Introduction: Youth in foster care face greater rates of trauma and subsequent mental health challenges (Bruce et al., 2009; O’Neill et al., 2012; Seltzer et al., 2012; etc.) that place increased burden on their caregivers (Daniel, 2011; McKeough et al., 2017), suggesting that these specific groups of youth in foster care may be difficult to place with suitable caregivers. From a child welfare research perspective, discovering ways to support caregivers to better support these youth may help decrease placement stability challenges for youth in care. More research is needed to determine what child and foster caregiver characteristics may contribute to placement stability trajectories for youth with behavioral problems and/or emotional disabilities. The present study aims to examine the interplay of youth mental health, placement stability and the role of the foster family for youth in care using an existing data set. Methods: Data in the parent study were collected on 328 youth (164 sibling dyads) in foster care in an NIMH funded RCT (Kothari et al., 2017) and included information on various behavioral problems and/or emotional disabilities, number of placement changes in the system, feelings of integration in the foster home, relationship to current caregivers, and demographic caregiver characteristics. The present study conducted a secondary analysis of a subsample of this dataset. Results: Results from this investigation suggest that youth who experience more behavioral and/or emotional problems/disabilities (i.e., depression, PTSD, aggression, ADHD, etc.) experience more frequent placement disruptions than youth who have fewer. In preliminary findings, youth identified as difficult to place indicated no differences in youth reported feelings of home integration when compared to youth not identified as difficult to place. Results also suggest that relationship to caregiver (e.g., kinship/stranger) is associated with D2P scores, and caregiver education is associated with D2P scores for older siblings only. Conclusion: Youth in care who experience behavioral and/or mental health problems are more likely to experience placement disruptions than youth who do not, and there are child and family factors that are critical to understand. Future research should continue to explore these factors because these findings have important practice and policy implications.