State’s foster care system discharges ill-equipped young adults

On his 18th birthday, a boy with a history of behavioral health problems was turned out of the Spokane group home where he had spent the previous two and a half years in the state’s care and started a life on his own for which he was unprepared.

Recently cut off of the powerful psychotropic drugs that had been used to control his aggression, Tyler Dorsey ended up in the Spokane County Jail on a domestic violence charge six weeks after aging out of child welfare.

A new state law, which takes effect on Friday, might have protected Dorsey, who was turned away by numerous agencies because of his juvenile record of assault.

HB1128 entitles foster youth without a high school diploma or GED to remain in foster care until age 21 by opting into the federal Fostering Connections to Success and Increasing Adoptions Act.

Local, state and federal government officials know they have to help more teenagers who through no fault of their own have been taken out of abusive or neglectful homes and placed in foster care or institutions. Many of the approximately 500 children who age out of the Washington system each year end up on the street.

A recent report by the National Alliance to End Homelessness in America 2011 estimated that 1 in 6 young adults who age out of foster care is likely to experience homelessness.

While the number of federal, state and privately funded programs available to Washington foster youths transitioning into adulthood has increased in the past decade, it’s still not enough, people familiar with or who work in the foster-care system say.

“Washington state, as well as every state in this nation, has a history of discharging people who are unprepared and ill-equipped to be on their own,” said Jim Theofelis, executive director of The Mockingbird Society, which advocates for children in foster care.

Theofelis said the foster care system contributes to the youth homelessness problem, which he described as “one of the most egregious behaviors our country has engaged in.”

Long-term studies of former foster children are rare.

One study, published last year by researchers at the University of Washington and the University of Chicago, looked at about 700 former foster children in their teens and 20s in Illinois, Iowa and Wisconsin.

A quarter of them didn’t have a high school diploma and only about half had jobs. Nearly a third said they sometimes went hungry. More than 17 percent of them were likely to be incarcerated or homeless with mental health or substance abuse problems.

Stories like Dorsey’s are familiar, said Spokane County Sheriff Ozzie Knezovich, whose jail is so filled with mentally ill inmates he calls it the state’s second-largest mental health facility. “The mental health system needs to find a safety net for these individuals,” Knezovich said. “The street is not a safety net.”

Without blaming the Children’s Administration or Spokane Mental Health, who he thinks are doing the best job they can with available resources, Knezovich said the Dorsey case makes him wonder what the priorities of government are.

“It comes down to this,” the sheriff said. “How effective can an organization be if you don’t have the funding to deal with a problem?”

Knezovich said Spokane County’s is the only jail in the state that has a certified mental health program.

“The jail should not be in the mental health business, but until somebody picks up that responsibility, the only thing we can do to ensure the safety of the community is try to help address these mental health issues,” he said.

Treated since age 7

Anyone could have guessed that without close supervision Dorsey would end up in jail, or worse.

His mother, Theresa Stapleton, started raising the alarm months before Dorsey was released from Helping Hands Residential Treatment Center, a behavioral rehabilitation services provider contracted by the state to care for troubled youths.

Dorsey’s records were made available to The Spokesman-Review after he and his mother authorized their release by the Department of Social and Health Services.

Dorsey first came to the attention of CPS in 1999 when it was determined he was at risk of abuse or neglect because of his mother’s ongoing substance abuse and mental health concerns. His estranged father, who has an extensive criminal history, was prohibited from contacting the boy by a restraining order.

Since age 7, Dorsey, who has six brothers and sisters, has been treated at Spokane Mental Health or Lutheran Community Services for attention deficit-hyperactivity disorder and a variety of psychiatric and personality disorders.

On April 1, 2008, when Dorsey was 15, he entered Helping Hands because of “problems with aggression,” according to court and DSHS records.

Stapleton said CPS offered her “a Sophie’s Choice”: Either Dorsey had to go or she would lose her younger children to state dependency.

During his time at the group home he was kicked out of two Spokane high schools because of assault. He received independent and transitional living services through Volunteers of America.

Spokane Mental Health began prescribing lithium to stabilize his mood and reduce anger, as well as the antipsychotic drug Abilify.

Children in foster care are 16 times more likely to receive a psychiatric diagnosis and eight times more likely than their peers to take psychotropic medications, according to a study by the University of New Hampshire’s Carsey Institute.

But the drugs didn’t stop Dorsey from lashing out. On several occasions during his 32 months at the group home, he was arrested and placed in juvenile detention for fights with staff and other boys, as well as property damage.

While in detention in November 2010, Dorsey was assessed by Dr. John Jaccard, a psychiatrist at Spokane Mental Health, who determined that Dorsey’s behavior improved in the structured environment of detention.

