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Foster care is a system in which a underage has been placed into a ward, group home (residential child care community or treatment centre), or private home of a state-certified caregiver, referred to as a "foster parent", or with a family member approved by the state. The placement of a "foster child" is normally arranged through the government or a social service agency. The institution, group home, or foster parent is compensated for expenses unless with a family member. Any adult who has spent time in care can be described as a "care leaver", especially in European countries.
The state, via the family court and child protective services agency, stand in loco parentis to the minor, making all legal decisions while the foster parent is responsible for the day-to-day care of the minor.
Scholars and activists have expressed concerns about the efficacy of foster care services provided by non-government organisations. Specifically, this pertains to poor retention rates of social workers. Poor retention rates are attributed to being overworked in an emotionally draining field that offers minimal monetary compensation. The lack of professionals pursuing a degree in social work coupled with poor retention rates in the field has led to a shortage of social workers and created large caseloads for those who choose to work and stay in the field. The efficacy of caseworker retention also affects the overall ability to care for clients. Low staffing leads to data limitations that infringe on caseworkers' ability to adequately serve clients and their families.
Foster care is correlated with a range of negative outcomes compared to the general population. Children in foster care have a high rate of ill health, particularly psychiatric conditions such as anxiety, depression, and eating disorders. One third of foster children in a US study reported abuse from a foster parent or other adult in the foster home. Nearly half of foster children in the US become homeless when they reach the age of 18, and the poverty rate is three times higher among foster care alumni than in the general population.
In the United States, formal foster care started as a result of the efforts of Charles Loring Brace, who founded the Children's Aid Society. Taking note that nearly 30,000 homeless or neglected children lived in New York City alone,"Foster Care History & Accomplishments." The Children's Aid Society. N.p., n.d. Web. 05 Oct. 2013. Brace took these children off the streets and placed them with families around the United States, particularly Christian families living on farms, in an attempt to improve their quality of life.Nordmark, Oliver. "Orphan Train History.": REVEREND CHARLES LORING BRACE. N.p., 09 Feb. 2010. Web. 19 Oct. 2013. Between 1853 and his death in 1890, Brace transported over 120,000 children by train, giving name to the Orphan Train Movement."Foster Care History & Accomplishments." The Children's Aid Society. N.p., n.d. Web. 05 Oct. 2013 When Brace died in 1890, his sons took over his work of the Children's Aid Society until they retired. The foster care approach pioneered by Brace and the Children's Aid Society became the basis for Concurrent Planning, which was the basis of the federal Adoption and Safe Families Act of 1997.
From August 1999 to August 2019, over 9 million American children were removed from their families and placed in foster homes. As of August 2022 there were 368,530 children nationally located in foster homes. On average, an American child in foster care spends two birthdays in the system.
To create a safe environment for the child long term, children in American foster care have both a case plan and a case plan goal. A case plan is a clear statement about why the child needs protection and the roles and responsibilities of all participants (case worker, foster parents, etc.) in addressing the child's needs and their protection. The case plan goal is the end goal for the child that ends their stay in foster care. 52% of foster children in America have the goal to reunify with their parent(s) or primary caretaker(s).
The Foundling Hospital in Paris is often considered the first state efforts to assist children, founded in 1670 by Saint Vincent de Paul. Mothers had the option of anonymously depositing their infant children at the gate, a practice that was unique across much of Europe. Simple adoption, a form of additional parentage, was first codified into French law through the Napoleonic Code and allowed only adults over fifty without any legitimate children to adopt. The specificity of a lack of legitimate children hoped to reduce interference with inheritance.
Traditionally, there is an emphasis on keeping families in contact as much as possible as parents often keep parental responsibility . The majority of social services for these children relies on both local authorities and Judicial Juvenile Protection, which includes laws outlining protections allowed to the children. Current laws limit families to three children in foster care, but exceptions may be made by the president of the Departmental Council in certain cases.
Italian law considers familial relationships to be pivotal to a child's developments and gives primary relevance to the original family and offer home based support. However, if neglect or abuse is present, the judicial system may intervene to remove involved children. In 2001, all institution based facilities for displaced children were closed and replaced with residential homes in order to provide a more familial feeling.
If no related family member is willing or able to adopt, the next preference is for the child to be adopted by the foster parents or by someone else involved in the child's life (such as a teacher or coach). This is to maintain continuity in the child's life. If neither above option are available, the child may be adopted by someone who is a stranger to the child.
