Comparing Outcomes

When you propose a move from institutionalisation to family-based care, you usually get inundated with arguments against it. The belief that institutional care is cheaper is one of the arguments (one that was already refuted HERE), but not the only one. There is usually also a fear of trusting another family, strangers, to care for a child. The feeling is that the child will be alright in the institution, because that is all organised and more or less official, but it seems dangerous to just trust ‘random strangers’ with a child, anything could happen.

These kinds of fears are not surprising, particularly in people who are not used to things like foster care and do not know much about it. However, it is important to look closer at the realities of the situation.

The first reality being that it has been proven, at different times, in different countries, that children who live in institutions are much more vulnerable to physical, sexual and psychological abuse than children who do not live in institutions. They are also more vulnerable to child trafficking and exploitation.

The second reality is that while it would certainly not be safe to allow ‘random strangers’ to take care of children – this would attract predators intent on harming children – this is not what actually happens. Foster care systems have a strict selection procedure to make sure prospective adoptive families are suitable to take care of children in a safe manner. As someone in charge of a foster care programme recently told me: ‘Out of the 200 families that applied to become foster families, we approved 4.’ Plus, training is provided to foster families to prepare them for what is expected of them. And they are provided with continued guidance and support.

‘But,’ people exclaim ‘look at the mistakes that are being made in countries in North Western Europe, foster children who are completely let down by the system!’ I completely agree that more needs to be done to improve the foster care system in North Western European countries, to make sure that children do not fall through the cracks. However, it is important to realise that the stories you find in the media, are always the stories of failure, never those of success and that there are many, many children in those countries growing up in secure and stable foster homes.

Most importantly, however, you need to know what you are comparing. When you make a comparison between children who grow up in foster families and those who grow up in institutions, you see again and again that the outcomes for children from foster families are much better than for children who grew up in an institution. And this is despite the comparison not actually being fair.

When you compare the outcomes of children who grew up in foster care, for example in the UK, to those of children who grew up in an institution in India, you are not comparing similar groups of children. A really big difference is that the children in India generally had nothing wrong with them when they entered the institution, they may have had a poor background, but no severe mental health issues or behavioural problems, while children in the UK are not removed from their family unless there it is unsafe for them to stay there. This means that children who end up in foster care in the UK all have either a very traumatic history or their own severe mental health issues, putting them at a disadvantage to the average population.

And yet, when you compare the outcomes, the children who grew up in foster care in the UK still do a lot better – despite their significant issues putting them at a disadvantage – than children who grew up in an institution in India. This is something to think about.

It is absolutely true that foster care needs to be well organised, monitored and guided in order to be really safe and beneficial. But that does not mean that it should not be attempted. Even when it is not done as well as it should be, it is likely to be less damaging to children than institutionalisation is.

One study showed that young adults who had grown up in institutions were 10x more likely to end up in prostitution, 40x more likely to end up with a criminal record and 500x more likely to kill themselves than those who grew up in a family. That is something worth preventing.

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