Children in foster care are especially vulnerable to mental health challenges. Research indicates they are three to four times more likely to attempt or complete suicide than their peers in the general population. For LGBTQ+ foster youth, the risks are even higher. These children often navigate their identities in environments that may not be supportive or safe, amplifying feelings of hopelessness and despair. Despite these heightened risks, the foster care system has historically lacked comprehensive, proactive mental health screening and intervention programs tailored to these needs.
The absence of consistent mental health screening upon entry into foster care means many children slip through the cracks. Imagine entering a new environment with no assessment of your emotional well-being,no questions asked about thoughts of self-harm or feelings of hopelessness. That’s often the reality for foster youth. Without standardized screening protocols, caseworkers and caregivers remain unaware of the mental health crises simmering beneath the surface. In turn, these young people are left without the support they urgently need, increasing their risk of suicidal behavior.
Now, consider what happens when federal funding, which supports vital mental health programs, faces drastic cuts. The Trump administration’s decision to shut down a dedicated LGBTQ+ youth suicide hotline exemplifies how fragile these vital services have become. When funding diminishes, so does access,especially for those who need help the most. Children in foster care often rely heavily on Medicaid-funded mental health services, which are already stretched thin. Proposed shifts in Medicaid policies threaten to reduce access to mental health care across many states, further endangering these children.
The impact of reduced funding extends beyond individual support. It hampers systemic efforts to implement universal risk assessments for children entering foster care. Such assessments are critical,they serve as the first line of defense, identifying children at risk of suicide early and often, throughout their time in the system. When these screenings are missing, or when mental health services are inconsistent or unavailable, we risk losing children who are silently battling despair.
Some states have taken steps to address these gaps,Kansas, for example, increased salaries for social workers and reduced caseloads after legal action highlighted systemic deficiencies. Yet, these efforts are patchwork solutions in a patchwork system. True change requires nationwide standards, ongoing training for caseworkers, and the integration of mental health screening tools into routine care. Without consistent implementation, we are leaving too many children vulnerable to preventable tragedies.
The work of dedicated professionals like child psychologists and social workers is crucial. They are calling for universal suicide risk assessments and better training for those who are on the frontlines of child welfare. In Michigan, efforts are underway to update training programs for child welfare workers to include suicide prevention, ensuring that those who care for foster children are equipped to recognize warning signs and intervene appropriately.
But the challenge is bigger than individual programs. The systemic issues,funding cuts, lack of federal standards, and inconsistent services,must be addressed comprehensively. Every child in foster care deserves to be seen, heard, and protected from the risk of suicide. Their lives are precious, and prevention begins with proactive screening, accessible mental health services, and a system that prioritizes their well-being.
As we navigate these complex issues, it’s essential to keep the focus on the children. Ensuring they receive mental health support is not just a policy issue; it’s a moral imperative. We need sustained investment in mental health infrastructure within the foster care system,funding that recognizes these young lives as deserving of care, compassion, and hope.
Learn More: The Foster Care System Has a Suicide Problem. Federal Cuts Threaten To Slow Fixes.
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If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”
Elliott Hinkle experienced depression and suicidal thoughts even before entering the foster care system in Casper, Wyoming, at age 15.
At the time, Hinkle, who is transgender, struggled with their sexual identity and gender issues, and their difficulties continued in foster care. They felt like they had no one to confide in , not their foster parents, not church leaders, not their caseworker.
“To my knowledge, I don’t remember ever taking a suicide screening,” Hinkle said. “No one ever said: ‘Are you having thoughts of taking your life? Do you feel hopeless?’”
With their psychological and behavioral health needs left unaddressed, Hinkle’s depression and suicidal thoughts worsened.
“Do I stay in the closet and feel terrible and want to end my life?” Hinkle said. “Or do I come out and lose all my supports, which also feels dangerous?”
Children in foster care are significantly more likely to have mental health issues, researchers say. They attempt or complete suicide at rates three to four times that of youths in the general population, according to several studies.
LGBTQ+ people in foster care, like Hinkle, are at an even higher risk of having suicidal thoughts.
Yet despite the concentration of young people at risk of serious mental illness and suicide, proactive efforts to screen foster children and get them the treatment they need have been widely absent from the system. And now, efforts underway to provide widespread screening, diagnosis, and treatment are threatened by sweeping funding cuts the Trump administration is using to reshape health care programs nationwide.
In June, federal officials announced they would shut down a suicide hotline serving LGBTQ+ youths as part of those cuts.
Children in foster care use a disproportionate amount of Medicaid-funded mental health services. Meanwhile, President Donald Trump’s massive budget package, passed this month by Congress, contains substantial shifts in Medicaid funding and policies that are projected to dramatically reduce services in many states.
“I think anybody who cares about kids’ well-being and mental health is concerned about the possibility of reduced Medicaid funding,” said Cynthia Ewell Foster, a child psychologist and clinical associate professor in the University of Michigan psychiatry department. “The most vulnerable children, including those in foster care, are already having trouble getting the services they need.”
A lack of federal standards and other system-level issues create barriers to psychological and behavioral care in the child welfare system, said Colleen Katz, a professor at Hunter College’s Silberman School of Social Work in New York.