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New placement crisis report shows 1 in 4 enter care with high-acuity needs; report featured in Congressional testimony today

New placement crisis report shows 1 in 4 enter care with high-acuity needs; report featured in Congressional testimony today

A survey of county children services agencies revealed that in 2021, nearly 1 in 4 (24%) children entered children services custody primarily because of mental illness, developmental/intellectual disability, or as a diversion from juvenile corrections. A workforce crisis in child protective services and behavioral health care, combined with a shortage of placement options for children with high-acuity needs, has led to children sleeping in county agencies at least one night rather than immediately accessing the services they need.

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The report released today by PCSAO was developed in the wake of concerns from county directors about a rising crisis in finding appropriate, available placements for youth with significant behavioral needs, developmental/intellectual issues and as a diversion from juvenile corrections, said Angela Sausser, PCSAO’s executive director. It comes on the heels of a call by many national organizations for an emergency declaration on children’s mental health, and of a report by the U.S. Surgeon General on a mental health crisis among the nation’s youth.

Sausser will testify on America’s Mental Health Crisis before the U.S. House Ways and Means Committee today at 10 a.m. as one of five invited national experts. “We confirmed just how serious the issue is, and we are issuing a call to action to Gov. DeWine’s Administration and to our system partners at the state and local level,” she said. “Child Protective Services (CPS) has become the system of last resort for any youth whose behaviors require assistance outside the family, regardless of whether the child has been abused or neglected, and our system does not have the tools to serve these youth.”

The survey also showed that a concerning number of youth diverted to children services custody were accused of or committed felonies. “Our agencies are charged with protecting children from abuse or neglect, but in these cases, we are being asked to protect the community from youth with criminal behaviors. We don’t have many foster parents willing to bring young people with a history of violence into their homes,” Sausser said.

While a residential treatment facility is not the preferred option for any child, many of the youth identified in the survey appear to require such placement, at least until their condition can be stabilized. “Staffing shortages in these facilities, brought on in part by the pandemic, mean that many of the centers we turn to are full or lack the expertise to care for these youth with complex trauma, high-acuity, multi-system needs,” Sausser said. “Caseworkers make a hundred calls to find a foster family willing and supported to take such a child or an available bed in a treatment facility, sometimes leaving youth to spend one or more nights at the agency with round-the-clock staffing. It’s simply unsustainable, and it will lead to further trauma for the youth and unsafe conditions for staff and the community.”

Sausser’s Congressional testimony will also highlight how this placement crisis has further exacerbated the children services workforce crisis. “We found that the stress placed on our workforce is compounded by the diversion of youth previously involved in other systems of care who have been increasingly referred to the child protection system,” she said.

Sausser noted that new investments by Gov. DeWine’s Administration and the General Assembly designed to serve multi-system youth are starting to make a difference and that new programs like OhioRISE are on the horizon, but the crisis requires immediate action in addition to these longer-term solutions. “We appreciate Gov. DeWine’s and the General Assembly’s efforts to improve outcomes for multi-system youth,” Sausser said. “However, it is imperative that we come together now at both the state and local level with a sense of urgency and a clear timeline to develop and implement a comprehensive, rapid-response approach for these youth.”

Sausser shared a recent story where in rural northern Ohio, a youth entered foster care due in part to his severe behavioral challenges. There was no foster family able to take a child with such highly acute needs. The caseworker made dozens of calls to find a residential treatment center for him. After hours of phone calls, the caseworker found a center able to take the young man two and a half hours away. “Two and a half hours away from his family, his school, and all that was familiar,” Sausser said. “During the long car ride, the young man asked the caseworker about where he was going, what it would be like. She couldn’t tell him because the agency had never placed a child at that center; all the caseworker knew is that she finally had found a place where the youth could stay.”