Promoting Emotional Safety for Youth in Foster Care: A Clinic’s Approach to Supporting Caregivers’ Understanding and Use of Youth Crisis Interventions Services

Background: The COVID-19 pandemic has negatively impacted the mental health of children, especially child welfare-involved youth, who are at a higher risk for behavioral health issues (Turney, K., & Wildeman, C. 2016). Approximately a quarter of Massachusetts youth who previously received psychotherapy discontinued care at the beginning of social distancing restrictions in 2020 (Massachusetts Health Policy Commission, 2021) and similarly the utilization rate of mental health services like Youth Mobile Crisis Intervention (YMCI) teams declined during the pandemic (Commonwealth of Massachusetts: MCI, 2021). YMCI teams provide urgent mental health evaluation and stabilization services for children in crisis either in the child’s home or school, reducing emergency department visits. This project aims to identify and address barriers children in foster care may face when accessing YMCI. The goals are to 1. Characterize the Foster Children Evaluation Services (FaCES) clinic staff’s and community organizations’ understanding of YMCI use by foster parents 2. Create resources that guide families on when and how to access YMCI.

Methods: Strategic exploration discussions were held with community organizations involved with foster youth to identify barriers to accessing YMCI. Additional meetings were organized with members of the FaCES interdisciplinary pediatric and behavioral health team, which includes clinicians and foster caregivers, to better understand the clinical team’s current experience with utilizing YMCI as well as identifying when clinicians discuss YMCI with caregivers. Clinic workflow was reviewed to identify how educational materials may be provided to patients and foster families.

Results: Based on discussions with the FaCES clinic team and community organizations, a lack of knowledge about YMCI among foster caregivers was identified. This included confusion about when to call YMCI and misunderstandings regarding the possible outcomes of a YMCI evaluation. Targeted educational handouts were created to help foster caregivers better understand accessing YMCI when a child is in a mental health crisis. These resources were integrated into the clinic’s current workflow as handouts clinicians can e-mail to foster parents and posted on the clinic’s website.

Conclusion: The COVID-19 pandemic has exacerbated and exposed the mental health needs of children in foster care. Discussions with foster caregivers, clinical providers, and other professionals revealed a need for clear guidelines on accessing resources, such as YMCI, for youth in foster care experiencing mental health crises. The created materials guide families on how to access these resources to help keep youth in their care emotionally and physically safe.