Depending on which study you read, kids in foster care are diagnosed with mental illness two to five times more often than in the general population. That's not surprising, considering that trauma and loss (which can lead to mental illness) are the reasons why children enter foster care in the first place. So the quality of mental health care is especially important for foster kids.

Most children in foster care get mental health services from publicly funded programs. But a report published last year by the National Center for Children in Poverty, at Columbia University, shows that the public health systems in many states are failing poor children, including those in foster care.

The researchers asked top public health officials across the country to rate mental health care for children in their states. The results: officials in more than one-fifth of states said that none of the seriously mentally ill children in their states receive good care.

How did things get so bad? Recent news reports highlight some of the problems. Kids aren't getting the mental health services they need soon enough to keep problems from getting worse, and there aren't enough public mental health programs to meet the needs of teens. It can be even worse in foster care, where teens are less likely to have strong advocates pushing to get them the kinds of help they need.

Another concern is doctors over-prescribing psychiatric drugs to young people in foster care. Last summer, The Dallas Morning News reported that some Texas doctors prescribing these medications to kids in care had close ties to the companies that made the drugs. At the same time, others have doubts about whether kids have enough access to the medications they need and to psychiatrists whose job it is to make sure the drugs are working safely.

Fortunately, child welfare agencies are starting to respond to these problems by making better guidelines and keeping a closer eye on the kind of psychiatric treatment received by kids in foster care. Here in New York City, Children's Services (ACS) recently added a new department to make sure the use of psychiatric medications for children and teens in foster care is safe and appropriate and that their rights are respected. Child welfare agencies in other states have begun similar efforts to monitor the use of medications.

These are important steps, but there's still a long way to go.

Reprinted with permission from Represent, Copyright 2009 by Youth Communication/New York Center, Inc. (www.youthcomm.org)