Here is an excellent editorial on this subject, sent by my friend Lynn at First Five of Marin. In a nutshell, this piece brings our attention to the mental health needs of foster children and the ways our systems have failed to meet them.  Specifically, it says, psychiatric assessments and care are not provided soon enough, if at all. There is an over-reliance on medication alone to solve mental health problems. There is work to be done to improve access to services and collaboration among the systems that serve foster children.

So true.

The piece also cites advances in care for foster children. Prop 63 was passed and will enable California to improve its mental health system. California has participated in a nationwide movement to reform and redesign child welfare systems.

All the suggestions in the editorial piece are good ones, but I'd take it one further. Just like all mental health problems can't be solved by medication, I would say that not all mental health needs can be met by mental health professionals. Or mental health systems. Mental health systems do an untold amount of good in this world, helping to relieve tremendous suffering and strengthening the safety of communities. Having said that, it's also important to note that children raised by systems are raised as clients. They are "cases" to the adults whose livelihood involves relating to them. A well-funded and well-run children's welfare system will be rich with services, but even the finest of "services" cannot make up for the lack of a LIFE. Lives are lived in families, friendships and communities, not someone else's office. Lifelong mental health is sustained, in large part, by relationships that are reciprocal, where we give as well as receive and where the other person relies on us to be true to them.

Everyone needs at least one person who loves us unconditionally. My last post addressed the issues of "transitional age youth" — kids coming out of the system in need of lifelong relationships and living skills. Younger foster children also have needs that go beyond treatment for post-traumatic stress, abandonment and abuse. Consider a child — any child's need for attachment, friendship, blood connection and stability. The older the child, the more important it may be to keep him/her in contact with important friends and relatives from his/her birth family. These are people to whom the child has become attached and, while contact may need to be limited with certain people, completely severing connections — even with pretty messed up birth parents — is proving to be problematic for many children. Child welfare researchers are finding that connections with birth siblings are often key connections to maintain.

As policy makers, administrators and helping professionals, we have an obligation to these children (and their loved ones) to go beyond the delivery of psychiatric services. This might sound odd, but what I want to say is that the professionals that populate the life of a foster child need to learn how to think less like a professional and more like a really good grandma. Children need good mental health care. They also need a neighborhood, friends, adults that are with them for keeps, and a connection to their biological heritage.