HMN 2025: How Instability in foster care doubles the risk of mental health problems

Children in care who experience frequent changes in care placements are more than twice as likely to experience mental health problems, according to new research led by the University of Bath in the UK.

The study, published in the British Journal of Psychiatry, is the first meta-analysis globally to examine the link between placement instability and children’s mental health. It looked at data from 15 UK studies involving nearly 7,000 care-experienced children and found a clear link between frequent placement changes and serious difficulties, including self-harm, behavioral problems and psychiatric diagnoses.

Around 45% of children in care already live with a mental health disorder. The researchers suggest that frequent moves are likely contributing to this high level of need, leaving lasting scars on children’s well-being. The problem is likely being made worse by a national shortage of around 8,500 foster caregivers, which means more children are placed in unregulated settings such as hostels and shared housing.

Lead author Cody Varnish, from Bath’s Department of Psychology, said, “Nearly a third of children in care in England move home at least once a year. These moves are often unexpected and can disrupt children’s relationships, education, and routines, ultimately undermining their sense of safety and belonging. Providing children with stable homes is a critical step toward improving outcomes for care-experienced children and young people.”

Senior author Professor Sarah Halligan said, “Early support is essential and can prevent difficulties from escalating. Children from ethnic minority backgrounds and those with disabilities are particularly vulnerable to instability, so services need to be designed with that in mind.”

Senior author Dr. Katherine Button said, “The relationship between placement changes and mental health can create a vicious cycle. While placement moves can negatively affect children’s well-being, those with existing mental health difficulties may find it more difficult to adjust, increasing the risk of further placement breakdowns. Breaking this cycle requires timely and targeted support.”

The researchers are calling for early, accessible mental health support tailored to the specific needs of care-experienced children. They also want to see closer collaboration between local authorities and mental health services, and better training and support for foster caregivers to reduce placement breakdowns. Efforts to safely support children within their families where possible, reducing the need for care placements, are also highlighted.

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