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Approximately 60 percent of the over 425,000 children in the United States foster care system will experience mental health struggles, including depression, anxiety, post-traumatic stress disorder, and other behavioral problems.
Community stressors, such as chronic trauma, poverty, and lack of social support, compound these psychological struggles.
There is an overrepresentation of racially marginalized youth in the U.S. foster care system. Black and Hispanic children represent approximately 44 percent of foster children despite comprising only 32 percent of the population. Scholars highlight two main drivers for these historic discrepancies: sociodemographic factors (e.g., socioeconomic status, race, and gender) and systemic discrimination.
To understand how some institutions have addressed the needs of racially marginalized foster children, I interviewed the Director of Behavioral Health for the Foster Care Program in the MetroHealth System, Marsheena Murray, Ph.D., ABPP. As a board-certified child and adolescent psychologist, Murray leads a team of clinicians in partnership with the Cuyahoga County Department of Children and Family Services to provide mental health services to youth in the foster system.
“The system failed them long ago”; Systemic contributions to foster youth’s well-being
Murray and her team address the unique needs of racially marginalized foster children through a critical awareness of the systemic and institutional factors that influence their experiences in the system. For instance, racial minority children are more likely to be reported for “destructive” behaviors (e.g., belligerence and rowdiness) compared to their White peers. These discrepancies contribute to the disproportionate number of foster children referred for punitive interventions for first-time offenses.
These consequences both contribute to and are a product of the school-to-prison pipeline. As early as pre-K, racially marginalized children, especially Black males, may be alienated from academic domains through excessive exclusionary discipline (e.g., detention and expulsion for minor offenses). Racialized youth are also more likely to be separated from their biological family, with devastating consequences for mental health and life-long happiness.
Additionally, because most mental health counselors are White, racialized foster youth may distrust agents of intervention. Combined with historic cultural stereotypes that discourage using mental health services, racially marginalized youth may avoid or dismiss mental health care altogether. Therefore, Murray and her team utilize trauma-informed and culturally relevant methodologies to serve this vulnerable population.
Trauma-informed and culturally relevant care
Research suggests that at least 90 percent of foster children have experienced one traumatic event, such as abuse, neglect, and physical or gun violence. With this in mind, the first intake is a critical time for intervention efforts to disrupt the lasting consequences of trauma, including detriments in academic achievement and social, psychological, and physical development.
Through her advocacy and outreach, Murray strikes a delicate balance to improve the lives of those in her care despite systemic and individual barriers. Murray exposes and interrogates the multifaceted contributions to foster children’s psychological well-being through trauma-informed and culturally relevant counseling. She does so by shifting the narrative from the youth’s personal and individual struggles to a broader, community-oriented perspective.
At first intake, Murray and her team implement a brief mental health screening to understand a child’s lived experiences and identify those needing a more extensive assessment and intervention. Through validated, peer-reviewed frameworks, practitioners may meet the often-overlooked needs of children in the foster care system.
In addition to trauma-informed frameworks, Murray employs culturally informed models of trauma. These culturally informed models (e.g., the C-ACE model for Black youth) help practitioners reach teens who face the brunt of systemic oppression. For instance, in the summer of 2020, there was a wave of social justice movements protesting police brutality across the U.S. Murray highlights how these protests were transformational for racialized children in the foster system by bringing into sharp relief the consequences of historical trauma and institutional racism.
By utilizing trauma-informed and culturally relevant care practices, Murray ensures the counseling space is one of joy and healing that can improve multiple aspects of children’s lives. For example, Murray bridges the gap between research and practice by prioritizing relative placements and maintaining kinship ties to preserve the family unit as much as possible:
The overall goal is that we don’t want the placement to disrupt the child’s life. We must attend to the lifelong well-being and mental well-being of all involved.
Balancing the Playing Field
“I always feel powerful, not powerless,” Murray said in response to my question about how she maintains her passion for addressing these issues, “Kids have it so bad; they go through a lot… but doing what you can to help makes all the difference.”
She continued that her goal is not to focus on changing things out of her control, such as difficult family circumstances and mistreatment from institutional agents. Instead, she focuses on how she can shape and improve their worldview and critical awareness of systemic oppression in the U.S.
Murray’s infectious passion and dedication to serving the most vulnerable members of her community shed light on an ongoing issue in the U.S. With greater awareness of these lasting issues, we can help address the systemic injustices faced by our most vulnerable populations.
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