TORONTO - Changes are needed to ensure more kids in the care of child welfare agencies find permanent homes and don't "age out" of the system before being adopted, says an editorial published Monday in the Canadian Medical Association Journal.
Between 30,000 and 40,000 children are legally available for adoption in Canada, but only about 2,300 are actually adopted in a given year, statistics indicate.
It's easier for prospective parents to adopt a child internationally than across provincial boundaries, noted Dr. Noni MacDonald, one of the authors of the editorial, and a professor of pediatrics at Dalhousie University in Halifax.
"We need to grow up and we need to be parental about this, and we need to look at what the child deserves," MacDonald, a doctor at IWK Health Centre, said in an interview.
She's urging public discussion that would make it easier for people who want to adopt to learn about children who might be good matches.
"If you think about the best interests of the child, you are actually thinking about the best long-term interests of society ... A child who grows up damaged, we pay for the rest of that child's life."
Youth in care are 17 times more likely to be hospitalized for mental health issues; and by age 21, about four in 10 children and youth who were in care have been in contact with the justice system, the editorial says.
There's a need to agree that a specific amount of time spent in care of the state constitutes an adverse outcome, it says, and two years is a reasonable benchmark. Problems diminish when kids become attached to a new family.
MacDonald says it should be made simpler for adoptive parents to continue getting medical treatments or counselling that the youngster had as a foster child.
As well, the CMAJ editorial says Canadians need to get rid of legal barriers so that an adopted child can still be in touch with the birth family.
The majority of children in care are over the age of six.
"Part of the problem is, and I'm going to be very Victorian here, is in olden days, you know, if you were going to adopt a child from the poorhouse, you wanted a baby. OK? And that kind of ethos is kept in there," MacDonald said.
"So a lot of people running these child-care services don't even consider putting a seven- or eight-year-old up for adoption, even though they could be legally adopted."
But MacDonald said that mindset has been challenged in New York City, where an agency places 50 to 60 young people over the age of 18 in permanent homes every year. And in New Brunswick, 25 social workers were hired in 2002 to focus on permanent placements, and adoption rates jumped from an average of 25 children per year to about 100 children per year, the editorial says.
When older kids aren't adopted, they can "age out" of the system.
"In some provinces, that can be a disaster. In some provinces, you may `age out' at 16, out of children's society, and you can't get welfare until you're 18, so what do you do for those two years?" MacDonald asked.
"If you're now 17 years old, and you don't have any family to support you and you aren't eligible to (receive) welfare, tell me how you're supposed to live?"
A woman in London, Ont., who has two adopted children, says Canada has to do a lot better finding families for these youngsters.
"It's very sad there are that many kids without families," said the adoptive mother, who is unidentified to protect her daughters' privacy.
"And to me, adoption has been such a beautiful and wonderful thing. Both times. It's natural, it's normal. I don't get why more people don't consider it right off the bat."
Laura Eggertson, a co-author of the editorial, said a photo listing called Canada's Waiting Children lists kids who are waiting for homes.
"But the problem is not all provinces will refer children to the photo listing, which is one big barrier."
Another barrier is funding, said Eggertson, an adoptive mother who has trained adoptive parent support leaders for the Adoption Council of Canada.
"Only one province, Alberta, provides any money to keep that list up and running."
Jeannette Lewis, executive director of the Ontario Association of Children's Aid Societies, says November is adoption awareness month, and there are public service ads and ongoing campaigns to attract attention.
"Many Ontarians that are looking to adopt think they have to go internationally, and yet there could be a child available for adoption right around the corner from them in their Children's Aid Society."
Lewis conceded it is a "little bit more complicated" to adopt across provincial boundaries, but said it is possible - although there are times when children need to remain in their home province due to connections to their schools, communities and some parts of their birth family.
She also said she believes adoption subsidies should be available to continue counselling and treatments that were available in foster care, but each case is individual and "in these days of funding constraints, it's difficult."
Ontario has more than 9,000 children in permanent care who could be adopted, a number that's been growing over the years. There were slightly over 800 adoptions last year, Lewis said.