A task force created by state lawmakers will examine whether the Department of Children and Families (DCF) should be prohibited from requiring that parents give up custody of their children in order to access mental health and other services, under legislation signed by the governor. The newly formed panel, which is charged with reporting its recommendations by Feb. 1, 2018, will study whether state statutes should be amended to prohibit DCF from requiring or requesting that a parent or guardian of a youth admitted to DCF on a voluntary basis terminate his or parental rights or transfer custody in order to obtain services. The task force also will study ways of increasing families’ access to voluntary services without making parents relinquish custody of their children. The legislation creating the task force was prompted by recent stories by C-HIT that detailed a practice known as ‘trading custody for care,’ in which parents who cannot meet their children’s severe behavioral health needs in a home setting are subject to “uncared for” petitions that turn their children over to DCF custody.
Last May, Samantha Collins’ drug use, legal problems and dealings with the Connecticut Department of Children and Families forced her to strike a bargain with the agency. In return for allowing social workers to come into her home three times a week to help her stay off drugs, improve her parenting and learn the practical skills needed to function as an adult, DCF would not remove her children. The 26-year-old Somers mother of 2- and 7-year-old boys entered Family-Based Recovery, a program created 10 years ago by DCF, the agency better known, perhaps, for separating families than working to keep them together. Family-Based Recovery, or FBR, is an example of DCF’s dramatic reversal in philosophy and practices, after years of a policy approach based largely on removing children thought to be at risk and placing them in congregate care facilities. “‘Pull and ask later,’” said Kristina Stevens, a former DCF social worker who is now administrator of the agency’s Clinical and Community Consultation and Support Division, which includes a fast-growing array of in-home treatment programs.
As recently as 2011, nearly 1,500 children and youths were separated from their families and were living in 54 group homes and other treatment centers in and out of Connecticut.
The legislature’s Committee on Children has proposed creating a task force to study the state’s so-called “custody for care” controversy, in place of a bill that would have barred the Department of Children and Families (DCF) from pushing parents to relinquish custody when seeking inpatient mental health treatment for their children. If approved, the task force would study the issue of why DCF takes over custody of children in some cases in which parents cannot meet their children’s severe behavioral health needs in a home setting. C-HIT has reported that the state uses “uncared for/specialized needs” petitions to take children into DCF custody in cases where parents argue for inpatient treatment or refuse to take their children home from hospital emergency rooms, for fear they will harm themselves, siblings or others. While DCF officials have said that custody relinquishment is used rarely, judicial department data show the state has used the petitions to take custody of more than 860 children over five years – or an average of three children a week. A bill drafted by state Rep. Rosa Rebimbas, R-Naugatuck, prompted by an October C-HIT story, would have prohibited DCF from “requesting or requiring” that parents relinquish their custodial rights when seeking specialized mental health treatment for their children.
The state’s efforts to direct children in mental health crisis away from emergency rooms, to other services, have fallen short, with major hospitals reporting staggering increases in patient visits since 2013: Up 32 percent at Connecticut Children’s Medical Center, and 81 percent at Yale New Haven Hospital. The children’s hospital (CCMC) reported nearly 3,300 visits last year – 275 a month, on average — with the average length of stay increasing to 15 hours from less than 12 in 2013. “I wish I could say we had made a lot of progress, but we haven’t,” said Dr. Steve Rogers, medical director of the emergency department’s (ED’s) behavioral health unit. “Unfortunately, I think it’s only going to keep trending this way.”
Similarly, Yale saw ED visits by children ages 15 and younger rise from fewer than 750 in 2013 to more than 1,350 in 2016 — and the numbers are running even higher this year, said Dr. Claudia Moreno, medical director for psychiatric emergencies in Yale’s children’s emergency department. At times, she said, all ED beds are full, and children wait on hallway gurneys.
The state has taken custody of more than 860 children since 2011 because their families could not access or provide “specialized care” for their mental health or physical conditions, according to judicial department data.
