Millions of American children have lived with people affected by substance use and mental health challenges. About 1 in 12 children have lived with someone with a mental health challenge, and about 1 in 12 children have lived with someone affected by substance use.

Parental behavioral health issues are a common risk factor in child welfare. Of the children who enter foster care, about 2 in 5 have parental substance use listed as a concern. But most families with these issues care for their children safely without child welfare involvement. Often these families receive support from kin and through community or faith-based support systems.