Report: Behavioral Issues, and Treatments, Plummet As Foster Youth Age Out

The number of teens in foster care who report behavioral problems and treatment for them plummets as they age out of care, according to a recent study based on a survey of California foster youth.

Nearly half (48 percent) of 611 youth surveyed reported behavioral health problems at age 17, with 27 percent reporting use of psychotropic medication and 54 percent receiving some counseling, according to the report by Chapin Hall.

By age 19, only 27 percent reported behavioral problems, which for the purposes of this survey included mental health and substance abuse challenges. Just 15 percent were taking psychotropics, and 27 percent were receiving counseling.

The shifts in medication and counseling “are consistent with existing studies that have examined trends in service usage, showing that foster youth with behavioral health issues transitioning to adulthood are less likely to receive ongoing treatment as they reach adulthood,” the study said.

Study authors suggest the steep drop in medication and therapy use could be attributable to personal preference against relying on them. But it could also be caused in some part by “structural barriers” as some portion of 19-year-olds would have emancipated from foster care, and might now lack the supports that ensure access to mental health services.

“Compared to the living arrangements at age 17, on average, the places youths lived at age 19 had less supervision and support by professionals or adults who are in a position to encourage youths to take advantage of needed behavioral health services and help them navigate the steps needed to receive medication,” the study said.

There were no statistically significant differences in the study along racial lines, and only a couple based on gender. Females were more likely than males at age 17 to note a behavioral health issue (53 percent vs. 41 percent), and to receive mental health counseling (59 percent vs. 45 percent). By 19, the statistical significance of the difference did not exist.

LGBT youth however, showed significant differences at both ages. Two-thirds reported a behavioral health issue at 66 percent, which dropped to 40 percent by 19. LBGT youth in the survey were also medicated with psychotropics more often (37 percent at age 17, 22 percent at age 19), and more received counseling (67 percent at 17, 35 percent at 19).

Among the youth medicated with psychotropics, 84 percent received concurrent counseling at age 17, and that only dropped to 80 percent by 19. It is a surprising and encouraging finding, given recent concern about the overall number of people who treat mental health conditions solely with medication.

The issue brief is the latest release from the California Youth Transitions to Adulthood (CalYOUTH) Study, a five-year research project looking at the outcomes of older foster youth in California as they transition to adulthood in extended foster care (ages 18 to 21).

In the past two years, the California legislature has passed three bills aimed at the appropriate prescription of powerful psychoactive medications. In 2014, reporter Karen de Sá wrote an award-winning series about the impact of powerful psychiatric drugs, which are prescribed to foster children in California at a rate three and a half times that of the overall population.

The passage of these bills followed a state audit that reported that child welfare agencies in the state failed to perform appropriate oversight of medication prescriptions to children in foster care.

Sunshine Decosta is a graduate of California State University, Northridge, and an intern with The Imprint.

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