Over the past 30 years, about 18,000 children have crossed the threshold at CHRIS Kids, an Atlanta nonprofit that helps Georgia’s mentally ill foster children.
And so the organization’s longtime CEO Kathy Colbenson can rattle off the numbers like machine-gun fire to make her case for why more needs to be done upfront to help emotionally disturbed kids.
She knows, for instance, that 35 percent of children in foster care are getting Medicaid-paid mental health services nationally; that 50 percent of children in foster care ages 6 to 11 are getting mental health services; and 60 percent of those age 12 and over are getting it.
Unfortunately, Colbenson said, that help often comes much too late or not at all.
“The child welfare system should be doing a trauma assessment on every child that enters care,” she said.
Why? It would get kids the help they need on the front end, she said.
Generally, Colbenson said, children who enter foster care have been neglected or physically or sexually abused. Add to that the fact that they are re-traumatized each time they change homes, and it’s not surprising that the children who come to CHRIS Kids have emotional problems.
Even children from stable environments, however, can suffer from mental illness, said Dr. Adolph Casal, practice director of psychiatry at Children’s Healthcare of Atlanta.
“Mental disorders in children are very common,” he said, “and we have some concern some disorders, including anxiety, bipolar disorder and autism, may be increasing in prevalence.”
Casal said he probably sees one kid a week suffering from post-traumatic stress disorder, three to four a week with bipolar disorder and four more with depression.
For all of those, he said, children can be taught coping skills to help manage mental illness in the same way people can be taught to manage a physical illness such as diabetes.
“So there is a lot of hope, because there is a lot we can do,” he said.
Behind the numbers
Child advocacy organizations have studied the issue. According to a Casey Family Programs study, youths who age out of foster care have twice the rate of post-traumatic stress disorder as veterans of the 1991 Gulf War. A 2012 report from Fostering Connections found nearly 30 percent had multiple criminal convictions and more than half had one or more incidences of homelessness.
In all, CHRIS Kids — which has a combination of charitable funding and state and local government contracts — operates eight group homes for kids in foster care who have been diagnosed with a mental illness. Most have had an average of seven prior placements and are on an average of 2.3 medications that treat severe mental health problems.
“It’s bad,” Colbenson said.
While the numbers are important, Colbenson said they tell only half the story. The other half is the flesh-and-blood tales of children, like the little boy who would fly into a rage for no apparent reason, and like Mia Calvo, who was adopted at age 3, rejected again at 13, and on her own at 19.
She came to CHRIS Kids in 2010, shortly after graduating from high school in Florida, where she had moved in hopes of being adopted again.
“It didn’t work out, though,” said Calvo, one of about 44 young adults ages 17 to 24 living at Summit Trail, the agency’s apartment complex.
Because her case originated in Atlanta, the then-17-year-old was forced to move back here to a temporary foster care home.
“I felt like I’d wasted time,” she said. “I thought I was going to be adopted, but I should’ve been preparing myself to be on my own.”
Instead of adoption, Calvo said, she suffered more of the same: verbal, physical and sexual abuse and rejection.
“I was big on bottling up everything because I always felt I needed to be strong,” she said. “And I was, but I was so angry. I didn’t trust anyone.”
She said the anger manifested itself every time she sat down to cut herself.
“By the time I was 16, I was on four or five different medications for depression, bipolar disorder,” she said.
The only good thing that came from her move to Florida, she said, was that her therapist weaned her off the medication.
In Atlanta, she said, her case manager referred her to CHRIS Kids, where she is learning coping and life skills that she will need to be an independent contributing citizen.
“I’ve always been independent, but having the support has made the transition a lot easier,” Calvo said. “They provided a lot of workshops on independent living, budgeting, banking, all the things I needed.”
Each child’s potential
At the end of the day, Colbenson said, CHRIS Kids’ mission is to heal children, strengthen families and build community (the acronym stands for creativity, honor, respect, integrity and safety).
“We are dedicated to unlocking the potential in each child and family so that they can become taxpaying, contributing citizens,” she said.
But to do that, Colbenson said, more needs to be done on the front end to assess children’s mental health so that they get the help they really need.
She said that her agency has been working with the Division of Family and Children Services on developing a policy on trauma assessments. Under current policy, children entering the system are given social and psychological assessments, but neither screens for trauma.
Colbenson said that three decades ago, when she joined CHRIS Kids, the children might suffer from depression or bipolar disorder. Today, they come to her with multiple mental health issues.
“These kids have suffered so much trauma, the older they get, the more it takes to help get them on the right track,” she said.
But she agrees with Casal: There is a great deal of hope.
“I’ve seen a remarkable resilience in our kids,” she said. “We just have to make it a priority to give them the help they need to become contributing citizens. As a taxpayer and a donor, I’d much rather pay money on the front end for a good outcome than pay for prisons.”