Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis

•Foster youths show more problems than non-maltreated youths (community or at-risk)•Foster youths experience problems like unplaced maltreated or clinical youths.•Kinship care and stable placements are protective factors.•Youths are vulnerable to mental health problems even after placement in foster care. This meta-analysis aims at comparing mental health problems of children in foster care to those living with their biological parents while taking in consideration different protective and risk factors. Across 41 studies with a total of 72 independent effect sizes, a significant but small effect size was found between foster care placement and psychopathology (d = 0.19). Children in foster care showed higher levels of psychopathology compared to those from community samples or matched/at-risk samples. They were as likely to show mental health problems as maltreated children living with their biological parents or children from clinical samples. Results showed that foster children’s mental health problems also varied as a function of type of placement and study methodological characteristics. Being placed in kinship care, longer stay in the same foster home and fewer placement disruptions, all acted as protective factors limiting mental health problems of children in foster care.