The Blue Backpack: Unpacking the Mental Toll of Foster Care in West Virginia

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He is 9. He doesn’t count time in birthdays or holidays. He counts it in bus rides, backpack zippers, and beds that never truly feel like his.

Right now, he’s sitting on the edge of a twin bed in a quiet house. The air smells like lavender and wood polish. There is a rocket-shaped lamp on the dresser and a dinosaur poster taped to the wall. The quilt is folded neatly at the end of the bed, but he doesn’t crawl under it yet. His shoes stay on. His backpack, a standard-issue blue one with a ripped seam, rests on the floor, unopened. He rarely unpacks. He has learned not to.

~

This account is fictional. But for many children in West Virginia’s foster care system, it is deeply familiar. These are the rhythms of survival in a world that shifts too often and settles too rarely.

There are more than 6,000 children currently in foster care across the state. Many are moved multiple times, often with just a few hours’ notice. Siblings are separated. Homes are temporary. School becomes optional, not because they do not care, but because it is hard to focus on spelling tests when you do not know where you will sleep next week.

Mental health needs are high, but access remains limited. The trauma these children carry often speaks in quiet ways. It whispers through the clenched jaw of a child who flinches when someone closes a door too quickly. It hides in the way they keep a flashlight under their pillow or ask for plastic utensils instead of metal. Sometimes it looks like a child who refuses to unpack, not because he forgot, but because he remembers too much.

Some progress has been made. A few schools now offer embedded counselors. Some foster parents are beginning to receive trauma-informed training. But these steps are not enough. In many counties, a single therapist is expected to meet the needs of hundreds of children. Therapy comes late or not at all. What these children need is access that meets them where they are. Mental health screenings should happen within 30 days of placement, followed by quarterly check-ins. Mobile mental health units and regional care hubs could help reach the most rural hollows. Therapists must be supported, not overrun. And children should not have to suffer in silence while systems wait to respond.

Even more troubling is what happens when children are returned too soon to homes that are not truly healed. While reunification is a worthy goal, it must not come at the cost of a child’s safety or emotional health. Nationally, more than 16 percent of reunified children return to foster care within 3 years. In some West Virginia counties, that number is even higher. These returns are not always redemptive. Sometimes, they are another heartbreak.

Somewhere, a judge signs a reunification order, and a little boy waits on a school bus, clutching a paper with a new address. He has been here before. He does not know if he is going home, or just somewhere else.

Reunification must be based on more than a parent passing a drug test or checking off a court-ordered list. It must reflect true, sustained healing. That means providing parents with access to parenting classes, trauma counseling, stable housing, and in-home support. It means giving them the time and tools to succeed, not just the pressure of a deadline.

But we must also speak plainly about another difficult truth. Not every foster home is safe. There are children who are harmed in the very system meant to protect them. Some placements are made because a bed is available, not because the environment is appropriate. Oversight can be inconsistent, especially in regions where caseworkers are juggling overwhelming caseloads. A child might sit at a dinner table with strangers, picking at food they cannot name, wondering if anyone will ask how their day really was.

We need stronger systems of accountability. An independent ombudsman’s office could review complaints and investigate red flags. Foster care should never be about convenience. It should be about care.

Foster parents need more than one-time training. They need ongoing education that reflects the realities children carry with them. Annual trauma-specific sessions should be standard. And kinship caregivers, like grandparents, aunts, or close family friends, should receive the same financial and therapeutic support as licensed homes. The label may be different, but the love and the need are the same.

Caseworkers, too, deserve support. The people on the frontlines of this system cannot continue to carry double or triple the recommended caseload. We must invest in better pay, realistic expectations, and emotional support for those who shoulder so many broken stories. A consistent worker means a consistent adult in a child’s life. Without them, even good plans fall apart.

And we must listen, truly listen, to the voices of those who know this system best. Judges who have watched cycles repeat in their courtrooms. Caseworkers who spend long days and longer nights navigating impossible choices. Foster parents who open their homes and hope their hearts can carry what comes next. And the youth who have aged out of care, who speak with the clarity of lived experience. These are the subject matter experts. Their insights are not just important, they are essential.

Every part of this process should be guided by one question: What brings safety and peace to the child? Not what clears a caseload. Not what meets a deadline. The answer should come from the quiet places, the child who sleeps in jeans just in case, the one who stashes crackers in pillowcases, the one who keeps a picture of a brother folded tightly in a sock.

These changes will take time. But time is something children like him should not have to spend waiting for love to last. With the right tools, the right hearts, and the right decisions, we can give them more than a place to stay. We can give them a reason to unpack.

~

He is still sitting on the edge of that twin bed. The rocket lamp is glowing. There is spaghetti on the table downstairs. He does not ask for plain noodles, even though he does not like the sauce. It is easier not to ask for too much.

Maybe tomorrow he will take his shoes off. Maybe tomorrow he will hang the picture of his brother next to the lamp. Maybe tomorrow he will unpack.

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