Tracey feared for her safety from her 15-year-old son’s violent aggressive behavior.
Tracey, who asked that her full name not be used, had been in and out of the emergency room 12 times with her son after failing to find appropriate services to help him.
A short-term placements at the Albert J. Solnit Children’s Center, a psychiatric residential treatment facility that is part of Department of Children and Families, helped but continued mental health services were delayed when he came home, causing him to regress, Tracey said.
“I don’t expect my child to be miraculously cured of his mental illness by any one service or program but when they have been admitted to psychiatric inpatient 12 times, psychiatric residential treatment facilities four times, six-month intensive in-home services five times, multiple therapeutic extended day treatment programs, two intensive outpatient programs and being moved between several therapeutic schools we must question ‘the system,’” Tracey said. “I have called DCF on myself begging for support only for them to refuse to open a case because they have nothing more to offer.”
Tracey said she had to advocate for her son to be readmitted after months without adequate mental health services at home.
Mental health resources for children are lacking across the state, several child protection attorneys and advocates for children have told the Courant, and children in the state’s welfare system. Child protection attorneys said there are long wait lists to get children into mental health programs, which impact their ability to recover, often leading to escalating behaviors and longer stays in shelters for problematic behavior.
The need for more mental health providers is a systemic problem and therefore the legislature and DCF must find a way to increase meaningful supports for children, advocates and lawyers say.
“High-profile tragedies as well as findings from recent state and federal audits on the unmet needs of children in state custody raise serious concerns that the state is not investing the resources to fulfill its legal obligations to abused and neglected children,” said Sarah Eagan, executive director of The Center for Children’s Advocacy. “Children have a legal right to be protected from abuse and neglect; they have a right to appropriate care in state custody; and they have the right to treatment in the community and not be forced into shelters and hospitals.”
A state audit released this past summer found an increase in children missing from DCF care between 2021 and 2023.
The audit found that DCF did not “perform formal assessments of common risk factors or plans to address children who go missing from care.” Further, the audit said that DCF did not meet the clinical needs of multiple female teenagers whose records were reviewed by auditors.
The federal audit of Connecticut’s system last year found that only 41% of children’s mental health needs were met.
The Office of the Child Advocate reported in its child fatality review of 2-year old Liam Rivera that reviewers found that “while DCF case plans typically identified appropriate services needed for family (90%), only 49% of cases included documentation that the identified service was actually delivered to the family during the review period.”
A DCF spokesperson said that Connecticut has an extensive array of behavioral health services for children which are delivered by nonprofit providers who are supported by state funding and/or fee-for-service.
“Any child and family is able to access this system of care,” the DCF spokesperson said. “That does not mean that all children and their families have had their service needs met. We continually work with our providers and other stakeholders to identify service gaps in order to better respond to the needs of children and their families.”
DCF also said that, similar to jurisdictions across the country, “Connecticut is experiencing a workforce shortage for community-based services especially in areas such as behavioral health.
“The inability of a program to be fully staffed directly impacts their ability to provide in-home and office-based supports to meet the complex demands of today’s children and families and therefore, waiting lists for services may occur,” DCF said.
DCF said further that wait times for access to behavioral health services can “vary depending upon the type of program, provider and location.”
The Children’s Committee is proposing legislation focused on reforms to the Connecticut Department of Children and Families prompted by the alleged fatal abuse of an 11-year old New Britain girl discovered by police last October.
Jacqueline “Mimi” Torres-Garcia’s death, which Chief Medical Examiner Dr. James Gill ruled a homicide, coupled with a state audit released this past summer that found an increase in children missing from DCF care, has prompted lawmakers to propose legislation focused on transparency, permanent guardrails and supervisory review of the agency, according to lawmakers familiar with the proposed legislation.
“It exasperates what is already a difficult situation”
Ingrid Swanson, a staff attorney at New Haven Legal Assistance, said there are not enough mental health services for both children and parents.
The challenge oftentimes is finding the next level of care for children to provide more comprehensive intervention.
