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Tennessee children face high foster care instability, poor access to mental health services, other challenges

Foster care instability, poor access to mental health treatment and high child care costs are among the biggest challenges facing Tennessee children and their caretakers, according to a statewide report released Wednesday.

While youth depression rates in Tennessee are similar or below the US as a whole, Tennessee ranks in the bottom five of states in terms of ensuring children receive treatment for major depressive episodes, according to The State of the Child 2022 report from the Tennessee Commission on Children and Youth.

The annual report provides an overview of child well-being in the state based on the most recent available data. It’s intended to guide the Tennessee government and other stakeholders in making data-driven improvements to systems that support children and families in the state.

“Youth across the nation are twice as likely to receive (depression) treatment, and in the best-performing state, four times as likely to receive treatment, compared to youth in Tennessee,” states a news release from the commission about the report, which said 71.1% of youth who experience a major depressive episode in Tennessee don’t receive treatment compared to 60% nationally.

(READ MORE: Mental health crisis among children is a national emergency, experts say. Here’s where to get help in Chattanooga.)

Pennsylvania, followed by Maine, was the best performing state in terms of prevalence of mental illness and access to care for youth, according to the data source cited by the report.

A significant mental health workforce shortage in the state combined with growing demand were largely to blame for Tennessee’s access issues, the report said.

Among the other findings, Tennessee “struggles with foster care instability at a level not seen across the rest of the country,” according to the news release.

The report cites federal data showing that the percentage of foster children in Tennessee who changed placement three or more times in the first 12 months of custody has far exceeded all other states from 2016-20. In 2020, nearly 34% of Tennessee foster children changed placement three or more times in the first year.

Puerto Rico had the next closest instability rate, with roughly 26% of foster children experiencing three or more placement changes in the first 12 months, according to the report — which also references a recent audit that found unsafe conditions for children under Tennessee Department of Children’s Services care.

The cost of caring for children also poses a significant challenge for many Tennesseans. The report found that the average cost of caring for an infant and 4-year-old is 81% higher ($19,539) than the average annual cost of rent across all housing types in the state ($10,764).

In addition, roughly 25% of families spend over 30% of their monthly income on housing and/or report routinely not having enough to eat.

Despite the challenges, the number of children living in poverty in Tennessee reached an all-time low as the percentage of children living in poverty declined by 8% between 2019 and 2021, according to the report.

“Certain counties, particularly rural counties, saw even more significant declines. Bledsoe and Sequatchie counties saw overall child poverty decline by 29% and 26% respectively,” according to the release.

The report attributes the improvement to child tax credits and state investment in rural communities.

“Additional state and federal intervention can build resilience and support the health and well-being of families with children,” the release states. “Increased investment in our children, youth and families can prevent these challenges or mitigate the negative effects. The choices we make to address children’s needs and support their development will determine our state’s future health, economic and community success.”

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.

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