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April 2012Vol. 13, No. 3Mental Health Care and Placement Change

The correlation between frequent foster care placement changes and the use of crisis mental health services is explored in a recent journal article. Researchers Kya Fawley-King and Lonnie Snowden examined the use of these services, including psychiatric hospitalization, by more than 19,000 children during their first 90 days of foster care between October 1998 and March 2011. The study sought to confirm the results of earlier research that suggested that the need for mental health care services leads to changes in placement, and frequent changes in placement may create the need for mental health treatment. The research is important because these negative outcomes are highly prevalent among children in foster care.

Results confirmed the bidirectional relationship. Children who use crisis mental health services tend to be older and are more likely to have received mental health treatment prior to entering foster care. Also, preexisting mental health issues may be triggered by placement changes. Children who experience a  placement change are more likely to need treatment, including psychiatric hospitalization, than children who remain with current caregivers.

The authors suggest that a factor in placement instability for these children is that many foster parents are unprepared to deal with the children's behavior and could benefit from training on coping with foster children with mental health challenges. Other strategies to promote placement stability include improved outpatient mental health care services, including services that are designed specifically for children in foster care such as the Fostering Individualized Assistance Program or New York City's the Foster Care Initiative.

The article concludes with suggestions for future research. "Relationship Between Placement Change During Foster Care and Utilization of Emergency Mental Health Services" was published in the November 2011 issue of Children and Youth Services Review, 34, 348–353, and is available on the ScienceDirect website: