Four years after settling a class-action lawsuit over its care for children with mental health needs, the state Department of Children and Families has revised its procedures to keep hundreds of children from being shunted into institutions, jail or hospital emergency rooms, officials and advocates say.
“It was too hard to access services before,” said Bert Plant, director of community programs for DCF. “We are avoiding arrests and ER visits now.”
State Child Advocate Jeanne Milstein: ‘One of the worst things you can do is have a child lose that family connection or take them away from their community. That has changed.’
In a 2002 class-action lawsuit, plaintiffs’ lawyers said DCF failed to provide mental health services to children living at home or in foster care. The lawsuit and a report issued the next year documented cases of children being arrested, physically restrained and drugged because they did not receive appropriate care in a timely fashion.
“DCF has a long history of having difficulty serving children with mental health needs,” said Anne Louise Blanchard of Connecticut Legal Services, the lead attorney for the plaintiffs in the class-action suit. “Instead of bringing the same suit year after year for individual clients, we decided to do systemic change and hopefully fix this for good.”
The 2007 settlement of the lawsuit required DCF, among other things, to make it easier for clients to access mental health services and to intervene earlier and more often when mental health issues arise.
Before the settlement, DCF got about 5,000 calls a year requesting help for a child with mental health needs–a number that Plant says didn’t make sense.
“We knew more children were ending up in the emergency room in crisis,” he said.
Under terms of the settlement, DCF made it easier to find help by allowing children and their caregivers to reach Emergency Mobile Psychiatric Services through the 2-1-1 social services hot line number. Over the last four years, the number of calls for mental health assistance has increased from 5,000 a year to almost 12,000.
DCF workers also respond more frequently to calls for assistance. Workers used to visit only about 60 percent of the homes from which calls were received; they now respond to about 90 percent of all calls.
“It’s hard to assess services that are needed when you’re not there in person,” Plant said. “If the family feels it’s a crisis and calls then we try to respond in person to prevent more serious issues down the road.”
“They have much faster and better responses now when someone reaches out for help,” Blanchard said. “We just hope now that this is over and that they continue this approach.”
One holdup could be money, as this overhaul cost the state $8.3 million over two years. Now that the settlement has been fulfilled DCF is under no obligation to continue spending this money. Plant said the Department is committed to continuing these programs not only because they ensure better care for these children but it’s also cheaper to keep children in the community than placing them in expensive institutions.
The lawyers and Child Advocate Jeanne Milstein said the problems for children with mental health needs in DCF custody ran much deeper than just identifying what care was needed, which this new strategy fixed.
“There was an extraordinary reliance on longterm and frequently ineffective institutionalization,” said Milstein. “Well certainly that thinking has changed. This [settlement] was a very necessary catalyst for change.”
“The continuum of services just weren’t there before,” said Catherine Williams, a co-counsel in the class-action suit. DCF “didn’t have the opportunity for them to remain in the community which ultimately gives them a much better shot at life then just parking them in an institution.”
DCF agreed in the settlement to have a total of 45 therapeutic group homes to ensure there were some other options for this population besides sending them to a psychiatric hospital. These group homes were aimed at providing specialized treatment for these children in neighborhood settings.
“There were only the extreme placements before,” said Blanchard of the choice between institutional placements or remaining in a foster home with little to no services available.
Because of this settlement, DCF reports the total number of children now receiving services in the community has, “increased substantially.”
In the final report on the mental health services provided by DCF, the consultant hired to oversee the settlement said of the 356 children that have gone through this new program, 88 percent were able to remain in community-based placements.
“There is a substantial population of youth who can benefit from community based service plans,” wrote Robert B. McKeagney, the consultant. “This [settlement] has established a durable process that, while not entirely embedded in DCF policy and culture, should be continued and strengthened.”
McKeagney wrote this settlement created a “streamlined process that certainly encouraged an increased volume of referrals” for children to receive the a la carte programs for specific needs to avoid their child ever needing to leave the home in the first place.
Milstein agrees, saying children with mental health needs are now in a better situation because they are able to receive services at home or nearby in a community setting.
“One of the worst things you can do is have them lose that family connection or take them away from their community. That has changed,” she said.