Almost one in four tamariki and rangatahi in state care don't feel they can contact their birth families as much as they would like to.
The finding is from a Oranga Tamariki survey of more than 1500 children in care.
The survey, Te Tohu o te Ora, is the first of its kind for the ministry and will be carried out annually. It is set out in the report Te Mātātaki.
Ebony Flemming was taken into care at the age of five with her brother, and is now studying social work at university.
She said going into care was exciting at first because her birth mother said the siblings were going on holiday.
As time went on, the excitement faded into sadness.
"Just feeling alone and disconnected from especially my biological mother," she said.
"I did feel unsafe at some points because of course we were living with strangers for quite a few years."
She said Te Tohu o Te Ora was a good way to ensure voices like hers were heard.
Results of the survey offered some positivity.
Almost all respondents said they had people in their life who loved them, and most felt settled where they lived.
But there was also concerning feedback.
Dislocation from birth whānau was a common theme, with almost one in four saying they were not able to stay in touch as much as they would like.
Two in 10 did not feel they had a stake in big life decisions, and almost three in every 10 were not sure of a good future.
That was not a shock to Tahirah Moton who spent her adolesence in state care.
"One of the things that you are primarily concerned about when you are in care is just surviving," she said.
"You don't really have any capacity to be hopeful and to be imaginative, which is really a failing of the system."
Disparities for Māori and Pacific tamariki and rangatahi were also clear.
They were less likely to feel comfortable speaking to a social worker about what made them unhappy.
Moton said Oranga Tamariki needed to make sure it was actively listening to every young person in its care.
She said those voices needed to be acted on, and young people needed to be included in building a system they could belong in.
Oranga Tamariki spokesperson Kiri Milne said that was exactly what the ministry wanted to do.
She said the survey is just one way to get there, and that Oranga Tamariki had additional means of including young voices.
It included an independent advisory group, research and design projects with young people and working closely with the advocacy group, Voyce Whakarongomai.
"We firmly believe that it's critical that we are hearing from those current and previous lived experiences of the care system.
Oranga Tamariki has identified six priority areas for action as a result of Te Tohu o Te Ora.
Those include supporting whānau contact, enabling Whānau participation in decisions, and strengthening social worker relationships.
It also wanted to provide young people with the opportunity to learn about their whakapapa, support them to have confidence in their future, and improve experiences for tamariki and rangatahi who identified as both Māori and Pacific.