Outcomes and challenges for youth aging out of foster care

Foster Care Aging Out

Societal Problem

Annually, about 20,000 of 542,000 youths age out of foster care across the United States (Courtney, 2005). Except for incarcerated youth, foster youth are the only individuals who are involuntarily removed from their families through government intervention. Despite the fact that this separation is mandated to protect these young adults from harm by their caregivers, when they leave their homes, the state becomes responsible for helping them handle their new independence. Due to the youth's already unstable upbringing, this separation often aggravates problems, such as severe health problems, participation in crime, substance abuse and unemployment. Courtney (2005) reported that 37% of foster youth who are 17 to 20 years of age do not have a high school degree; 12% have been homeless one or more times since aging out, and, if they do marry, have a much higher incidence of marital problems or divorce. They often have to rely on public assistance

Unexpectedly, the majority of children are in foster care for a brief period of time. Wulczyn and Hislop (2001) conducted a study of a dozen state foster care systems and found that most of the youths who were being cared outside their homes at the age of 16 had just made this transition in the previous year; only 10% had begun out-of-home circumstances before their teen years. In the U.S., there were only 7% of youth who were "aged out" of care in 2001 (U.S. Department of Human Services, 2003). However, there is a greater chance for such youths age 16 to 18 to be living in group homes or institutions, or those environments that are least like family homes, than the general population of foster care children. These youths have less of an opportunity to form long-term relationships with adults who will provide them the support needed to be independent. The problem is that most of these institutions are staffed by inexperienced employees who do not stay long in their positions and thus cannot act as mentors or provide personal support (Courtney, 2005).

These aged-out youths do not receive the counseling and informational support required in high school for effective decision making and personal care after graduation. In the study "Pathways to College for Former Foster Youth: Toward Understanding Factors that Contribute to Educational Success," Merdinger et al. (2005) interviewed 216 young adults at 11 California State University campuses who aged out of foster care after the age of 18. Merdinger and colleagues (2005) found that even if these young adults were academically successful, they had financial difficulties, potential psychological distress and lack of ability to access health insurance.

Present Solution

Since the Foster Care Independence Act of 1999, or often known as the Chafee Act after the late Senator John Chafee who advocated for its passing, approximately $140 million is set aside for these young adults every year to provide improved mental health services, life skills training, mentoring and employment opportunities, and educational support, as well as housing stipends and Medicaid until the age of 21. Before this act, foster care youths were not eligible for Medicaid unless they were poor mothers. The act also includes state funding training and education vouchers. Each state is different in how it uses its funding. Only two-fifths of eligible foster youth receive independent living services, which also varies greatly among states and counties. The allotted money, which has not increased since it was first made available, is not enough to provide the needed support for all the youths who are aging out. For example, if all the money allotted were used for housing, this would be the equivalent to about $700 per individual. In addition, only a handful of states offer the Medicaid benefit and many of the programs that are being run for these youths are ineffective (Courtney, 2005).

Possible Alternative

One of the problems of the Chafee Act is that it is designed specifically for individuals who age out of foster care, and many youths thus fall through the cracks. As noted above, there are not that many youths who age out in relation to those who have been in foster care during their teen years. This program does not include the many young adults who are discharged to their family of origin before age the age of 18. Many of these youths, who are highly vulnerable, are unable to stay with their biological families and end up trying to find another place to live. The program also does not address those individuals who run away from foster care before turning 18, who are the greatest risks. As an alternative, Courtney (2005) recommends that the policy should be widened to provide services to all youth who spend time in out-of-home care after turning 16. It is not only the youths who leave foster care who will most likely face future problems, but all older youths who have been in care at some time during their childhood and adolescence.

