The state of the foster care system in the United States is grim. On any given day, nearly half a million kids in the country are in foster care — in 2017, almost 700,000 kids were in the foster care system. That spike is at least somewhat attributable to the opioid crisis, which according to the U.S. Department of Health and Human Services, accounted for 32 percent of all foster placements from 2013 to 2015, a near 10 percent jump from just eight years prior. And the problems don’t end there.
Every year, around 23,000 kids in the foster care system are pushed out, many of whom with no permanent placements lined up, when they turn 18. One investigation by the Kansas City Star found that, of 6,000 prison inmates interviewed, 1 in 4 had been a product of the foster care system. As the system overcrowds, more and more children are put into untenable and unsafe situations: in 2019 in Texas, reports of abuse and mistreatment skyrocketed. This is despite the fact that the system, as designed, is supposed to try to keep families together, rather than separate them and institutionalize kids. Recent bills such as the Family First Prevention Services Act, authorized in the 2018 spending bill, have attempted to solve the foster care system problems. Policymakers and child welfare advocates are clamoring for intervention, rather than moving straight to institutionalizing kids, if at all possible.
Dr. John de Garmo has seen the havoc that the opioid crisis has wrought on kids firsthand. De Garmo has been working in foster care for nearly two decades. In that time, he’s helped raise 50 foster children and become an adoptive parent to several, all while raising his own biological children. De Garmo has also built a career supporting foster parents and children in the foster care system. He’s the director of the Foster Care Institute, writes training manuals for parents who foster kids, and works directly with foster care agencies across the country. He lives, breathes, and sleeps foster-care reform, which, right now, gives him plenty of reason to lie awake at night.
For de Garmo, the horrific effects of the opioid crisis are not an abstraction. The aforementioned spike in opioid-related placements means, for de Garmo, hundreds of young people in pain. Dozens of children who have lived in Dr. de Garmo’s home have gone through withdrawal. The pain is emotional, but it is also very real and very immediate. And it’s not getting better. As more children enter the foster care system, more would-be foster parents are phasing out of it. There are too few homes for too many kids.
Dr. De Garmo spoke to Fatherly about what states have seen the worst effects of the crisis, why the crisis is worse than what he’s seen in the past, and how he hopes to change the tide of the problem.
You’ve been involved in the foster care system for a long time. How do the effects of the opiate crisis compare with previous trends you’ve seen during financial crises or other periods of upheaval?
It’s worse by far. It’s happening in every community, it’s happening at a staggering rate, and there are so many opiates out there right now that are so inexpensive to produce.
Something like 33,000 people died last year of opiates in the U.S. alone. In the last eight to 10 years it’s just been increasing. It hasn’t been until the last few years that we started recognizing it as a society.
To what extent is the foster care system being overcrowded simply because of the opiate crisis and to what extent is the overcrowding compounded by other foster care system problems?
The numbers in foster care across the country are rising considerably due to mainly the opioid crisis. We’re getting close to 500,000 kids in foster care across the nation. In Georgia, for example, I have seen the numbers of children placed in foster care double in the past two years. That’s indicative of a lot of states.
With more kids being placed into the system, there are less homes for these children to stay. That’s why we read stories of children in foster care who are sleeping in offices of case workers or hotel rooms with the case workers because there aren’t enough foster homes for these children. The foster care system is just being overwhelmed by this opiate crisis.
Your read is that there really is one main issue we need to focus on.
Well, as a society, we need to focus on helping children in need, whatever the reason; from abuse, from human trafficking, from neglect. At the same time, it is important to note that on average, every 25 minutes, according to studies, a baby is born suffering from opiate withdrawals. I’ve seen it in my own home dozens of times. Children will come to my house who are suffering from withdrawal symptoms from opiates their parents were addicted to while pregnant.
But surely some of this rise is because of basic neglect, not necessarily opiate addiction.
Children are placed into foster care for a number of reasons, including various forms of abuse, neglect, and abandonment. But the larger number of children being placed into foster care, nationwide, is due in part to an increase in parental drug usage and substance abuse. Heroin use is the chief drug increasing among parents. Other substance abuse is meth, cocaine, and prescription medication abuse. More children are also being placed into foster care due to parental neglect.
Is the system merely being overcrowded because there are more needy children in foster care? Or is it because of something else?
There are less parents who are volunteering to become foster parents. The turnover rate of foster parents ranges from 30 percent to 50 percent. That’s another reason why the system is struggling so much: more kids in it, less people to take care of these children. I’m actually on a nationwide campaign called Foster10K, to try to recruit 10,000 new foster parents by the year 2020. As I travel the nation and work with child welfare agencies in every state, I see it every single day. There are not enough foster homes.
Would you say that there are certain states that are struggling more than others?
Yeah, I would. The city of Los Angeles has more foster children in it than many states do. Five states in particular have been affected: Arizona, Florida, Georgia, Indiana, and Minnesota. They account for 65 percent of the nationwide increase of foster children. Georgia saw the number of children placed in state care rise from, 7,600 in 2013 to 13,300 in 2016. Indiana has a 37 percent increase in children in foster care. Minnesota saw an increase of children placed into their state foster care by 33 percent. The state of Florida saw an increase of children being placed into care between this time period of 24 percent.
Have you seen a lot of kids come through your home who have been affected by this?
I have had dozens going through withdrawal symptoms in my home. Out of every thousand babies born in these states, at least 30 are born with Neonatal Abstinence Syndrome.
When you’re holding that baby and that baby is screaming and there’s nothing you can do for that baby to comfort them because their body is wracked with pain and the suffering of withdrawal symptoms, that’s exhausting. The baby screams and cries and is restless. Later on, in life, when they have developmental issues. That’s frustrating too because its not their fault. They were born with those challenges.
I’ve seen a lot of babies being placed in the foster care system because they are born addicted to the drug. If the mother is pregnant and she’s on drugs, that child will most likely be removed from their home and placed in the foster care system as the birth mother and father undergo treatment. So we see a lot of babies.
Do you see kids who are put in the system who are older, too?
When the parents are being arrested for opiates in their house, they’ll be whatever age. They’re either going into the foster care system that can’t handle it or they’re being placed with their grandparents or kin, relatives who are not necessarily ready for that either. So many grandparents today are taking care of their grandchildren and they didn’t sign up for that. What many do not understand is that around 22,000 kids will age out of the foster care system each year, so there is a large number of older children and youth in the system across the nation. We have had several teenagers come and join our family from foster care.