Half of all foster kids in Norway have mental disorders
Researchers think Norwegian legislation and the organization of the country’s child welfare services might be part of the problem.
The first study of mental disorders among children in foster homes paints a distressing picture.
Severe lack of care, being shuffled from one home to another, physical and psychological abuse in their original families – these are factors that increase the risk of foster children being encumbered with mental health problems.
As many as 51 percent of such children aged 6-12 fit the criteria for one or more mental illness diagnoses. This is ten times the rate for Norwegian school children overall.
“It’s surprising that the prevalence is so high,” says research fellow and psychologist Stine Lehmann of Uni Health, the Regional Centre of Child and Youth Mental Health and Child Care in Bergen.
“We shouldn’t forget that things go pretty well for about half of these children. But it's alarming that such a high proportion have problems,” she says.
The children’s diagnoses were distributed rather evenly among the categories of behavioural problems, reactive attachment disorders, ADHD, anxiety and depression. No gender differences were found with regard to these problems.
Lehmann led the study along with researchers at the University of Bergen and the University of Oslo.
Emphasis on protection
“Norwegian child welfare is family oriented and the law requires child welfare officials to try to intervene and correct the situation prior to placing children in foster homes,” Lehmann says. “In view of the harmful consequences that we have documented of insufficient care and of child abuse, we should balance our approach so that even more weight is put on protecting the child."
She also described other results that show that children placed in foster homes in Norway spend three years in their biological home on average after interventional measures were initiated, prior to being moved into foster homes.
“In many cases the initiatives from child welfare to help are successful, but an average of three years is a long time for children who suffer more harm during that time,” she said.
“Help initiatives should concentrate more on whether the child is sufficiently protected,” Lehmann said.
Over half with multiple diagnoses
The results also show that many of the foster children grapple with several difficulties simultaneously, with regard to behaviour as well as emotions.
“Over half of the children with a mental disorder have multiple disorders,” says Lehmann.
She thinks the findings demonstrate a huge need for a more thorough evaluation of the individual child’s mental health when it is taken out of biological parents’ home and placed in a foster home.
Major risk factors are acute lack of care and being subjected to violence.
“Mental and physical abuse prior to placement entails the biggest risk of mental disorders. This kind of trauma can result in behavioural disorders and ADHD,” explains Lehmann.
Young and vulnerable
A 2011 state-backed study of user satisfaction among foster children in Norway shows that many are content with their living situation, even if they have mental problems.
Most of the kids feel safe and at home where they live with foster parents and experience mutual trust. But these studies have not truly focused on the children’s mental health.
The new study involved 279 children in foster homes, both municipal and state organied, after the child welfare service had taken custody. The sizeable number of participants was just one factor which distinguished this study from previous investigations.
“This is one of few studies that is thorough enough to reveal anything about diagnoses, rather than just the children’s symptoms,” says Lehmann.
The children in the study lived in five of Norway’s 19 counties, had an average age of nine and had spent at least five months in foster homes. Four out of ten were placed in foster homes prior to the age of two.
Information about the children's mental health was gathered from foster parents as well as teachers. The researchers explained that the children were not personally interviewed because of their tender ages and vulnerable situations.
The study highlights the importance of good analyses and investigations of foster children in Norway, because child welfare services are organized differently in different countries.
“A study from Great Britain reported a high degree of behavioural disorders, whereas in Norway we see more anxiety and depression,” Lehmann said.
“If we base our development of initiatives on international studies we may easily make the wrong moves. Each individual country’s foster children may have distinct differences,” she said .
Translated by: Glenn Ostling
- Stine Lehmann, Odd E Havik, Toril Havik and Einar R Heiervang. Mental disorders in foster children: a study of prevalence, comorbidity and risk factors. Child and Adolescent Psychiatry and Mental Health 2013, 7:39 doi:10.1186/1753-2000-7-39