had been put in a private foster-care program — which had more services for children and their foster parents.
The extra services included mental health screening, tutoring, summer camps and job training for kids, as well as increased financial assistance and parenting training for foster parents.
Ronald Kessler, a research sociologist from Harvard University, compared the two groups as adults. Of the 479 people who took part in the study, he found that those who had been given the enhanced foster care had dramatically fewer medical problems, such as heart disease, hypertension, ulcers and diabetes. They also had much lower rates of depression, anxiety, post-traumatic stress disorder and substance abuse.
Extra foster-care services cost more — about 60 percent more money than the typical state-run foster care program — but Kessler says the benefits outweigh the cost.
"The outcomes are more than 60 percent better because you really get a dramatic, dramatic increase in the quality of the outcomes for the kids in the model program," he says.
The next step, he adds, is to figure out which foster-care kids benefit the most from expanded foster-care services. Kessler and his team are conducting that research now.
Emory University research psychiatrist Charles Nemeroff agrees. He suggests that the target group for a study should be children who have experienced the trauma of parental abuse and inherited a genetic vulnerability to depression or anxiety.
This group would be the most likely to suffer lasting health problems as adults and the most likely to benefit from an expanded, encompassing foster-care program.
9(MDAyNzUwMDI2MDEyNTA3MTU5NzcyNTQyNA004))
A Harvard University study found that children in enhanced foster-care programs had dramatically fewer medical problems as adults. Below, some of the extra services found beneficial to foster-care programs:
For Foster-Care Kids
-- Mental health screening
— Tutoring
-- Summer camps
-- Job training
For Foster-Care Parents
-- More financial assistance
-- Parenting skills training
-- Support from case workers
For Case Workers
-- Better trained
-- Earned higher salaries
-- Lower case loads
-- Every year, 3.6 million children and youth are investigated as potential victims of abuse or neglect.
-- 25 percent of children and youth investigated (899,000) on average are confirmed as victims of abuse or neglect.
-- On any given day, there are about a half million children living in foster care in the United States.
Source: Casey Family Programs, U.S. Department of Health and Human Services. Data are as of Sept. 30, 2005.
ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
On any given day, about half a million children in the U.S. live in foster care. Often they are victims of severe abuse and neglect by their parents, and many of the kids end up in foster care programs that have problems of their own.
We have several stories now on efforts to improve foster care and the people behind those efforts. First, a study published this week explores what it takes to create a successful foster care system, a system which helps children heal psychologically and physically.
The study appears in the Archives of General Psychiatry, and Michelle Trudeau has our story.
MICHELLE TRUDEAU: A child is placed in foster care only as a last resort, when parental maltreatment or neglect is extreme and unremitting. Such abuse has long-term consequences. Sociologist Ronald Kessler of Harvard Medical School investigated two groups of foster care children from Oregon and Washington State. They were adults who've been raised in foster care from childhood through their teenage years. One group had been placed in the state-run public foster care system and the other group was placed in a private program with expanded services.
Professor RONALD KESSLER (Harvard Medical School): We traced both groups of kids to see how they turned out as adults.
TRUDEAU: Both groups had similar social and economic backgrounds. They'd been placed in either the standard state program or the expanded private program, depending on space availability. Kessler says they turned out very differently.
Prof. KESSLER: The people who were alumni of the more intensive program had dramatically better mental health and physical health than the people who were in care in the conventional program.
TRUDEAU: Significantly less hypertension, heart disease, ulcers, chronic pain and headaches.
Prof. KESSLER: They had 50 percent lower rates of depression and anxiety disorders and substance disorders.
TRUDEAU: So what made the difference? A whole list of things, including that case workers in the private program were better trained, earned higher salaries, had lower caseloads. The kids got more services, such as mental health counseling, tutoring in school, summer camps. And the foster parents received more financial assistance and support, even some parent training. Of course these expanded services cost more - about 60 percent more. But Kessler says the benefits outweigh the cost.
Prof. KESSLER: The outcomes are more than 60 percent better. You really get a dramatic, dramatic increase in the quality of the outcomes for the kids in the model program.
TRUDEAU: But with the foster care system already costing the country well over $5 billion a year, it's perhaps more realistic, Kessler says, to target these expanded services at foster children who were particularly vulnerable.
Prof. KESSLER: We're now going in and digging in to the data and saying, is there some subset of kids who it really makes a big difference for, and others that it doesn't?
TRUDEAU: Research psychiatrist Charles Nemeroff at Emory University agrees, and suggests that the target group should be children who have experienced the trauma of parental abuse and inherited a genetic vulnerability to depression or anxiety. This group would be the most likely to suffer lasting health problems as adults and the most likely to benefit from an expanded encompassing foster care program.
For NPR News, I'm Michelle Trudeau. Transcript provided by NPR, Copyright National Public Radio.
