Report: Texas foster kids left in state psychiatric hospitals for weeks or months
Austin American-StatesmanMar 08, 2019
Nearly 600 foster kids in fiscal year 2017 spent a total of almost 14,000 days in psychiatric hospitals after doctors said they were ready to leave, according to a new report by
The consequences can be serious. While psychiatric hospitals provide medication and treatment, they can also be dangerous places where kids are assaulted by other patients or, sometimes, staffers.
Meanwhile, foster youth forced to remain hospitalized after they're stable sometimes become frustrated and revert back to their old behaviors, such as becoming violent or trying to hurt themselves. In one case examined by Disability Rights, a teen girl who had been waiting for a place to go for three months became so agitated that she was restrained 14 times and given emergency medication 16 times.
All this extra time in hospitals costs money. In fiscal year 2017, the state spent
"These are kids that are being removed from society and forgotten about," said
Officials with the
"If ever there was an issue that belonged to all of the state, its public and private sectors, it's this one," he said.
DFPS has hired seven caseworkers who specialize in working with children in psychiatric hospitals and assigned additional staff to find placements for youth once they leave the mental health facilities. The agency is also constantly working with residential treatment centers to add more beds, which have decreased in the last year, Crimmins said.
Officials say their efforts are paying off. In
Rep.
"It appears there are issues every step of the way here that need to be addressed," she said.
The problem of foster kids being stuck in psychiatric hospitals is not new. Fourteen years ago, a Statesman investigation showed that between
The agency has struggled in the past with having to temporarily house foster children in state offices because there was nowhere else to put them.
Nowhere else to go
When foster children go into crisis, sometimes trying to hurt themselves or others, they are sent to psychiatric hospitals to be stabilized. The average stay is generally five to seven days, according to the Disability Rights report.
But some kids end up in hospitals for months after doctors say they can leave.
Sometimes it's because there isn't space for them at appropriate, less restrictive facilities. Sometimes it's because the foster parents or centers who admitted the kids to the hospital won't take them back after they're discharged, said Disability Rights attorney
"
In September, DFPS began requiring residential treatment centers to take back any hospitalized youth once they were discharged, Crimmins said.
But Disability Rights blames much of the problem on DFPS, saying state caseworkers often send kids to psychiatric hospitals without looking for less-restrictive alternatives. Caseworkers are supposed to meet with these foster children weekly and often do not, the report states. In some cases, the caseworkers never meet the kids in person, relying solely on phone calls.
A lack of placements isn't the only thing slowing down foster kids' timely release from psychiatric hospitals, Disability Rights says. DFPS caseworkers often fail to arrange for psychological evaluations until after a home is found, sometimes delaying the move for weeks.
High employee turnover at the department is also a problem for foster youth in psychiatric hospitals, Disability Rights says. When people leave, it takes time for new caseworkers to catch up, slowing down the process.
Crimmins said blaming the agency's caseworkers won't fix the problem.
"Anecdotal criticism of our caseworkers is easy to do, but doesn't really contribute to solutions," Crimmins responded.
Hospital dangers
While psychiatric hospitals provide necessary services, they can be dangerous, Mitchell said. In recent years, mental health facilities across the state have had serious problems.
The
Being forced to stay in psychiatric facilities longer than necessary can take a negative toll on foster kids, said
"They're around kids that are acting out, which may cause them to act out," Bryan said.
Keeping foster children longer means there's less room for others who need help, she said. Clarity has been working with DFPS to move kids out of the facility faster.
"DFPS has been trying case by case to try to help fix this but we still have a lot of work to do," Bryan said.
One solution is to keep kids out of the hospital in the first place by using and creating more community-based services for youth with severe mental health issues, Mitchell said.
Meanwhile, doctors screening youth for admission at these facilities should be psychiatrists, the Disability Rights report states. More than half of the doctors who completed the admission assessments reviewed by the advocacy group were internists, family doctors, anesthesiologists or practiced in other unrelated fields.
"We think there are ways we can keep them from going into hospitals in the first place," Mitchell said. "Then they would never get stuck there."
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