There are approximately half a million children and adolescents in foster care in the U.S. and it is estimated that between 42 and 60% of them have emotional and behavioural problems. Despite the high prevalence of mental-health problems in these children little is known about how such problems affect the outcome of foster placements. A study of 5,978 children in Illinois looked at their medical records to see whether they had received inpatient mental-health care and followed their progress for several years to see how their foster placements turned out. Five percent of the children had had at least one episode of inpatient mental-health care prior to being placed in foster care. The children who received inpatient psychiatric care had a substantially greater risk for parent-child separation. They were also at a greater risk for frequent placement disruptions and were less likely to be reunited with their birth family or permanently adopted. About half of the sample experienced more than three placement changes during their first spell in foster care. Having had inpatient care raised the risk of placement instability by 75% among White children and 24% among African-American children.
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