Foster Youth Mental Health

Background

Children and families involved in child welfare must navigate complex systems such as medical care, behavioral health, social services, intellectual and developmental services, education, and the justice system. Mental health challenges are a major concern among children and youth in the foster care system. Up to 80% of children in foster care have significant mental health challenges, compared to approximately 18-22% of the general population (“Mental Health,” 2019). Half of children and youth receiving foster care do not receive any specialty mental health services (SMHS) which could help address trauma and prevent the development of later health conditions (DHCS, 2022).

The American Academy of Pediatrics identified mental and behavioral health as the greatest unmet health need for children and youth in foster care (DHCS, 2022). Factors contributing to the mental and behavioral health of children and youth in foster care includes the history of complex trauma, frequent transitions of placement and situations, complex family relationships, inconsistent and inadequate access to mental health services and the over-prescription of psychotropic medications (DHCS, 2022).

What is Being Done at the State Level?

The Foster Care Model of Care Workgroup met between June 2020 and April 2021 and was charged with providing recommendations on how to better deliver coordinated services for children and youth involved with child welfare. The workgroup, co-led by Department of Health Care Services (DHCS) and the California Department of Social Services (CDSS), recognized Medicaid’s importance in transforming the experience of children receiving foster care, and led to launching several initiatives to transform the Medi-Cal program. This workgroup’s efforts are documented in the DHCS Foster Care Strategies. Strengthening California’s behavioral health system for children receiving foster care is a key priority outlined in the DHCS Foster Care Strategies which is a goal being pursued through multiple vehicles:

• The California Advancing and Innovating Medi-Cal (CalAIM) takes concrete steps to bring meaning to “whole person care,” for the most vulnerable. Children and youth involved in child welfare are a key population of focus in these efforts.
• California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment Demonstration (BH-CONNECT), aims at improving care for Medi-Cal members living with significant behavioral health needs. Children and youth involved in child welfare are a key population of focus in these efforts.