As a former foster youth, I applaud the U.S. Surgeon General’s recent advisory on Protecting Youth Mental Health that highlighted ways to support children involved with the child welfare system. This advisory comes a few months after the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association declared a National State of Emergency in children’s mental health.
Children in foster care, who came into this pandemic with all the grief and loss associated with that experience, are among those most impacted as they fear for the loss of their new families or caregivers and experience isolation more deeply than their peers. In this country, we were failing to meet their mental health needs long before the pandemic.
My hope is that this advisory and emergency declaration are enough to get the attention of people in power to implement solutions that are right in front of us to ensure mental health protections for youth in foster care. Innovative trainings such as Training for Adoption Competency and the National Adoption Competency Mental Health Training Initiative exist to build a workforce that can address the needs of children and youth like me.
Even before the COVID-19 pandemic set in, I struggled to access the support I needed because Medicaid mental health coverage in New Jersey is extremely inadequate. The only options that were available to me pre-pandemic were therapy in a large group setting or hard-to-access one-on-one sessions that would have forced me to take time off from school or work.
The COVID-19 lockdown also posed circumstances that triggered my complex post-traumatic stress disorder as it was the first time that my feelings were not being suppressed by school, work and community activities. I had no idea nor was I trained to unpack the years of trauma that I had suppressed. Through talking to other foster youth, reading the Think of Us Aged Out Report, and taking part in research on how COVID-19 was impacting my university community, I realized that I was not alone, that many people (especially foster youth) were suffering with their mental health struggles in silence.
Ambiguous losses occur in the child welfare system as a result of children being physically separated and removed from their biological families and siblings, moving from placement to placement and school to school, with court dates that remind children of failed reunification or everyday reminders that they may never possess a “real family.” These losses are seen as a natural part of foster care rather than something that the system should address, even though this trauma is system-induced. The fact that we currently do not have common vocabulary for these issues further disenfranchises these children experiencing trauma, as the system ignores it and ultimately perpetuates it because healing cannot occur without this trauma being addressed.
The Surgeon General’s advisory highlighted that we must do further research to “advance dissemination and implementation science to scale up and improve compliance with evidence-based mental health practices in systems that serve children, youth, and their families.” Training for Adoption Competency is one such evidence-based model. Combined with the curriculums developed as part of the federal government’s National Adoption Competency Mental Health Training Initiative for state child welfare professionals, we have tools to disseminate. As a person who has been there, I hope that the advisory and emergency declaration is the call to action we need to ensure child welfare and mental health professionals are getting the training they need to better serve people like me.