Mental Health After Foster Care

My memories are a mosaic, a blend of both the bitter and the sweet. The searing pain of a hot iron pressed against my arm was punishment for attempting to protect my foster mother from abuse. Then there are the brighter moments: the moon rocks in the Smithsonian, riding my first horse, my first climb. These fragments coexist, a testament to the depths of my past. Buried beneath the pain lies a stolen childhood, nearly erased by a repressed mind. It wasn’t until I turned 27 that I decided to confront this past and seek therapy.

Therapy isn’t as easy to come across these days as mental health support is in short supply and direly needed for individuals who have experienced any kind of child welfare involvement. Congress has an opportunity to expand this support with the upcoming reauthorization of Title IV-B of the Social Security Act, and should act swiftly to ensure kids who have been in foster care have the opportunity to thrive after such trauma. 

In 2021, the American Academy of Pediatrics declared a national children’s mental health emergency. Shortly after, the Surgeon General issued a crucial advisory addressing this pressing public health crisis for children, adolescents and young adults. For children in foster care, as I was, the situation is even graver: we, too, often lack the traditional support systems enjoyed by many of our peers. 

My brother and I spent four years in the foster care system, our sister separated from us and placed us with another family. We never received an explanation for why we were taken from our parents or why we were later returned to them. We never talked about it afterward as a family. Our family was fractured before it had a chance to coalesce. An abusive, manipulative mother and a passive father who disavowed therapy were the perfect recipe for a traumatized child, only leading to resentment. 

Having grown up as what many would label a “broken” child, I sought my own family. I found it in the army, drawn by the allure of serving a higher purpose and standing by those in need, regardless of their backgrounds. The military, I discovered, embraces you for who you are, so long as you hold up your end. 

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J. Christian Bell

I enlisted at 18, a boy in a man’s world. It was a sink-or-swim scenario, and I immersed myself in the role, forging some of the strongest friendships of my life. These friends became brothers, though we would lose some — either to suicide or down range, often the former. Seeking therapy carried a stigma in the army: higher-ups viewed it as an excuse to evade work, much like avoiding sick-call. If you are going through something, bury it and keep working. The reprieve became drinking — whether to laugh, remember or forget. It was a mere Band-Aid for the healing I needed.

It wasn’t until Jim, one of my oldest friends in the army, died in 2017 that I finally took the step toward therapy. I was injured  in the field and decided to get out. I scheduled an appointment and was fortunate to be assigned to a therapist named Holly. When she asked why I sought her help, I replied, “One of my best friends and spotter was shot in the head a month ago, and I downed a bottle of Jameson last night.”

Beginning from the earliest memories of my time in the foster care system and delving into my tumultuous relationship with my mother, I felt an enormous weight being lifted from my shoulders. Holly and I explored my family dynamics — the early years and the gradual deterioration. She inquired why I hadn’t pursued therapy as a child despite enduring four years in the system, a situation that undoubtedly took a toll. I couldn’t provide a clear answer. Despite the persistent signs and enduring scars, we simply never discussed it.

Opening up about my past allowed me to slowly reclaim lost memories. These memories came like a short series, piecing together a narrative. Conversations with Holly revolved around my emotions — jaundiced, heartbroken, and mostly blithesome when I could remember at all. She guided me in managing these feelings, and as time passed, my life started to take a positive turn. I was no longer stolid in my relationships. I could be open and share my story without shame. Finally, I lowered my guard.

Leaving the army, I faced setbacks. But through therapy, I persevered and emerged stronger. Therapy enabled me to revisit my past and leverage it for my future. It became the bedrock of my life, allowing me to prioritize my own happiness. I let go to grow and found the strength to fulfill my purpose today.

According to the National Conference of State Legislatures, “up to 80% of children in foster care have significant mental health issues, compared to 18-22% of the general population, with 21.5% of foster care alumni suffering from Post-Traumatic Stress Disorder (PTSD).” The reasons behind these statistics are multifaceted — shifting environments, broken families and limited access to mental health care often lead to pernicious wounds. Some may reach out for help, while others suffer silently.

The dire need for accessible mental health care for current and former foster youth cannot be overstated. Neglecting mental health issues can have enduring, insidious consequences. However, it is not the fault of mental health professionals, who grapple with the monumental task of helping individuals rebuild their lives. The system’s inadequacy lies in its failure to support and fund initiatives or programs addressing mental health for those in foster care. Congress should create a funded program for individuals with lived experience to serve as peer mentors and deliver treatment programming and services to families as they navigate the child welfare system and other health and social services programs. 

Last month, the House Committee on Ways and Means’ Work and Welfare Subcommittee held a hearing on modernizing the child welfare system to better protect vulnerable children, an initial step toward reauthorizing Title IV-B of the Social Security Act. This process presents Congress with an opportunity to expand long-overdue mental health support for individuals like me, and I implore legislators to take action and prioritize the mental health of the foster care community — it is an urgent and compelling imperative.

Congress should allocate Title IV-B, Subpart 1 funding for — and require states to develop —  comprehensive systems for children’s mental health and wellbeing services, including prevention, early intervention and treatment. 

These systems should be built through a partnership between pediatricians, mental health professionals, child-serving agencies, child advocates, family groups, housing services, alternative programs that support mental health and wellbeing, and other key organizations to ensure children and youth in care have timely access to non-pharmaceutical mental health services. These state plans and frameworks can provide important information and resources on strategies for reforming the current children’s mental health system and building networks of service provision to ensure that children and youth can access services.

Throughout my tumultuous journey, one element stands out: resilience. It is the keystone that has enabled me to endure and thrive. Without resilience, the weight of our burdens would surely crush us. Some possess it innately, while others find it through therapy, summoning the courage to confront life, or even in a friend’s reassuring words. 

Therapy taught me a valuable lesson — that it’s acceptable not to be okay, as long as you persevere and refuse to give up.

#Mental #Health #Foster #Care
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