Nowhere to turn

Some provinces are sending troubled kids as far away as Utah for rehabilitation

Nowhere to turnAfter months of battling social services to keep her grandson close to their Nova Scotia community, Gloria learned from a voice mail message that she had lost. The recording, left on July 6, informed her that in a few days, the 14-year-old, who has severe emotional and behavioural difficulties, would be sent to a residential treatment facility near Trenton, Ont., more than 1,500 km away from home. Of immediate concern, however, was that she’d have to wait until the next morning to find out how long he’d be gone, or when she’d have to say goodbye.

Gloria has raised Nathan, who was abandoned by both parents, since he was four. Last October, his impulsive behaviour, drug use and habitual running away prompted her to temporarily give up custody, thinking the province “would put him some place where he would get help,” she says. Along with attention deficit hyperactivity disorder, he is suspected of having an alcohol-related neurodevelopmental disorder. But Nathan continued to run and get himself deeper into trouble. Within months, he was shuffled through six placements with foster families and in group homes, and racked up a slew of criminal charges. Nova Scotia determined that neither it—nor she—could meet his needs, and decided he should go to Cinnamon Hills, a private treatment facility in Utah, where it had sent a number of youth with similar issues. When all else fails, provincial governments are often willing to dispense huge amounts of money to ship the most critical cases to residential treatment facilities far from home.

Outraged, Gloria, whose name and that of her grandson have been changed, poured thousands of dollars into legal services to fight the decision, but the judge upheld the ruling. By then, her concern had become about more than the distance: it emerged that a former Cinnamon Hills worker, Joy Lynette Andrews, was facing charges relating to an alleged sexual relationship with a 16-year-old resident. (The 34-year-old pleaded not guilty last month.) Though Nathan didn’t end up going to Utah (he was deemed inadmissible to the U.S.), the alternative of Trenton has left Gloria only marginally less desperate. “He doesn’t need to be going where he’s going,” she says. “That child needs to be loved.” (Days after his arrival in Trenton, Nathan ran away. He was later returned by police.)

Of the roughly 1,700 kids in the care of Nova Scotia’s Community Services Department, more than 98 per cent are placed in foster families and group homes within the province. But for those who require extensive treatment for complex emotional and behavioural difficulties, says Rickcola Slawter, youth duty council for the province’s legal aid, “there’s really nothing here.” Though a long-term residential treatment centre is in the planning stages, funding has yet to be secured. Currently, the only option is Wood Street, a locked-door facility in Truro for short-term stabilization. So for now, when a longer-term solution is required, Community Services casts the net further afield. Last year, 25 youth were placed in treatment facilities elsewhere in Canada and the U.S. Since 2004, 20 kids have gone to Cinnamon Hills. According to Vicki Wood, director of child welfare for the department, the tuition—$114,000 annually—is comparable to that of Nova Scotia programs, but “the range of specialists [at Cinnamon Hills] would far outstrip anything that we could offer here.” As for the allegation of mistreatment, she says, “We have absolutely no knowledge of substantiated abuse,” adding that in child welfare cases, the burden of proof “is much lower than for a criminal test.” And though Wood acknowledges that the 5,000 km between Halifax and St. George, Utah, presents a challenge for families, she insists subsidized visits and regular phone calls can bridge the gap: “It’s the constant and regular contact that’s important, not the distance over it.”

This explanation is not good enough for Bernard Richard, the ombudsman in New Brunswick, which also occassionally sends troubled kids out of the province. Struck by how many complaints he was receiving about inadequate services for kids with complex mental health needs, Richard, who is also the province’s child and youth advocate, dug up the files of seven such cases. His resulting 2008 report, “Connecting the dots,” chronicles the failure of a system that bounced these kids between foster families, group homes, hospitals and jail without providing appropriate treatment. In one instance, a 13-year-old boy was kept in the province’s youth detention centre for several weeks in 2005, not due to committing a crime, but rather because “there was nowhere else to send him.” As a young adult, he was later among three of the seven who were sent to Spurwink, a highly specialized treatment residence in Portland, Maine, where the annual cost of comprehensive services ranges from $125,000 to $500,000 per person. Says Richard, “I fail to be convinced that we can’t do this locally.” The 48 recommendations he came up with push hard for community-based treatment options. The idea, he says, is to give these kids the stability and help they so desperately need—long before they require a half-million-dollar solution.

Gauging the effect on kids of being moved far from home is difficult, but anecdotal evidence suggests it is often significant. John Mould, who is the child and youth advocate in Alberta, says youth in care sent from Nunavut and the Northwest Territories, where treatment options are scarce, can “feel like they’ve been forgotten. They don’t know how and when they’ll get home.” While Alberta almost never resorts to out-of-province placements for its own kids, the distance between rural communities and treatment programs can lead to similar feelings of isolation.

According to Moncton psychologist Charles Emmrys, this is “a ridiculously expensive system that does not work.” He calls the widespread practice of removing the most damaged kids from their communities “a quiet crisis,” and is part of a small group of advocates pushing for a different solution. That facilities, rather than families, remain the default placement for those who are most at risk is, he says, “one of the greatest injustices in society right now.” In an impassioned plea to a New Brunswick government-commissioned mental health task force earlier this year, Emmrys argued instead that placing professionals in communities, investing in biological families, and significantly increasing the support—and compensation—foster parents receive would be “revenue neutral at worst.” But more importantly, he says, it’s what’s been proven successful. Unlike residential facilities, which effectively sentence kids to a life in institutions, the family model, though considerably more “messy,” gives them the continuity and connectedness they need, he says. “The ‘there is no place’ argument is simply an attestation to the fact that planners did not do their work.”

Still, the reality of just how difficult it is to access children’s mental health resources on their own means that some families would jump at the chance to have the province seek out treatment for their son—even it required sending him to Utah. In the course of her legal aid work, Slawter routinely hears from parents who’ve pressed charges against their own child, believing that “if they bring him before the court, he can be ordered to get treatment.” Ian Manion, executive director of Ontario’s Provincial Centre of Excellence for Child and Youth Mental Health, says that because resources are in such short supply “right along the continuum,” early intervention is rare. And despite the best intentions of child welfare, by the time kids’ mental health issues are identified, many have already turned to drugs or become tangled up in the criminal justice system. The effect: “You’re constantly dealing with the deepest end of the pool, which is the most specialized, most expensive way of doing business,” he says.

For most of Nathan’s life, his grandmother has been fighting for him. At two, Gloria spotted him on the side of the road, in the arms of a stranger. “I stopped that car and jumped out,” she says. Apparently, his father had handed him over and walked off—as it turned out, for good. And when his mother, who had taken him to live in Vancouver, lost custody, Gloria ran up her phone bill “so high I couldn’t afford it,” she says, “but I found my grandson.”

However, when she finally got word from social services that he would likely be in Ontario for a year, it was her emotions, not mettle, that came to the fore. “When he comes back, we’re all strangers,” she says. “It’s really sad for this child.”

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