Extent of Problem

Adolescence is a challenging time for every youth, particularly those experiencing greater stress from family-related problems. They are adversely affected by hormonal changes and emotional swings, as well as more stress from added responsibilities. Studies have found that the degree to which young people adapt to this time period is based on how well they have thus far handled their experiences; those not being able to cope well are at greater risk of having behavioral or emotional difficulties (Browne, 2004). Such reports do not bode well for foster care youths, who usually do not show similar coping skills and abilities in comparison to their peers. As a result, social and psychological factors will frequently simultaneously impact these foster care youths.

In general, children and youth who are at foster homes have to deal with more trying circumstances than the usual child at risk, with physical, emotional and sexual abuse often reported (Simms, Dubowitz, & Szilagyi, 2002). Even those who were victims of abuse when they were young will still be affected with such issues as they get older as lowered self-esteem, depression, and being less able to form long-term relationships. Sixty-two percent of adolescents report seductive behavior with peers, promiscuous behavior (63%), substance abuse (54%), threats of suicide, and suicide attempts (52%). It is not unusual for these same problems to extend into adulthood. Troubled behaviors often make youths too difficult for foster parents to handle. These young adults frequently terminate their placement prematurely, which adds even more stress to their lives.

Experiencing a higher rate of personal harm leads to other problems. Courtney et al. (2004) contended that a greater number of foster youth said they experienced more serious injuries than their peers. Perhaps the lifestyle of foster children places them at more risk for serious injury, which could also relate to their higher rate of participating in and instigating violence. Casey Family Programs, Harvard Medical School, the State of Washington Office of Children's Administration Research, and the State of Oregon Department of Human Services (Stephens, 2002) found that rates of post-traumatic stress disorder (PTSD) among alumni of foster care program adults were as much as twice that of American war veterans. Even without a catastrophic event, many children experience troubling feelings and behaviors in the course of placement. For example, a study compared PTSD rates of sexually abused, physically abused, and non-abused foster children (Dubner & Motta, 1999). Over 60% of the sexually abused foster care children were diagnosed as having PTSD. The physically abused group also demonstrated 40% rates of PTSD as did almost one fifth of the non-abused foster children. In terms of gender, a larger number of girls than boys were diagnosed with PTSD. Children aged 8 to 12 exhibited more severe PTSD symptoms than older children. Such youths frequently must deny the faults of their biological parents, such as incompetence or misbehavior, to be able to handle the psychological trauma of rejection. In order to prove their own parents were not as bad as believed, they push the limits of their foster parents' patience or ability to handle negative behavior. Such theories may help explain why youths who have a history of abuse are especially difficult to foster because of their rebelliousness (Massinga & Perry, 1994).

Involvement of Social Workers

Social workers have long been part of the supportive staff for the foster care program and aging out process. Depending on the state and county, they play different roles in the schools and social service agencies to help these youth. Many times, they work in collaborative programs with other agencies, the city and school systems. The work that is done by the social workers, however, often depends on the money available for this special needs population of youth. Many times, as noted above, the foster care youths are asked to participate in the same programs as their peers who have been living with their biological families but may be facing similar challenges. Although these foster care youth receive support, it is not specifically aimed at their individual needs. For example, foster care youths have to deal with feelings of abandonment or have perhaps suffered extensive abuse in different living situations. Social workers and others employed in social service agencies and public programs that collaborate to ease the youths' transition from foster care to independent living have an especially difficult mandate relative to the continuum of services. They have to launch these young adults into their future adult life against all odds, and must also help them cope with unresolved emotional injuries and accumulated experiences of loss. Many times, programs are not in place that provide these unique provisions, and social workers must make do with the services in place for a general population.

Future Steps

It is necessary that additional programs be put into place to help this unique population. Chipungu and Bent-Goodley (2004) recommend what they call the "One-Stop Solution: Engaging Youth Through Concrete Services" to help foster care youth make a successful transition from foster care to adulthood and independence. Chipungu and Bent-Goodley recognize that young people who have been involved with foster care must have the necessary preparation, support and guidance before, during and after discharge from the system. Specifically, they require customized services in career counseling and job development, health and mental health care, housing support, educational guidance, legal advocacy, mentoring and practical life skills training, which are particularly designed for young adults, ages 14-21, at various levels of their individual development and maturity. In addition, services for these youth need to be co-located in one all-purpose center and open outside of the usual office hours to accommodate work and school schedules.

