The child welfare sector is "at a tipping point" as families of youth with complex needs are increasingly unable to access treatments and supports in their communities and are turning to children's aid societies for help, one organization is warning.
The Children’s Aid Society of Ottawa (CASO) is calling on the government to act as more youth can't access treatment or are "unable to remain safely at home," the organization said in a news release issued on Thursday.
“The sector is at a tipping point, and we’re in a situation where we can no longer provide the necessary care for our most vulnerable youth,” CASO executive director Kelly Raymond said in the release. “Inadequate resources and delays in access to services have left the health sector struggling to deliver care to kids with complex needs. The unintended consequence is that families with high-risk kids turn to us for support. But we’re not a treatment facility; we’re a corporate parent with the same limited access to treatment options as any other parent.”
As a result, CASO said, some parents who are unable to care for their children are "voluntarily surrendering their children to CASO for placement, in the hope that they will receive the necessary care."
Raymond told The Trillium the CASO has received a number of referrals from families saying they need access to treatment, but the problem is that treatment options are limited in Ottawa and in other cities. This means that sometimes youth might receive placements that don't meet their needs or are out of the region.
"That referral could be, 'I need support because my young person is struggling with significant mental health, is struggling with a diagnosis on the autism spectrum, compounded by behavioural, I can't manage as a parent,'" she said. CASO said these situations often involve youth who need constant care and might have been discharged from youth justice facilities or hospitals.
She said required treatments cover a range of things, from in-home supports to live-in treatment services. On the lack of services, Raymond gave the example of the Ontario Autism Program (OAP). A report from the Financial Accountability Office earlier this week said there are more than 70,000 youth registered with the program, but that the ministry's funding for core services — a key part of the program — would likely only cover less than 20 per cent of them.
Michele Thorn, an adoption worker with the Children’s Aid Society of Ottawa, said families of youth with autism are coming to them even where they wouldn't have previously.
"They're not child protection cases, per se, but they're saying, 'I'm giving up, I can't do it, I just need some help," Thorn said, adding that CASO doesn't have respite homes. "They're not incapable of parenting, but they need the resources to help them do it, and those aren't out there."
"It's community and social services, health services that are lacking across the province and it's coming down onto child welfare, because we're that last resort and where parents have nowhere else to turn go," added Thorn, who is also the Ontario Public Service Employees Union's Local 454 president.
"It's that timely response, and the longer you wait for service, the chances of the crisis escalating is pretty significant," Raymond said, adding that sometimes CASO will need to pay for services to help families, not funded by the government. "For Ottawa, I can say that there are currently 40 children in our care system that require special services that cost above and beyond $500 per day."
The Ontario Association of Children's Aid Societies (OACAS) shared CASO's concerns, saying it is increasingly hearing from its members that there aren't enough appropriate placement options and they're dealing with more families in crises who don't know who else to turn to.
Sometimes when there isn't an available placement, such as a foster home or treatment bed, "youth with complex needs (i.e., social, emotional, developmental, mental health, addictions, etc.) sometimes need to be placed in temporary, supervised settings, which may include hotels or motels," the OACAS said in a statement to The Trillium, adding that these are "options of last resort and are the result of broader systemic gaps."
Raymond said conversations CASO has had with the Ministry of Children, Community and Social Services need to continue, with the government listening to the sector's views on how to address the challenges they're facing.
"I'd also call upon our ministry to also engage with other ministries in similar conversations, but also (to take) action," she said, referring to the ministries overseeing education, justice and health and mental health and addictions.
Raymond said while each of these sectors has seen some sort of "redesign," it's been done in silos. There's opportunity, she said, for all of these sectors to come together to "wrap supports around a family and a child so that their outcomes there are absolutely positive or better than what we currently have."
She said the funding formula for the sector also needs to be revisited.
CASO said while it appreciates the ministry's $13.5 million over three years to boost support for at-risk populations, "this funding must be part of a broader, more comprehensive strategy that includes substantial investment in child protection services specifically."
"To effectively address the needs of children and youth with complex needs, we need targeted funding that ensures sustainable, long-term support and capacity building within the child welfare sector," the organization said.
The OACAS echoed these comments, saying "continued investment in service providers delivering highly specialized, intensive care, including mental health, is urgently needed to ensure there are enough appropriate placement options in communities across the province.
"We continue to call for greater collaboration between the Ministry of Children, Community and Social Services and the Ministry of Health to work with key partners in the child and youth services sector, including child welfare, to put in place real solutions that address the gaps and challenges faced by children and youth with complex needs," the OACAS said.
In response to questions about CASO's concerns, Children, Community and Social Services Minister Michael Parsa's spokesperson issued a statement after this story was first published outlining the government's investments in the sector including $1.5 billion in child welfare societies.
Anastasiya Romanska said the province increased funding this year by $14 million for child protection services and by $109 million for children and youth services.
"Our government wants every child and youth to have a safe and stable home regardless of their circumstances. The government does not direct children’s aid societies on placement decisions. What we do require is for children’s aid societies to make placements that are safe, appropriate, and meet the child’s needs. That’s not an option: it’s the law," Romanska said. "We expect every children’s aid society make safe and appropriate placements that meet the individual needs of a child and work together with their local community partners to identify collaborative best practices and foster creative solutions to help address placement challenges."
She also pointed to more funding for children's rehabilitation services, a separate initiative aimed at improving "the experiences and lifelong outcomes for more than 1,100 children and youth with complex special needs at the Children’s Hospital of Eastern Ontario, Holland Bloorview Kids Rehabilitation Hospital and McMaster Children’s Hospital," and the province's autism program.
Editor's note: This story was updated with a statement from the minister's office released after it was initially published.
