Expanding Access to Home-Based Behavioral Health Services for Children in Foster Care

Children in foster care in the United States often require behavioral health services due to their high rates of previous trauma and abuse. Unfortunately, as part of the U.S. mental health crisis, many children in foster care needing behavioral health treatment end up in hospitals and psychiatric institutions, even when not medically necessary. They can remain there for weeks or months as child welfare searches for foster homes equipped to meet their needs. Meanwhile, they don’t have access to schooling, community activities, socialization, or exercise.  

Home-based behavioral health services (HBHS) for children can result in similar or better clinical outcomes than in-patient care, often with higher family satisfaction and lower costs. Having access to home-based services may even help with recruitment and retention of foster parents willing to care for children with behavioral health needs.  

With multiple states facing ongoing lawsuits aiming to increase HBHS and keep more children and youth at home, legislators and systems leaders have a unique and timely opportunity to enact policy and practice change. This article presents recommendations for health policy and health services researchers to guide these changes.