Ten years have gone by, but Lisa Vincent and her son, Jose, flash back to their goodbye with fresh anguish and faltering voices. He is 21 now, but the 11-year-old boy he was back then easily re-surfaces, all anger and confusion. “I didn’t understand. I was under the assumption I was going back to her,” Jose says. “For a long time, I felt that whole ‘she gave up on me like everyone else did.’ Now, I realize it wasn’t her.
A new report that identifies the most distinctive cause of injury death for each state, compared to national rates, has some findings that might be expected:
Seven states in Appalachia and the Southwest, for example, had unintentional firearms deaths roughly two to four times the national rate. Those states have high gun ownership rates and lack safe-storage laws. Three states – Montana, South Dakota and Nebraska – had as their most distinctive injury motor vehicle crashes involving passengers. Four safety provisions – primary seatbelt laws, mandatory key ignition locks for drunk drivers, booster seats, and nighttime driving restrictions for teens – are absent in Montana, while South Dakota and Nebraska have only one each. Connecticut had as its most distinctive cause of injury death “unintentional suffocation” – the only state with that outlier cause.
Connecticut has made strides in identifying and helping children who have experienced trauma – with more than 50,000 undergoing trauma screenings since 2007 – but more must be done to ensure all children’s needs are met, according to a report released today. Those who work with at-risk youths have placed a growing emphasis on providing trauma-based care, with some encouraging results, according to the Child Health and Development Institute’s (CHDI) Impact report titled “Advancing Trauma-Informed Systems for Children.”
Giving trauma-informed care means professionals – such as child welfare workers, behavioral health specialists, those in the juvenile justice system and pediatricians – are knowledgeable about childhood trauma, its warning signs and its repercussions. While many children in general are exposed to at least one traumatic event, trauma disproportionately impacts the lives of children involved with services such as juvenile justice and child welfare, according to CHDI. Thanks to efforts statewide since 2007, according to the CHDI report:
• More than 8,600 professionals have been trained to understand childhood trauma. • At least 35 community agencies or programs at 79 sites have implemented trauma screening.
Tens of thousands of Connecticut infants and toddlers are at risk for social and emotional problems, and the professionals who interact with them most need mental health training in order to help them, according to a report released this week. Children who live in poverty, are homeless or have suffered abuse or neglect are among those most likely to experience trauma at a young age, according to the report by the Child Health and Development Institute (CHDI) of Connecticut, and the key to helping them is providing the right support. “There is a tremendous opportunity to improve children’s lives by promoting a child’s secure attachment with a caregiver from the beginning,” said Judith Meyers, a psychologist and president and CEO of CHDI. “Professionals who care for young children are in the unique position to help families develop nurturing relationships.”
The nonprofit institute suggests that all doctors, teachers, early care providers and others who work with infants and toddlers in Connecticut be trained in infant mental health. Helping children process and cope with trauma early is essential to their future success, said Melissa Mendez, co-lead author of the report and associate director of early childhood at the Wheeler Clinic in Plainville.
The state Department of Children and Families will increase oversight and services to families with parental substance abuse, mental health and other problems who are identified at “highest risk” of a young child dying, the agency announced Monday. The move comes as Connecticut grapples with a high number of child deaths, outlined in a recent report by the state Office of the Child Advocate (OCA). In the report, OCA found that DCF’s response to “at-risk infants” was often insufficient, showing “gaps in risk assessment, treatment planning, case follow-up, and quality assurance.”
DCF said the new effort to target high-risk families came out of its own study of 124 fatalities that occurred between January 2005 and May 2014 of children ages three and under in families with some DCF involvement. The study findings are “prompting changes that will pinpoint families with the highest risks and increase oversight and services for these families,” the agency said in a statement. The study, which compared cases in which a child died to a control group, found that fatalities were less likely when DCF had conducted comprehensive assessments of parents’ needs.