Swanson described one of her clients, a 4-year-old, who had significant behavioral problems. He was first placed with a therapist who was not equipped to meet his needs, according to Swanson.
“But the problem has become the wait list for the next level of care, something that can provide more comprehensive intervention is six to nine months,” she said. “Six to nine months is nearly a quarter of his life.”
Swanson said in such situations, the child is going to continue to struggle over the next six to nine months with trauma issues and separation from his parents, which could lead to an emergency room stay and disruption of placement.
“These are the kinds of things we see,” Swanson said. “It exacerbates what is already a difficult situation. I will compliment DCF. They do work hard to find the resources and sometimes it is out of their hands. DCF needs a greater network and to ensure its accessibility to mental health providers that can support the kids its responsible for.”
Swanson said she has had many cases in which youth who were in a relative placement and could not be supported adequately ended up in the emergency department. From there, they went to a shelter, which was supposed to be a short-term stay, but ended up being nearly a year.
In another case, she saw a child with specialized needs who was in the hospital for a long period and was discharged with a 30-day supply of medications.
“In those 30 days, despite the best efforts of the parents and DCF, there is no psychiatrist to be found to continue the medications,” she said. “He runs out of medications, a terrible circumstance which likely snowballs to potential increased mental health and behavioral issues and likely more hospitalizations.”
‘Out of their hands’
Rachel Levine, a family and juvenile law attorney, said DCF is working very hard and that the lack of adequate mental health services might be out of their hands.
“DCF needs to get more funding and to find more services,” she said.
Eagan said that DCF’s budget has suffered, losing roughly $150 million since 2010 but still opening 30,000 cases a year.
Levine said inadequate mental health services in the system have negative impacts on children, who often “don’t have the resources or the coping skills or become involved with the juvenile justice system. Behavior led to bigger consequences because they couldn’t get the help they needed.”
Levine described a case of a girl who had significant behavioral needs because of her intellectual disability and the parents said they couldn’t be safely at home with her. She was transferred to a STTAR (Specialized Trauma Informed Treatment Assessment and Reunification) program. DCF refers to STTAR homes as “a last resort for youth when all other placements have been unsuccessful or haven’t met the youth’s needs.”
Levine said she was advocating for the girl to get into a therapeutic group home instead of a STTAR home but it was a battle between the expectations of the therapeutic group and insurance.
“We had to fight for six months to get back into the school,” she said.
She shared another case of a 16-year old autistic child who had severe trauma and was sent to a group home with mental health services.
He was unable to return to a relative’s foster home, she said, because DCF “was not able to come up with the resources to do wrap-around care.
“There are so many hoops to jump through and if you do qualify, you need to meet so many specifications,” she said. “We need to fix the mental health crisis by addressing the lack of services for children in Connecticut.”
Dana Simoni, a child protection attorney, said from a service perspective, the mental health services are abysmal.
“There are wait lists for everything,” she said. “I had a case recently where a parent was trying to get a child into individual behavior therapy. The earliest intake this mother could get at one of the primary facilities that do therapy was a two-month waiting list to get an intake.”
Simoni said she is seeing cases of significant mental health issues, drug use and domestic violence and neglect.
“The mental health issues for children are happening at an earlier age and for parents, mental health cases are more acute,” she said.
She said prior to 2012 there used to be more residential facility group homes.
“The department has done a better job of keeping kids with their families,” she said, but she added it is important to recruit core foster parents.
DCF said its rate of removal is 30% below the national average. Further, approximately 50% of youth in Connecticut are placed with relatives or close family connections, compared to a national average of about 35%, DCF said.
“The national average for placement with kin is approximately 35% and Connecticut is recognized as a leader across the country in this area of practice,” a DCF spokesperson said. ”Across the country, there is a shortage of non-kin foster homes which makes searching and supporting kin an even greater priority. In order to recruit and retain more non-kin homes, DCF is working with a national organization and two Connecticut based organizations to develop a comprehensive recruitment and marketing plan to attract more families into the system.”