If none of these options are viable, the plan for the minor may be to enter OPPLA (Other Planned Permanent Living Arrangement). This option allows the child to stay in custody of the state and the child can stay placed in a foster home, with a relative or a long-term care facility, such as a residential child care community or, for children with development disabilities, physical disabilities or mental disabilities, a treatment center.
671,000 children were served by the foster care system in the United States in 2015. "After declining more than 20 percent between FY 2006 and FY 2012 to a low of 397,000, the number of children in foster care on the last day of the fiscal year increased to 428,000 in FY 2015, with a slightly higher percent change from 2014 to 2015 (3.3%) than observed from 2013 to 2014 (3.2%)." Since FY 2012, the number of children in foster care at the end of each FY has steadily increased.
The median amount of time a child spent in foster care in the U.S. in 2015 was 13.5 months. That year, 74% of children spent less than two years in foster care, while 13% were in care for three or more years.Id. Of the estimated 427,910 children in foster care on September 30, 2015: 43 percent were White, 24 percent were African-American, 21 percent were Hispanic (of any race), 10 percent were other races or multiracial, and 2 percent were unknown or unable to be determined.
Children may enter foster care voluntarily or involuntarily. Voluntary placement may occur when a biological parent or lawful guardian is unable to care for a child. Involuntary placement occurs when a child is removed from their biological parent or lawful guardian due to the risk or actual occurrence of physical or psychological harm, or if the child has been orphaned. In the US, most children enter foster care due to neglect. If a biological parent or legal guardian is unwilling or unable to care for a child, the child is deemed to be dependent by the Juvenile Court and is placed under the legal care of the child protection agency. The policies regarding foster care as well as the criteria to be met to become a foster parent vary according to legal jurisdiction.
Especially egregious failures of child protective services often serve as a catalyst for increased removal of children from the homes of biological parents. An example is the brutal torture and murder of 17-month-old Peter Connelly, a British toddler who died in London Borough of Haringey, North London after suffering more than 50 severe injuries over an eight-month period, including eight broken ribs and a broken back. Throughout the period of time in which he was being tortured, he was repeatedly seen by Haringey Children's services and NHS health professionals. BBC: A short life of misery and pain Haringey Children's services already failed ten years earlier in the case of Victoria Climbié. In the time since his death, in 2007, cases have reached a record rate in England surpassing 10,000 in the reporting year ending in March 2012.
Although caregivers are put through a through and intense screening before being allowed to take in any children, the foster care system often lacks any safeguards to reevaluate families once they have taken in children. The death of a child in foster care may not be investigated as throughly in order to not further displace other children in the same foster home. Organizations such as Child Abuse Prevention Services, located in Long Island, New York, suggest regular home visits and monitoring to ensure early intervention in the case of any avoidable issues or clearly unsafe conditions.
In a 2023 study, 66% of the 143 youth currently in foster care who had reached out for help were victims of sexual abuse by a foster family member. These youth may encounter different barriers than their peers not in foster care such as concerns for safety, a lack of trust in the foster care system, previous negative reception to disclosure of sexual abuse, or not wanting to move placements.
The race, sex, age, and sibling status all significantly influence potential instability of a placement. Non-white children, males, older children, and those who are only children were the most at risk of an unsafe or unstable foster care placement. In general, older children in foster care are more likely to experience behavioral and mental health issues, which have been correlated with less likely success of adoption and fostering.
In a research study conducted at the University of Minnesota, researchers found that children placed in non-parental homes, such as foster homes, showed significant behavior problems and higher levels of internalizing problems in comparison to children in traditional families, even those who were mistreated by caregivers. A child who has lived in an orphanage or a home for multiple children may have learned survival skills but lack family skills due to a lack of permanency.
In the Casey study of foster children in Oregon and Washington state, they were found to have double the incidence of depression, 20% as compared to 10% and were found to have a higher rate of post-traumatic stress disorder (PTSD) than combat veterans with 25% of those studied having PTSD. Children in foster care have a higher probability of having attention deficit hyperactivity disorder (ADHD), and deficits in executive functioning, anxiety as well as other developmental problems.
These children experience higher degrees of incarceration, poverty, homelessness, and suicide. Studies in the U.S. have suggested that some foster care placements may be more detrimental to children than remaining in a troubled home,
but a more recent study suggested that these findings may have been affected by selection bias, and that foster care has little effect on behavioral problems.