Jaccard increased Dorsey’s prescription of Adderall, an amphetamine used to treat ADHD, and stopped the teen’s dose of lithium. DSHS records show that Stapleton had worried about her son’s high dose of the lithium. Dorsey’s prescription for Abilify was halved and soon thereafter stopped as well.

“He just did better,” Jaccard said in an interview, “cognitively sharper with no instability of mood.”

On Dec. 29, his 18th birthday, Dorsey was released from Helping Hands. In the weeks leading up to his being discharged, Dorsey said, the boys and staff members would bet $1 each in a pool on how long it would take teens aging out of the group home to end up in jail.

“I won $20 once,” Dorsey said.

No adult homes would have him

For months, Stapleton had expressed concern that she did not know what to do with her son after he aged out of child welfare. She had been warned by a social worker that if Dorsey moved back in with her, it would mean an automatic CPS referral for her two younger children, ages 8 and 14, living in the home.

By law, DSHS must have a transition plan for children aging out of its care, and it has the authority to provide continued foster care or group care to youths ages 18 to 21 if they wish.

“There was no foster home that was able to be located that would be able to serve Tyler based on his level of need,” said Josh Koutecky, a social and health program consultant specializing in independent living programs for the Children’s Administration.

Records show that the plan for Tyler was to move him into an adult group home, but none would have him.

Notes from a Feb. 8 team meeting of Dorsey’s social service providers show that the Division of Home and Community Services, which provides long-term care for persons with disabilities and the elderly, explored 16 placement options. All declined to place the teen either because of his behavioral history or because there were no openings. Dorsey’s IQ was high enough to disqualify him for care through the Division of Developmental Disabilities.

Stapleton, worried about her son’s increasing agitation, asked that a psychiatrist re-evaluate Dorsey’s medication.

Koutecky called Dorsey’s one of the more difficult cases he has seen, but he believes the Children’s Administration did everything that could have been done for him.

“Yeah, I think we exhausted the resources we had available to us, absolutely,” said Koutecky.

So Dorsey moved in with his mother, who sent her younger children to live with their seriously ill grandmother.

“They told me to take Tyler to the mission,” Stapleton said, referring to the Union Gospel Mission, a homeless shelter for men.

Stapleton said her son needed supervision to keep him safe. While he was staying with her, she said, Dorsey used part of his Social Security disability checks to buy two realistic-looking BB pistols, which she quickly took away from him.

“I don’t want him to end up in prison or shot by police or beat up on the street,” she said.

Jaccard said Spokane Mental Health continued to manage Dorsey’s medication but that he missed a critical appointment on Feb. 2.

On Feb. 14, Dorsey was arrested by Spokane police responding to a domestic disturbance at Stapleton’s south Spokane home after Dorsey had exploded in a rage. He remained in the Spokane County Jail until May 5 when he pleaded guilty to third-degree malicious mischief, his first conviction as an adult.

Dorsey currently lives at the Carlyle Care Center, an assisted living facility in downtown Spokane, under an arrangement worked out by the Carlyle’s former administrator.

Psychiatric unit last stop

While at Helping Hands, Dorsey had a couple of fights with another boy his age with a similar story.

Upon turning 18 on Oct. 23, Andrew Wattles was discharged from Helping Hands, the last of a succession of facilities that had tried to care for him since he was taken from his mother at age 9.

He is the eighth and youngest child born to Mary Wattles to be placed in state care because she was unable to protect them from abuse and neglect.

Wattles entered Helping Hands on May 20, 2009, with a diagnosis of attention deficit-hyperactivity disorder and oppositional defiant disorder resulting in episodes of anger and aggression.

In April 2010, six months before aging out of state care, Wattles moved in with his adult sister with support from the Division of Child and Family Services. But things didn’t go according to plan.

Within a month, Wattles returned to Helping Hands. The new plan was for him to remain at the group home until he turned 18 and then go to a foster home under a voluntary program, but this would require a foster home willing to take him.

Wattles says no one would take him and there was no transition plan for him.

Since October, he has gone back to live with his sister in Spokane and another sister in Tacoma. But these relationships were strained by the teenager’s behavior, so he bounced from homeless shelter to homeless shelter until he landed at the psychiatric unit of Providence Sacred Heart Medical Center. He was released this week into an adult group home in west central Spokane.

Jason Gregory, executive director of Helping Hands, said social workers try very hard to accommodate children like Dorsey and Wattles.

“We are trying to make sure that when they are 18 we are not dropping them off at the mission,” Gregory said. “There is a huge need for kids 18 to 21 and not enough resources.”