The Kids Who Are Cleared to Leave Psychiatric Hospitals—But Can’t

In the spring of 2016, a 12-year-old named Gabriel Brasfield spent three and a half months in a psychiatric hospital in Chicago. His hair, which he liked to wear cropped, grew long and unkempt. He forgot what it felt like to wear shoes because he was allowed to wear only hospital socks. He missed months of school, and couldn’t go outside. He celebrated his 13th birthday at the hospital, where he said the walls were bare and there was little to do.

And for eight weeks of those three and a half months, he didn’t even need to be there. Doctors had agreed Brasfield was ready to be discharged about six weeks after he arrived, but the Illinois Department of Children and Family Services (DCFS), which is his legal guardian, couldn’t find anywhere for him to go.

As I found during a four-month investigation for ProPublica Illinois, Brasfield is one of hundreds of children in the care of DCFS who are held each year inside psychiatric hospitals for weeks or months, even though they have been cleared to leave. Instead of moving on to a foster home or residential treatment center—a less restrictive facility where children live while receiving treatment—these children have languished in secure mental-health facilities, the consequence of the child-welfare agency’s failure to find them appropriate placements.

These unnecessary hospitalizations are another failure for a state system that has frequently fallen short in its charge to care for Illinois’s most vulnerable children, who suffer from conditions such as severe depression or bipolar disorder. Though statistics to compare how states handle children in psychiatric hospitals are scarce, and other states also experience similar challenges, psychiatrists and mental-health experts say circumstances in Illinois are among the most dire in the nation.

Unnecessarily prolonged hospital stays often have detrimental effects on children. Doctors in some of these cases said the delays caused the children to deteriorate emotionally and behaviorally. Some child-welfare advocates said the children slipped behind their peers in their behavioral and social development, often dramatically. Meanwhile, lawyers who represent many of the children say such stays deny them their right, guaranteed by Illinois state law, to live in the “least restrictive” setting.

While confined to a psychiatric hospital, some children received just an hour or two of educational instruction