In order to figure out if a child has developed PTSD, there is a PTSD module, the 'anxiety disorder interview'. This is considered a reliable resource for establishing if a child has developed post traumatic stress disorder due to physical, sexual, or mental abuse.
In a study conducted in Oregon and Washington state, the rate of PTSD in adults who were in foster care for one year between the ages of 14 and 18 was found to be higher than that of combat veterans, with 25% of those in the study meeting the diagnostic criteria as compared to 12–13% of Iraq war veterans and 15% of Vietnam war veterans, and a rate of 4% in the general population. The recovery rate for foster home alumni was 28.2% as opposed to 47% in the general population. Understanding the impact of the child's early experience, and the maltreatment that brought the child to child welfare's attention is critical to identifying causation.
"More than half the study participants reported clinical levels of mental illness, compared to less than a quarter of the general population".Casey Family Programs, Harvard Medical School (2005.04.05). "Former Foster Children in Oregon and Washington Suffer Posttraumatic Stress Disorder at Twice the Rate of U.S War Veterans" Jimcaseyyouth.org. Retrieved 2010.03.23.
Three out of 10 of the United States homeless are former foster children.V.Roman, N.P. & Wolfe, N. (1995). Web of failure: The relationship between foster care and homelessness. Washington, DC: National Alliance to End Homelessness. According to the results of the Casey Family Study of Foster Care Alumni, up to 80 percent are doing poorly—with a quarter to a third of former foster children at or below the poverty line, three times the national poverty rate. Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others experienced "unofficial" placements in the homes of family or friends.
Individuals with a history of foster care tend to become homeless at an earlier age than those who were not in foster care. The length of time a person remains homeless is longer in individuals who were in foster care.Web of Failure: The Relationship Between Foster Care and Homelessness, Nan P. Roman, Phyllis Wolfe, National Alliance to End Homelessness
A Sweden study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens, concluded:
Georgia Senator Nancy Schaefer published a report "The Corrupt Business of Child Protective Services" stating:
The study reviewed case records for 659 foster care alumni in Northwest USA, and interviewed 479 of them between September 2000 and January 2002.
Borton describes some of the barriers youth face in her article, Barriers to Post-Secondary Enrollment for Former Foster Youth. A few of those barriers include financial hurdles, navigating through the application process with little to no support, and lack of housing.
Many studies have shown that there are a few factors that have seemingly played a role in the success of foster youth making it to and graduating from a college or university. While having financial resources for foster youth is a huge help, there are other components to look at. Beginning with having support for these youth at the high school level. In order for foster youth to obtain a college degree, they must enroll at a university first.
Out of the different factors that play in increasing college enrollment such as youth participating in extended foster care, reading ability, etc., youth who received assistance or had supportive relationships from adults, were more likely than youth who did not have supportive relationships, to enroll at a university.
At colleges across the nation, there are programs that are specifically put in place to help youth who have aged out of the foster care system and continued into higher education. These programs often help youth financially by giving them supplemental funds and providing support through peer mentor programs or academic counseling services. While funding is an important key in helping get through college, it has not been found as the only crucial component in aiding a youth's success.
A study done by Jay and colleagues provides insight on what youth view as important in helping them thrive on a college campus. The study, which had a sample of 51 foster youth, used Conceptual Mapping to break down the different components of support that may be important for youth to receive on a college campus.
The use of expensive, brand name, patent protected medication was prevalent. In the case of the use of the most expensive medications was noted to be 74%; in the general market only 28% are for brand name SSRI's vs generics. The average out-of-pocket expense per prescription was $34.75 for generics and $90.17 for branded products, a $55.42, difference.
Multidimensional Treatment Foster Care (MTFC), also referred to as Treatment Foster Care Oregon (TFCO) and Treatment Foster Care (TFC) is a community-based intervention that was created in 1983 by Dr. Patricia Chamberlain and her associated colleagues with the initial design intended to offer a replacement for group facilities. MTFC has differing approaches for different age groups. Preschoolers receive “a behavior-management approach and intensively trains, supervises, and supports foster caregivers to provide positive adult support and consistent limit setting” coupled with “coordinated interventions with the child’s biological parents.” MTFC for adolescence consists of individual placement with an intensely trained foster family providing “coordinated interventions in the home, with peers, and in educational settings.” MTFC has been shown to provide better results than group facilities and proves to be more cost effective. Reports show that Multidimensional treatment has effective results in reducing depression, arrest rates, deviant peer affiliations, placement disruption, and pregnancy rates while having positive replication trials. It is one method that attempts to incorporate trauma informed care into its design. However, it is important to mention that MTFC is a voluntary program, and both the youth and their parent(s) must agree to participate. Delinquent youth may face less desirable settings, unlike those in the foster care system, that increases their motivation to participate.
