Mental health of children in foster care, a literature review

In France more than 140 000 children live in foster homes under the responsibility of the French Child Protection Agency. These children have lived in environments that cannot be good for their development and have been separated from their families which have to have consequences on their mental development. A literature review in France and abroad was made to identify the profiles of these children, their risk factors, and the mental disorders they can present. French child protection is handled by smaller territories, called Departements of which there are more than 90 and count around 1 000 000 people each. The number of foster children differ byDepartement, as do the placement types and meaning of the placement. More than half of these children have suffered maltreatment prior to placement. Comparing them to children of the same age, they present more internalizing and externalizing disorders, more addiction problems and suicidal behaviors. Protection factors have nonetheless been identified, such as early age of placement and placement stability. The main inhibitors of good health care are the absence of a common regulatory framework, source of organization difficulties, and the lack of collaboration between health and social services. French cohort studies using validated tools are necessary to precise and confirm these results. They could then lead to national recommendations for mental health screening and care organization, as well as validation of protocols for specific therapies for foster children. (C) 2019 L'Encephale, Paris.