The Abysmal State of Foster Care Alumni

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Foster children are so handicapped by their experiences in the child welfare system that four out of five fail to thrive as adults, and more than half experience clinical mental health problems, according to a comprehensive study of foster care alumni.

“Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study,” finds that significant numbers of foster care alumni lack the hallmarks of a successful adulthood, such as high school diplomas and jobs with adequate pay. (See Report Roundup for June 2005 for a related study.)

“The findings underscore the urgent need to improve the support provided to children and youth in foster care,” Ruth Massinga, CEO of Casey Family Programs, said in a statement when the study was released. Casey led the collaborative research with Harvard Medical School, the University of Michigan, the Washington Office of Children’s Administration Research, the University of Washington and the Oregon Department of Human Services.

In an innovative effort to identify critical areas needing improvement, the researchers developed a complex simulation model that allowed them to measure hypothetical outcomes for youth when positive foster care experiences were optimized and negative experiences were minimized.

Each year, 20,000 youth between ages18 and 21 leave foster care; various studies have found that most are woefully unprepared for adulthood.

Adult Functioning

The researchers reviewed the records of 659 foster care alumni whose cases were managed by Casey or the state child welfare agencies in Washington and Oregon. They also interviewed 479 of those alumni.

The study focused on measuring key foster care experiences that could be linked to better functioning in adulthood, including placement history; educational support services; access to mental health services; preparation for leaving care, including employment training and gathering resources; and positive relationships with at least one member of the foster family and the agency staff.

Most alumni reported unstable living conditions while in foster care. The average number of foster care placements was more than six; nearly one-third of alumni had eight or more. Nearly 12 percent had two or more reunification failures with their birth parents, and more than 21 percent had run away from a placement at least twice. Nearly one-third of the alumni had 10 or more school changes from elementary school through high school.

While nearly nine in 10 had access to supplemental education services, less than half actually used those services. Most received mental health, substance abuse or group therapeutic services.

Fifty-six percent said they felt somewhat or very prepared for independent living when they left care, but a close look reveals that they had few resources to do so. Only one-third had a driver’s license, fewer than four in 10 had at least $250 in cash, and less than one-quarter had dishes and utensils with which to set up housekeeping.

Three-quarters of the alumni reported participating in “fun activities” with their foster families. Forty-six percent had an adult mentor. More than eight in 10 reported that they “felt loved while in care,” although the study does not indicate by whom.

Richard Wexler, executive director of the National Coalition for Child Protection Reform, points out that one-third of the alumni case files contained reports of maltreatment by a foster parent or another adult in the foster home – a finding relegated to one paragraph in the 30-page study and omitted from the press release.

Predicting Outcomes

To identify the most critical areas for improvement, the researchers used a form of regression analysis.

First, they created a score for each alumnus in three “domains”: mental health, education and employment/finances. Within each domain several positive outcomes were listed, such as “did not experience major depression during the last 12 months” and “completed high school via high school diploma.” Domain scores were based on the number of positive outcomes an alumnus experienced within each domain, ranging from zero (no positive outcomes) to five (all positive outcomes).

Second, researchers plugged each person’s domain scores into a regression equation and calculated a “pre-optimized” outcome score for each domain, based on the alumnus’s actual foster care experiences, such as time in care and number of foster placements.

Then each person’s outcome variables were hypothetically “optimized” – scored again as if the alumnus had experienced optimal foster care conditions as defined by the researchers, such as less than 31û2 years in care and fewer than three placements.

Finally, the optimized scores were placed into a second equation that allowed researchers to estimate the outcome scores that could be achieved in each of the three domains by optimizing each of the foster care experiences.

Thus, the researchers came up with a way to answer the question: How much better off would these alumni be now if they had been provided with the best foster care possible?

Making Improvements

Optimizing the educational experiences of foster youth produced a 13 percent reduction in negative mental health outcomes. Improving the resources available to youth upon leaving care reduced negative education outcomes by nearly 15 percent and negative employment/finance outcomes by 12 percent.

The biggest impact in individual domains came from reducing the number of foster care placements to three or less. That reduced negative mental health outcomes by 22 percent and negative education outcomes by 18 percent.

Yet even the most “optimized” foster care yielded disappointing results. The researchers found that when all foster care experiences were optimized simultaneously, there was a 22.2 percent reduction in estimated undesirable outcomes in mental health, education and economics, combined.

“The key lesson from the study,” Wexler concludes, “is that the only way to fix foster care is to have less of it. … The study shows that if you made foster care almost perfect, you would reduce the rotten outcomes by only 22.2 percent. That’s not good enough.”

Eliminating the need for foster care is a long-term mission for Casey Family Programs, Massinga said in an e-mail, but the study “provides new statistical evidence of the value of implementing certain key program reforms that will improve child welfare systems around the nation now.”

The study is available free online at

Alumni Struggles

Among those surveyed:

22% – Experienced homelessness after foster care.
25% – Experienced post-traumatic stress disorder after foster care.
33% – Earn below the federal poverty line.
33% – Don’t have health insurance.
15% – Don’t have a high school diploma.
84% – Don’t have a vocational degree.
98% – Don’t have a bachelor’s degree.