The impact of welfare reform on foster care is examined in relation to children's mental health. Initial assessment of 125 young foster children randomly assigned to a special program found that half rated below normal on mental and psychomotor development, with two-thirds below normal on emotional regulation and motor quality. Implications for social policy and program planning, and the need for ongoing research, are discussed.

Several studies have reported large numbers of homeless adults with histories of childhood foster care. 1-5 Others have found that an increased number of homeless parents had children who were placed into foster care.' This study examines the prevalence of adult homelessness among the birth parents of foster children. It also examines whether foster children whose birth parents experienced adulthood homelessness are a special subpopulation of foster children and whether they suffer from more physical, psychological, or social problems than other foster children. MethodsThis study presents cross-sectional data from an ongoing longitudinal study funded by the National Institute of Mental Health on the health of and services needed by foster children. Between 1993 and 1996, 195 ResultsDemographic characteristics of the sample are shown in Table 1. Approximately half the children were male and half were female. Ages were almost evenly split among children under 2 years old, between 2 and 3 years old, and between 3 and 4 years old. Most foster children were Black, followed by Whites, Latinos, and others. Almost half the sample (95/195) had birth parents who had experienced homelessness.Often more than 1 charge against the birth parents was cited as the reason for foster care placement. In our sample, neglect (usually secondary to substance abuse) was the most common reason, followed by abandonment and abuse of a sibling. Comparisons between children whose birth parents had histories of homelessness and those whose parents did not demonstrated no difference in age at first foster placement, type of placement, or number of placements. However, compared with other foster children, more foster children whose birth parents had been homeless had siblings who also had been placed in foster care (52.6% vs 36.0%, P < .05). Compared with their counterparts, a higher proportion of children whose birth parents were without homeless histories were in foster care because of sexual abuse (8.0% vs 0%, P < .001).

Summary Our goal is to identify more relevant indicators of women

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An examination of Medi-Cal-paid claims was undertaken to assess the utilization of mental health services by children in California's foster care system. Using unduplicate counts of service use and diagnoses, it was determined that children in foster care account for 41% of all users of mental health services even though they represent less than 4% of Medi-Cal-eligible children. When partitioned into specific service categories, children in foster care account for 53% of all psychologist visits, 47% of psychiatry visits, 43% of Short Doyle/Medi-Cal inpatient hospitalization in public hospitals, and 27% of inpatient psychiatric hospitals. Expenditure for services paralleled utilization frequency. When compared to the non-foster care Medi-Cal-eligible child population, children in foster care have 10 to 20 times the rate of utilization per eligible child for selected services. For children in foster care, 75% of all diagnoses for billed service were accounted for by four diagnoses: adjustment disorders (28.6%), conduct disorders (20.5%), anxiety disorders (13.8%), and emotional disorders (11.9%), with clear age-related differences in the distribution of diagnoses.

In-depth interviews with 65 women in treatment contributed to a taxonomy of indicators of women's alcohol problems, with five major categories and numerous subcategories. The largest number of client indicators appeared in the Individual (psychological and behavioral) category. The Physiological category included unique indicators regarding physical appearance. Within the Social category, family/partner relationships were emphasized. The taxonomy can be useful in therapeutic assessments, to develop survey items, in comparative research, or in alcohol program development.

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