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Still No Answers to Lawmakers’ Questions About Children Stuck in Psychiatric Hospitals

Years after a ProPublica Illinois investigation revealed children in state care were being held in psychiatric hospitals beyond medical necessity, officials still haven’t addressed it. “This has not gone away,” said one state senator.

Lydia Fu for ProPublica

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In a hearing Monday, Illinois lawmakers pressed officials with the state’s child welfare agency to answer the same question they asked two years ago: What is the agency doing to find homes for the growing number of children stuck in psychiatric hospitals after they have completed treatment?

The questioning followed reporting Friday by ProPublica Illinois that the number of children in state care held in psychiatric hospitals after being cleared to leave has continued to increase, even though the state vowed to fix the problem in 2018.

The rise began in 2015, when the number of psychiatric hospitalizations that went beyond medical necessity reached 246, from 88 the year before, ProPublica Illinois found. That number climbed to 301 in 2017. During the most recent fiscal year, which ended in June, it rose again, to 314, according to the Cook County public guardian’s office.

“This has not gone away,” state Sen. Julie Morrison, a Democrat from Chicago’s northern suburbs, said during Monday’s Senate Human Services Committee hearing. Morrison, who chairs the committee, said after the hearing that she hasn’t seen any progress even though the agency has known about the problem for years. “It’s completely frustrating,” she said.

“I know this is a difficult population, but this is the mission of this department — to help those children — and they’re not,” Morrison said. “The cost is human lives. Those children, some of them are really young, will never recover from what we are putting them through.”

The chief deputy director of the Illinois Department of Children and Family Services, Derek Hobson, told lawmakers the agency’s clinical team reviews each child’s case in detail and has attempted to find them homes but has run into obstacles.

DCFS has looked for creative solutions, from federal legislation that focuses on prevention and early intervention to community-based services, in hopes of addressing the persistent issue, Hobson said. The challenge has been compounded in recent months by an increase in the number of children who have entered state care just before or at the time they are cleared for discharge, he said. That number has grown, Hobson said, as resources have diminished.

“This is challenging for us as a state,” Hobson said. “I’m not going to sugarcoat it. ... We’re struggling with it on a daily basis.”

The loss of hundreds of beds at residential treatment facilities and the loss of more than 2,000 foster homes in the past several years also has left the agency with far fewer placements for children, an agency spokesman said last week.

Cook County Public Guardian Charles Golbert, who filed a class-action lawsuit in late 2018 on behalf of some of the children, said the youngest child held during the last fiscal year was a 3-year-old girl. On average, children spent at least 50 days at psychiatric hospitals beyond medical necessity, he said. The lawsuit is pending, and DCFS has said that the children are covered by a federal consent decree.

Hobson said DCFS is working to expand the number of foster homes, including those that provide more specialized care. The agency also is looking for ways to increase placements at group homes and institutional programs. Thirty-six children are currently waiting at psychiatric hospitals for DCFS to find them a place to go, the agency said Monday.

In June 2018, ProPublica Illinois published an investigation that revealed hundreds of children in state care were confined in psychiatric hospitals after they completed their treatment. In response, lawmakers called a hearing two months later, during which doctors and other experts testified that children suffered emotional and mental distress during the weeks or months their release was delayed. One doctor said some patients attacked their peers or employees as a way to get out of the hospital, even if it meant going to jail. Some children reported being abused at the hospitals as they waited to be placed.

During Monday’s hearing, state Sen. Sara Feigenholtz asked what the agency is doing to recruit foster parents for the children, many of whom have complex mental and physical health needs.

“Whatever is going on, it’s not working,” said Feigenholtz, a Chicago Democrat. “It didn’t work before COVID. It’s not working during COVID.”

Both Feigenholtz and Morrison said if the agency has a plan to reduce the number of children held in hospitals beyond medical necessity, they have yet to see it. Feigenholtz said she wants the agency to establish benchmarks on moving the children out of the hospitals and increasing specialized foster care, then report back to legislators.

“It feels like inertia, and the inertia is stunning,” Feigenholtz said after the hearing.

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