Child Advocates of Silicon Valley

Mental Health

Mental Health


Foster youth are almost twice as likely to suffer from PTSD as US war veterans. According to a study by Harvard Medical School, the University of Michigan and Casey Family Programs - the frequent placement changes and lack of permanent support faced by foster children contribute to feelings of anxiety and social instability.

These factors affect education and occupational success and lead to long term medical problems. With the current climate of uncertainty in our country and the world, it is vitally important that all children – especially our community’s most vulnerable population – have a caring stable adult in their lives.

According to the National Alliance on Mental Illness (NAMI), 1 in 5 teens has a mental health condition. Half of all lifetime cases of mental illness begin by age 14 and 75% begin by age 24.

Working with young people in the foster care system will in many cases mean working with someone experiencing a mental health issue. These can range from depression to mood disorders to anxiety disorders to being suicidal to issues around eating and weight.

Providing foster youth with a CASA can be crucial to children struggling with mental health issues. A 2015 report from the America’s Promise Alliance found that supportive, adult relationships lessen the effects of adversity for youth and that youth are more likely to be successful in life when they have meaningful adult connections.

Remember: CASAs cannot provide therapeutic services to the children they advocate for, but you can be supportive members of your advocate child’s team, understanding what they’re going through and helping them access the resources they need to thrive.

We hope you never need them, but children who experience mental health issues can be more vulnerable to neglect and abuse, you can find the Suspected Child Abuse Reporting Procedures here.

Have a question about this issue? Ask a Specialist



4 Key Mental Health Concepts

  1. Trauma-Informed Care
    Trauma-informed care is a key piece of our approach to working with foster youth. One way to think about it is it uses a concept from the Substance Abuse and Mental Health Services Administration:
    Realize the widespread impact of trauma and understand potential paths for recovery.
    Recognize the signs and symptoms of trauma in youth, families, staff, and others involved with the system.
    Respond by fully integrating knowledge about trauma into policies, procedures, practices, and settings.
    Resist re-traumatization of youth (, p. 5).

    “I wish that the people who work within my school were more trauma informed and that they were focused - instead of on the disruptive behavior - on what was causing the disruptive behavior.” — LS, “Implementing a Trauma-Informed Approach for Youth across Service Sectors.”

    CASAs can provide consistent support for youth to address the after effects of trauma, “(e.g., anxiety, sadness, depressions, feelings of hopelessness, anger, shame, guilt) and build upon their strengths to instill good self-esteem and a belief that they are worthy of and can achieve goals in their life” (, p.7). CASAs can “provide ongoing assistance for children and youth to learn skills for daily life and development of goals for the ‘here and now’ and in their future” (, p.8).

  2. Adverse Childhood Experiences (ACES)
    As a framework, ACES help us approach foster youth with the idea that they have already experienced trauma. How has that trauma impacted their current behavioral, social, physical, and educational issues/problems? And what can be done to address the trauma without reopening the wound?

    Mental disorders and mental health problems appear in families of all social classes and of all backgrounds. No one is immune. Yet there are children who are at greatest risk by virtue of a broad array of factors. These include physical problems; intellectual disabilities; family history of mental and addictive disorders; multigenerational poverty; and caregiver separation or abuse and neglect.” (Mental Health: A Report of the U.S. Surgeon General, 1999). 
    More info in this TED Talk (15 mins)

  3. Get Started Talking Now
    Sometimes it can be hard to know what to say when someone is struggling with a mental health issue. You might feel like talking about the issue will make it worse. That is often not the case, but if you are worried or need advice about what language to use, talk to your Mentor/Supervisor ASAP.

    There are many kinds of mental health issues, but CASAs have told us the one they feel least prepared to handle are suicidal thoughts. We have found the suicide prevention advice in this article is useful and so here it is quoted at length:

    Suicide Prevention Strategies You Can Use
    If a family member or friend expresses suicidal thoughts, do not ignore him or her. That person might desperately need your help. Here are a few tactful steps you can take to help a loved one at risk for suicide:

    Where You Can Find Help
    Ask questions in a mild and sincere manner.
    - Explain why you are asking questions.
    - Express that your loved one is not alone, and that you are there for him or her.
    - If the individual is not comfortable speaking with you, suggest a qualified third party such as a therapist, spiritual leader, or doctor.

    Do not passively tell him or her to just call a hotline; lead the person to helpful resources such as suicide hotlines and local mental health associations.
    Help the person schedule and keep appointments with a mental health professional, even if the individual no longer feels suicidal. explains the warning signs of suicide so you can help prevent it from happening. allows people to call or chat online with a suicide prevention counselor. offers life-affirming programs to members of the LGBTQ youth community at risk for suicide.

    If you or someone you know is having suicidal thoughts, the suicide prevention hotline in the United States is 1-800-273-TALK. If you are outside the United States, visit or to get a helpline within your local area.

  4. Katie A.
    Definition: Katie A. v. Bonta is a federal class action lawsuit filed on behalf of California foster youth and children at risk of out-of-home placement. The plaintiff, Katie was a 14-year old who suffered from significant mental health issues and had been in foster care for 10 years. The lawsuit highlighted the need for significant reform of the systems assessing and delivering mental health services to foster youth. As a result of the suit, all children entering the dependency system are assessed to determine if they would benefit from mental health services. Services are ordered by the social worker and provided by MediCal - California’s Medicaid program. Here is a list of local Katie A. providers and resources.