Psychiatric diagnoses in children in foster care in rural NSW

Background: In Australia it is estimated that there are 19,000(1 in 200) children in Foster Care. There is little known about the nature of these children. There is anecdotal evidence that they have long-term problems and higher rates of criminal behaviour than the general community. This audit aimed to detect the current psychiatric morbidity in a cohort of these children seen in a community based rural setting. Methods: A retrospective audit of the charts of children attending a general paediatric clinic in Tamworth in 2003 was completed. The children were currently wards of the state and under the care of the Director General of the NSW Department of Community Services. The DSM-IVR was used to classify any psychiatric diagnoses present in the children. Results: There were 21 children aged 2–17 in Foster care. Children had been in care for an average of 2 years (Range 3months–5 years). 12(57%) of these children met the criteria for ADHD. 6(29%) children had a mild intellectual disability and 3(14%) had amoderate intellectual disability. 4 out of 6 teenage aged children in this group had a diagnosis of depression and 2 were currently taking SSRI medication for depression. 13 of the 21 children were siblings. 8(62%) of the Siblings were separated and cared for in different households. Discussion: Children in Foster care have high rates of behavioural problems, intellectual disability and suffer from depression during adolescence. They are likely to become separated from their siblings if several children from the one family are placed in Foster care. There needs to be a comprehensive national study to define the needs of this group of children to plan services to specifically support them and their carers so as to document and then to improve the outcomes of thismost vulnerable group of children in our community