Infant Mental Health Journal is devoted to infants in out-ofhome placement. Just as Henry Kempe argued that we need multidisciplinary teams to evaluate and treat abused and neglected children, we also need research from multiple perspectives to improve the lives of infants who enter foster or kinship care. We explicitly sought such an approach, and the issue incorporates epidemiologic, child welfare, clinical infant mental health, pediatric, and developmental approaches, to name some of them. The result is a rich set of articles on these infants and their many families.
Along with our colleague Christina Little, we have written the initial article in the volume, which summarizes the state of knowledge about assessment, intervention, and research with infants in foster and kinship care. Infants represent a large and growing proportion of all youth who enter out-of-home placement. They have high rates of medical and developmental problems, and they have serious risk factors for mental health problems, such as maltreatment and loss due to the placement itself. These problems, however, are usually addressed through four separate service sectors: the medical, early intervention, mental health, and child welfare sectors, which greatly complicates efforts to ensure they receive the care they need. Furthermore, we are in the midst of rapid policy change in child welfare. All of these issues frame our literature review on infants in foster and kinship care.
Four articles in the volume describe new research on infants in out-of-home placement. The first of these, by Wulczyn and colleagues, is likely to have a major impact on the field. The article reports new findings on the prevalence of infants in foster care in the United States. They used administrative data from 11 states, which together account for approximately 51% of the country's children and adolescents in foster care. They found that approximately 2.5% of all newborns in the United States enter placement within 3 months of their birth. In the largest cites in each of these states, approximately 4% of newborns enter out-of-home placement. These are startling findings. They clearly indicate the need for major public policy discussions about newborns who enter foster care. These data also call on the child welfare system to consider reallocating its recources and services in response to the age distribution of the children who enter foster care, and it calls on those in public health to rethink their programmatic commitments in the light of these findings.
In her article on congregate care for infants in out-of-home placement, Jones Harden