This "one-stop program" would provide a united group of highly effective, customized services at one central location (Chipungu & Bent-Goodley,2004). Specifically, it would offer the following: (1) Career services center that offers ongoing job counseling and support, access to any initiated employment readiness programs, available internships and apprenticeships, regularly updated listing of job openings, and assistance with resumes, interviews and professional etiquette; (2) Housing assistance with rental listing, applications and brokers, in addition to Section 8 and ACS housing subsidy applications; (3) Financial management training with hands-on coursework about budgeting, financial services, bill-paying, borrowing and managing debt, and credit; (4) Educational consulting, such as guidance counseling, pre-college examination preparation, counseling and assistance for college-bound high school students and college students, and critical information required to locate scholarship money and financial aid; (5) Health services that include screening for health insurance and an overview of community-based healthcare support; (6) Civil legal services, such as public assistance advocacy, Supplemental Security Income and survivor's benefits, Medicaid, housing and immigration; (7) Hard & soft life skills instruction consisting of an understanding of available supportive technology, finding and keeping employment, becoming aware of community-based resources, and eating nutritional meals and being able to handle stress; (8) Mentoring services by foster care graduates, job mentors, independent living mentors, and guest mentors. (9) Identification portfolio assistance to make sure that all the young adults leave foster care with a birth certificate, Social Security Number and state-issued identification card.; (10) Counseling and support groups that help students with concerns such as independent living, grief and trauma, relationships, substance use, sexuality and anger management; (11) Parenting and family planning program for both young parents and those who hope to raise children in their future; (12) Leadership training that consists of a youth advisory board to make sure that appropriate, effective and high-quality programming is followed including youth speak-outs, civics instruction, and public service opportunities; (13) Access to city-wide resources and (14) Recreational and cultural activities including access to organized sports and creative arts programs.

(Chipungu & Bent-Goodley, 2004) argue that the U.S. has not provided the necessary services to those youths who are aging out of foster care. When foster care youths are younger, their safety and emotional well-being is of major concern when being removed from their caregivers. However, when they get older and need support again, it is not available. Despite research findings that show how vulnerable they are when discharged from care, these young adults are continually leaving the child welfare system and entering into lives of uncertainty, emotional pain, destitution and marginalization (Chipungu & Bent-Goodley, 2004). Following a program such as this proposed One-Stop model offers a cost-effective approach to support foster youths as they make the move to be on their own and become adults. Such programs emphasize prevention and involve young people with the practical support services and interventions required, in addition to giving them the security of realizing they always have someone to whom to turn when they are in need of assistance and support as they travel the difficult road of independent living.

A program such as One-Step would respond to the needs of those especially expressed by this target population. For example, Casey Family Programs (2003) asked young adults who were alumni of foster care, to describe factors critical to success when leaving this system. They emphasized the need for transition services as a buffer, the necessity of financial support for college for those individuals who would like it, and the availability of ongoing services to support youths over 18 years of age in an effective manner. These alumni reported the need to receive information about available financial assistance, for example, cash payments and training on money management and money skills development. Those surveyed also stressed that foster care participants are not involved enough in the process of determining the required support tools when they are in foster care and after discharge. In a study of foster children with a median age of 12, 40% reported they were unclear about why they were in foster care. In another study, only 319 of 1,100 youths in foster care, or 29%, reported they discussed their situation with their caseworkers after leaving their families and living elsewhere.

