Press Release

Children and caregivers in “Grandfamilies” at Acute Risk for Mental Health Challenges

New report finds grandfamilies face heightened mental health crisis due to layers of trauma and less access to mental health services

Children and caregivers in “Grandfamilies” at Acute Risk for Mental Health Challenges

New report finds grandfamilies face heightened mental health crisis due to layers of trauma and less access to mental health services

WASHINGTON D.C. (November 8, 2023) — Children who have faced traumatic loss or traumatic situations which led to them growing up in families without their parents are particularly susceptible to experiencing mental health concerns. Additionally, gaps in America’s social safety net make it harder for these children to receive the care they need, according to the 2023 “State of Grandfamilies” report from Generations United. The report, Building Resilience: Supporting Grandfamilies’ Mental Health and Wellness, outlines the reasons grandfamilies have mental health concerns yet have more trouble accessing mental health services and supports for both children and their caregivers due to lack of availability, lack of legal authority, and limited understanding of grandfamilies’ needs among providers, cost, stigma, and ageism. This situation has been exacerbated by Covid-19, racial violence, and opioid use, the report found. 

“The mental health crisis affecting America’s youth today is felt in every corner of the country, but children who are growing up without their parents are at heightened risk of both suffering from past experiences with trauma and falling through the gaps in our nation’s safety net and healthcare system. Neither outcome should be acceptable,” said Donna Butts, executive director of Generations United. “Policymakers at every level must ensure that children and their caregivers in grandfamilies can get the help and support they need to grow up healthy and reach their full potential. When their mental health needs are addressed, both children and caregiver stress goes down and long-term outcomes improve.”

At least 2.4 million children in the United States are growing up in “grandfamilies,” also known as kinship families, where grandparents or other relatives or family friends care for children who are separated from their parents. The events that precipitate the formation of grandfamilies — such as parental death, substance use disorders, incarceration, or deportation — leave those children especially vulnerable to feelings of stress, anxiety, or depression. Nearly 30% of children in kinship care have previously experienced neglect, while more than 10% have experienced physical abuse. Research shows that grandfamilies offer children more stability and safety than non-relative foster care and can help mediate trauma.

Caregivers’ mental health is also impacted by unexpectedly becoming “parents” to their grandchildren, nieces and nephews, minor siblings, or family friends. The stress they experience in dealing with the often traumatic situation that led to the formation of their new family structure, plus added caregiving responsibilities, may cause them to live with chronic stress that impacts mental health. When they get access to mental health care, it positively impacts both them and the children in their care.

The report details challenges unique to grandfamilies that have been worsened by the pandemic, increased racial violence, and the opioid epidemic: 

  • A survey of more than 600 grandfamily caregivers found that mental health challenges and counseling were among the top issues for children in their care during the Covid-19 pandemic when there was a drastic decline in the availability of in-person support groups. 
  • Black, African American, American Indian, and Alaska Native children are more likely to live in grandfamilies than the general population.
  • Forty percent of grandfamily caregivers cited parents’ substance use as a reason for caregiving, compared to 21% in 2002; and the states with the highest percentages of grandparents raising grandchildren also have the highest opioid prescribing rates.

“The resilience of grandfamily caregivers can mediate the impact of prior trauma the children have experienced. That’s good for children and the communities where they live,” said Butts. “By providing grandfamilies with a seat at the policymaking table, we can be sure the needs they identify are met and make a critical difference in their lives.”

Among a series of recommendations, the reports urges policymakers to:

  • Increase access to affordable, quality, trauma-informed mental health treatment, and training for youth and caregivers in grandfamilies.
  • Ensure basic needs of grandfamilies/kinship families are met to address chronic stress and allow them to prioritize mental health and wellness.  
  • Provide health care, mental health, and educational providers training and resources on issues related to grandfamilies.
  • Increase access to quality and culturally appropriate services in schools.
  • Develop and implement mental health outreach and communication strategies tailored for grandfamilies.
  • Encourage kinship navigator programs to develop strong relationships and coordinate services with mental health providers.
  • Collect national data on mental health indicators, including adverse childhood experiences (ACEs), for children in grandfamilies.
  • Research the impact of chronic stress and community violence on grandfamilies’ mental health.
  • Encourage states to use opioid settlement funds to support grandfamilies mental health and wellness.



For more than three decades, Generations United’s mission has been to improve the lives of children, youth, and older adults through intergenerational collaboration, public policies, and programs for the enduring benefit of all. We have been the catalyst for policies and practices stimulating cooperation and collaboration among generations, evoking the vibrancy, energy, and sheer productivity that result when people of all ages come together. Critical to our mission, Generations United has two initiatives to support kinship families: its long-standing National Center on Grandfamilies, and the Grandfamilies & Kinship Support Network, which is the first-ever federally supported national technical assistance center on the families, run in cooperation with the U.S. Administration for Community Living. Learn more at and