The Harsh Reality of PTSD and Foster Children

By Jay Paul Deratany

Founding Partner, Deratany & Kosner


Chicago attorney and child advocate, Jay Paul Deratany (founder of Chicago’s Deratany & Kosner) has spent years working tirelessly to protect the rights of foster children. Most recently, he won a $45 million judgement – the largest award ever in the history of the State of Illinois – involving the death of a toddler in the foster care system. He is also the writer and producer of the award-winning film, Foster Boy, starring Matthew Modine and Academy Award-winner Louis Gossett Jr., a courtroom drama based on several of Jay’s actual cases. Basketball legend, Shaquille O’Neal, a child advocate himself, took special interest in Jay’s film, and is an executive producer. 

June is PTSD Awareness Month.


In the midst of a raging pandemic that has upended daily life as we know it and a global reckoning about privilege, race, and violence, there has arguably never been a more apt time to discuss post-traumatic stress disorder. Conversations about the complex nature of PTSD continue to occupy national space, which is sorely needed. I am writing to shine a spotlight on a little-known, desperately needed aspect of this conversation: PTSD in foster youth.


While people are more commonly beginning to understand PTSD, there are some facts that we should remind ourselves of before we enter any earnest discussion of under-discussed PTSD sufferers. First, we must dispel the notion that PTSD is solely suffered by first responders or combat veterans, or dictated by a narrow, cinematic stereotype of flashbacks and outbursts after loud noises. While those symptoms – heightened startle response and increased agitation – are definitely part of PTSD, they’re really just the tip of an iceberg that presents differently with everyone. PTSD actually physically alters aspects of the brain and body chemistry in medically obser vable, measurable ways. This can cause outward effects like behavioral changes, emotional numbing, outbursts, nightmares, substance abuse, self-harm, and suicide.


Most people immediately think of the terror that veterans face and their experiences with PTSD as the pinnacle of the disorder’s prominence. But it’s been well documented that foster youth are even more acutely vulnerable. We’ve chronicled this for years, including in a 2005 Harvard study that demonstrated former foster youth were nearly twice as likely to develop PTSD as veterans returning from tours in Iraq.


That’s about one in four.


Any system that is mandated to protect and nurture youth that results in 25% of its wards developing a serious, life-altering disorder is a system that has unequivocally failed. That is not a social services support net – that is a game of Russian Roulette being played with the lives of the most vulnerable children in our society. There are 400,000 kids in foster care in the United States today. There are no words to describe the immense amount of pain that it takes to lead to 100,000 children – who are supposed to be in the care of our state and society –  developing a debilitating condition we’ve historically associated with the horrors of wartime.


Any child that has contact with the foster care system, even for a short while, is bound to be in an already precarious emotional state. They may be disoriented or scared, unable to comprehend what’s going on with the adults in their lives or having just directly experienced or witnessed interpersonal violence or tragedy. There are a variety of dehumanizing, humiliating, frightening experiences that foster youth have to confront – many of them multiple times over.


In the course of my work as a foster youth attorney and advocate for change, I’ve been appalled to personally see the conditions that these kids have to face – from the degrading and disheartening experience of foster youth commonly having to transport their personal belongings in trash bags to the system failing to protect these kids in their darkest hours, placing them in negligent and outright violent homes, and even losing track of them.


Not only do these factors of trauma and instability permanently alter the health and well-being of foster youth well into their adolescence and adulthood, but they’re also used as fuel to further marginalize these children.


Without proper intervention, supervision, and support, foster youth experiencing PTSD may act out, resulting in disciplinary actions at school, further conflict at home, or even switching their placement entirely. This vicious cycle particularly traps children of color and LGBTQ+ youth. Black children are twice as likely as white children to be placed in foster care and are already disproportionately inappropriately disciplined and criminalized. These children are punished, not protected – which is one of the reasons that a quarter of foster youth will be in prison two years after they emancipate.


These experiences and harrowing statistics do not have to happen, and in a world with more understanding of PTSD, childhood abuse, and social support, they wouldn’t.


Now more than ever during COVID, these kids are vulnerable and need our help. There are common sense reforms we can take to improve foster care, including providing emergency funding and support for foster youth during the pandemic, increased accountability and oversight, and overhauls that make the system one based on kindness and care. We must stand together and provide these children with what they need: compassion not criminalization, and treatment, not more trauma.

June 27 is PTSD Awareness Day

Stress is a normal part of life for children and adults of all ages. Trauma is not. And although childhood trauma can have serious, lasting effects, there is hope. With the help of supportive, caring adults, children can heal. SAFY is dedicated to family, youth and mental health support. Learn more about what we do.