In a study in New York City, Freundlich, Avery, and Padgett (2007), analyzed the degree to which young adults feel prepared to leave foster care and the opportunities they receive to participate in planning and decision making about those areas that personally affect their futures. The research included interviews with professionals and young adults who exited foster care after their placement in congregate care settings. Both the professionals and foster care adults responding noted concerns about the quality of independent living preparation. They said that young people were not always ready to live independently and were concerned about the staff's failure to begin preparing them enough in advance of their discharge dates. Young adults also reported limited opportunities to participate in the planning and decision-making processes that were currently affecting them and would continue to do the same in the future.

Freundlich, Avery, and Padgett (2007) concluded that the variety and different levels of quality of services provided for those youths in foster care certainly indicate that the outcomes related to preparing youths in congregate care situations for discharge from foster care and entrance into adulthood must be monitored. Programs must focus on the youths' connections with family members and others in the community, in addition to employment preparation and educational achievement. It is very important to completely involve young adults in the development and decision-making processes regarding issues they face while living in congregate care and after being discharged from foster care. Programs that are meant for the preparation of youths for adulthood, especially when structured in a way to offer skills for interdependent living, need to consist of leadership opportunities for participants that place a stress on self-advocacy. These programs should also consist of mentoring programs for youths to support their active participation in case reviews and their court proceedings and fully engage them in identifying family members and other support people who can help them in the long-term when they leave foster care.

References Cited

Browne, D. (2002) Health care needs of children in the foster care system. Journal of Youth and Adolescence. 31(1), 57-66.

Casey Family Programs. (2003) the Northwest Foster Care Alumni Study Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study. Retrieved March 10, 2010 from http://www.casey.org/Resources/Publications/NorthwestAlumniStudy.htm

Child Welfare League of America (Nd) Programs and Resources for Youth Aging Out of Foster Care. Retrieved March 2, 2010 from http://www.cwla.org/programs/fostercare/agingoutresources.htm

Chipungu, S.S. & Bent-Goodley, T. (2004) Meeting the Challenges of Contemporary Foster Care. The Future of Children 14(1). 75-94

Courtney, M. (2005) Youth aging out of foster care. Policy Report published by the MacArthur Foundation Research Network on Transitions to Adulthood and Public Policy, 19. Chicago: Chicago Press.

Dubner, a. & Motta, R. (1999). Sexually and physically abused foster care children and post-traumatic stress disorder. Journal of Counseling and Clinical Psychology, 67(3), 367-373.

Freundlich, M., Avery, R.J., & Padgett, D.K. (2007). Preparation of youth in congregate care for independent living. Child and Family Social Work, 12, 64-72.

Massinga, R., & Perry, K. (1994). The Casey Family Program: Factors in effective management of a long-term foster care organization. In J. Blacker (Ed.), When there is no place like home: Options for children living apart from their natural families (pp. 163-180). Baltimore: Brookes.

Massinga, R., & Pecora, P.J. (2004). Providing better opportunities for older children in the child welfare system. Future of Children, Families, and Foster Care, 14, 175-189.

Merdinger, J., Hines, a.M., Lemon, K., & Wyatt, P. (2005). Pathways to college for former foster youth: toward understanding factors that contribute to educational success. Child Welfare, 84 (6), 867-896.

Simms, MD., Dubowitz, H., & Szilagyi, MA. (2006) Coping Alone. The Prospects of adolescent victims of child abuse placed in foster homes. Pediatrics. 117(5), 448-453.

Stephens, a. (2002) "What is Trauma?" Casey Family Services. Web site retrieved March 3, 2010. http://www.aecf.org/upload/PublicationFiles/what%20is%20trauma.pdf

U.S. Dept. Of Health and Human Services (2003), the AFCARS Report: Preliminary FY 2001 Estimates as of March 2003. Washington, DC: DHHSACF.

Wulczyn, F, & Hislop, K. (2001) Children in Substitute Care at Age 16: Selected Findings from Multistate Data Archive. Chicago: Chapin Hall Center for Children at the University of Chicago.