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A recent story out of Florida is among the more glaring examples of our failure to meet the mental health needs of America’s most vulnerable children—those in foster care. A sixteen-year-old girl who had been sexually molested by her father and then her grandfather was denied mental health services and, instead, referred for treatment of substance abuse.

It’s hardly surprising that a teen with a history of untreated trauma resulting from sexual abuse would turn to street drugs for comfort. Tragically, in this case, there were no facilities for residential drug treatment, while (costly) beds were available for in-patient mental health services. So, with both her Post Traumatic Stress Disorder and drug use untreated the girl was returned to foster care. She promptly ran away as she had before. She is most likely doomed to prostitution, life on the streets, and an early death.

Post Traumatic Stress Disorder (PTSD) is rampant among children in foster care; the incidence is higher among this population than among veterans returning from active duty in Iraq and Afghanistan. Untreated, PTSD can have serious, sometimes irreversible emotional and physical consequences. Children who are so anxious that they can’t stay at their desks have “behavior problems” and are often punished rather than helped. Those who experience the normal jostling in the school hallways as physical aggression and lash out may be seen as perpetrators rather than victims and sent to “anger management.”

Photo courtesy of Pink Sherbet Photography

where-angels-cry_blogChildren whose nervous systems are so frazzled that they cannot control their feelings or actions disrupt family routines. They don’t sleep well, often keeping other children and parents awake night after night. They shout instead of talking. They see danger around every corner and they can’t soothe themselves or easily accept comfort from others. Because they live at a feverish pitch—acting without the capacity to reflect—they are in danger of inadvertently harming themselves or others.

As a result, foster parents ask to have them removed—whether out of anger, despair, fear or a combination of overwhelming feelings. In the next family, the behavior escalates and the placement ends even more quickly. And so goes the life of a foster child whose original trauma was sexual abuse at the hands of an adult who was supposed to be caring for her.

Untreated PTSD affects not only the child, but also those around her. The children in the classroom who don’t know how to predict or protect themselves from the explosion have reason to be fearful. The other children in the foster families who have their routines and sleep disrupted find themselves more anxious and less able to function well in school. The foster parents who give up and have a child sent away are left to struggle with guilt and self-recrimination.

PTSD is not something that children outgrow. They don’t just “snap out of it.” These children need care from professionals trained to address their emotional needs. When we take children into the child welfare system, we make an unspoken promise to care for them. Failure should not be an option.

By Toni Heineman