Researchers have faced difficulty when it comes to accurately assessing what makes MTFC and other similar programs that involve multiple levels of intervention successful. It seems to remain in a "black box" scenario where it is unsure what aspect of the treatment plan is actually producing positive effects. Multiple peer-reviewed research articles on foster care programs point out a lack of research effectively evaluating the outcomes of specific foster care programs, calling for more complete assessments to be conducted in order to properly compare outcomes between treatment plans and evaluate what practices in MTFC are most effective. Ethical concerns have also been raised by Therese Åström and other associated researchers when conducting a systematic review on behalf of the Swedish Agency for Health Technology Assessment and Assessment of Social Services in 2018, noting that on the one hand MTFC is evaluated as effective, however, it tends to be implemented in a way that diminishes the child's agency.
The L.Y.G.H.T. program is a peer grief support program that has been shown to increase perceived social support and hope while decreasing perceived problems.
Children may be placed into foster care for a variety of reasons; including, removal from the home by a governmental agency because of maltreatment. Removals must be sanctioned by a legal authority from the Juvenile Court, and regular reviews conducted. In some jurisdictions, adoptive parents are licensed as and technically considered foster parents while the adoption is being finalized. According to the U.S. Department of Health and Human Services Children's Bureau, there were approximately 408,425 children in foster care in 2010. Of those children, twenty-five percent had a goal of adoption. In 2015, 243,060 children exited foster care and twenty-two percent were adopted. Nationwide, there are more than one hundred thousand children in the U.S. foster care system waiting for permanent families.
Adoptive parenting can have an impact on children, recent research has shown that warm adoptive parenting reduces internalizing and externalizing problems of the adoptive children over time.
In a study conducted by Gypen et al. (2017), involving a cross-database analysis of research articles relevant to the outcomes of former foster youth, they found that the educational, mental health, employment, income, stable housing, criminal involvement and substance abuse issues outcomes for youth who have aged out of the foster care system are substantially poorer than their peers. For example, Gypen et al. (2017), indicated that only 45% of former foster youth received a high school diploma, which is 23% lower than the general population. There are also significantly poorer outcomes for children who were formerly in foster care than children from low-income households and racial minorities. African American former foster youth graduate high school at a much lower rate then their white counterparts. The likelihood for secondary degree obtainment, whether a two or four year degree, is significantly decreased compared to the general population in every survey. A 2011 study found that between 8-13% of former foster youth obtained either a 2 or 4 year college degree compared to 34-44% of the general population. Children who are eventually adopted by their placement family show greater outcomes, in terms of finding stable housing, employment, finances and education opportunities, than those who aged out of the foster care system without a permanent placement.
Economically, former foster youth also fall behind their non-foster youth peers. Annually, former foster youth make about $7550 less than their peers. After aging out about 17%-33% are dependent on public assistance (such as food stamps). Of those who age out of the family services system and move in with a partner, 32% don't have any sort of income compared to 3% of the general population.
The mental health of those that age out of foster care also suffers more than the general population. Around 62% of former foster youth will be diagnosed with at least 1 psychiatric illness in their life time with a much higher rate of women getting such a diagnosis. Former foster youth also experience higher levels of substance abuse and alcohol dependency. Between 40% and 49% of former foster youth will abuse alcohol and 3% to 13% will become dependent on it. 39% of former foster youth smoke compared to 20% of youth in general and 16% use cannabis compared to 6.5%. Former foster youth who identify as male are 3 times more likely to abuse substances than females.
It has also been reported that former foster youth have a higher chance of ending up in prostitution, and even fall prey to sex trafficking. Sex trafficking This has also been called the "foster care to prostitution pipeline". From the system to the street a 2012 study in Los Angeles found that 59% of juveniles arrested for prostitution were or had been in foster care, but the generalizability of these findings has been disputed.
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