Recent reporting by The Imprint reveals that thousands of families across the United States are relinquishing custody of their children to access desperately needed mental health treatment.
It is a heartbreaking reality — and one that those of us working at the intersection of adoption and mental health have long understood. Adoptive parents are not making this choice because they want to; they are making it because they have run out of options. This is not a failure of families, but a failure of systems.
In testimony before Congress during a recent subcommittee appropriations hearing, I spoke about the root causes behind this crisis: a profound lack of access to adoption-competent mental health care; a workforce unprepared to meet the needs of children and families impacted by adoption, foster, and kinship care; and a fragmented system in which child welfare and mental health operate in silos. The Imprint’s reporting brings these failures into sharp focus, showing what happens when families cannot access the care their children need: Child welfare becomes the default entry point.
But this “solution” comes at a cost. It breaks up families, creates more trauma, puts parents in an adversarial role, and places children into systems not designed to meet complex mental health needs.
The Center for Adoption Support and Education’s research reinforces what The Imprint reported on. Children in adoptive, foster, and kinship families experience higher rates of trauma and mental health challenges, and their families seek services up to three times the rate of the general population. Yet in a recent survey of more than 200 adoptive parents, only about 21 percent said clinicians they saw provided adoption-competent care — meaning they were specifically trained to understand experiences of loss, grief, identity and trauma. This gap is where families fall through, where needs escalate, and where too many are pushed toward crisis decisions no family should have to make.
This is not a problem without a solution. At C.A.S.E., we have spent more than 25 years building and scaling models that work. Through initiatives like the Training for Adoption Competency (TAC) and the National Adoption Competency Mental Health Training Initiative (NTI), we have trained thousands of professionals nationwide to deliver evidence-based, adoption-competent care.
This work was born from the lived experience of our co-founder who, alongside her husband, adopted nine children from foster care over four decades. Their children carried the effects of profound trauma, loss, and disrupted attachments. As the symptoms of this early adversity surfaced through dangerous and harmful behaviors, the guidance they received from professionals was strikingly consistent: that their children were too damaged to remain in a family and should be returned to the foster care system. C.A.S.E. was founded in direct response to that reality — to ensure that no family is ever advised to return their children back into care.
Our national State of Practice report shows that when clinicians are equipped with the right training, families experience significantly better treatment outcomes on measures of family well-being and child/youth emotional, behavioral, and social functioning.With access to clinicians trained in adoption competence, crises that can lead to system involvement — including relinquishment — can be prevented. This approach is proven, scalable, and already making a difference across the country.
Seeking help for a child’s mental health needs should be encouraged — it is a sign of strength, not failure. The tragedy highlighted in The Imprint’s reporting is that families must reach a breaking point to receive that help. Access to care is too often tied to custody status rather than clinical need. Specialized training is not the standard, and services are fragmented across systems that do not communicate effectively. In this system, relinquishment becomes a rational, if devastating, decision.
This is precisely why we established the National Center for Adoption Competent Mental Health Services: to address these systemic breakdowns at their source. The National Center works to bridge child welfare and mental health systems by expanding access to adoption-competent care, strengthening the workforce through evidence-based training and technical assistance, and advancing policies that ensure families can receive support without entering foster care. By aligning systems, building capacity, and elevating adoption competence as a national standard, we can prevent families from ever reaching the point where relinquishment feels like the only option.
We have the opportunity and responsibility to build a different kind of system where families can access intensive mental health services without surrendering custody, where adoption-competent care is the standard, and where child welfare and mental health systems are aligned to support families, not separate them.
Federal investments in initiatives like NTI are already demonstrating what is possible when policy, training and practice align. But we must go further, embedding adoption competence into the fabric of our systems. The cost of inaction is too high, and it is being shouldered by families doing everything they can to help their children heal.
The Imprint’s reporting makes clear that this issue is national in scope and systemic in nature, but it is also solvable. We do not need to accept a system where families must break apart to get help. We can build one that strengthens them instead. The question is not whether we know what to do — it is whether we will choose to do it.
