Care for the mental health of foster children in the Asia-Pacific merits further study

To the Editor

Youth in foster care are a vulnerable group. Countries in the Asia-Pacific region widely diverge in their available health resources to understand and to care for this deserving population. Yet, studies from countries across the range of regional socioeconomic disparities suggest that the mental health of these youngsters is uniformly challenged. In an Australian sample of children living in foster or kinship care, children demonstrated poorer mental health relative to non-fostered youth (Tarren-Sweeney and Hazell, 2006), while in a Malaysian sample of adolescents living in orphanages, depression was found in over 85% of the teens, and anxiety in over 80% (Mohammadzadeh et al., 2018).

As pressing needs are increasingly identified in the region, further evaluation of regional psychiatric care practices is needed. Studies from beyond the Asia-Pacific can serve as a model for this work. Heightened polypharmacy in foster youth is increasingly recognized as a problem, with over a third of youth treated with three or more classes of psychiatric medications, and almost a sixth with four or more, in one southwestern state in the United States (Zito et al., 2008). These findings inform the importance of evaluating regional practices to avoid excess uses of medications in place of more appropriate psychosocial interventions. Such future studies can ensure best practices and be employed to promote advocacy for strengthening the availability of psychosocial service interventions for foster youth.

Research in trauma-informed care has produced validated tools for screening, evaluating, and treating childhood trauma in foster youth. In the referenced Australian sample, less than 6% of children had no known exposure to maltreatment. Further studies in the region may continue to expand our knowledge of the mental health of these youth, while also evaluating the current state of services and facilitating the further growth of comprehensive psychosocial trauma-informed care.