A study of life in institutions and group homes revealed firsthand testimony of poor nutrition, upended education and excessive use of psychiatric drugs, and urged an end to their use to house foster youth.
A team of seven researchers produced “Away From Home: Youth Experiences of Institutional Placements in Foster Care,” some with lived experience in the child welfare system.
“People can disagree about the extent of harm they do,” said Sandra Gasca-Gonzalez, the vice president of the Center for Systems Innovation at the Annie E. Casey Foundation, during a Wednesday press conference. “But you can’t dispute the youth experience as told in their own words. Now really is the time to hear their truth, and heed their wisdom.”
The study included 78 current and former foster youth from across the country who were 18 to 25 years old and had lived in group care settings; 37 were interviewed, and 41 were given “cultural probes,” assigned tasks aimed at eliciting feelings and memories about an event or period of time.
Among the 52 findings in 11 subject areas, almost all reflect negatively on life in group care:
- Despite the widespread assumption that group settings are a last resort, many youth said they experienced them as a first placement in foster care.
- The nutritional quality and taste of the food served at institutions is routinely subpar, causing some youth to gain weight and others to lose weight because they found much of it inedible.
- Youth experienced “mental, physical and sexual abuse” in group care, as well as discrimination.
- Interview responses suggested that youth who attended public schools while living in group care were happier with their education than those schooled on the grounds. But regardless of school setting, they did not feel they received a stable education.
- Many youth felt that they were overmedicated in group settings, and that medication was the only path used for dealing with their trauma.
Lexie Grüber-Pérez spent time in group facilities in Connecticut and served on a lived expert review board that was part of the study. She said the report provides a necessary view from the inside of group homes — qualitative data that adds to the existing body of research documenting the harm children suffer from institutional life.
Yet “quantitative research is unable to capture pain and trauma,” Grüber-Pérez said, and “to measure the injustice” of life in group settings.
The researchers and authors offered several recommendations, starting with the elimination of all institutional care in the child welfare system. But the study noted that such a drastic step was not initially endorsed by most of the 78 participants.
“Most could literally not imagine a world without institutional placements in foster care,” said study co-author Sarah Sullivan, in an email to The Imprint. “Their reasoning was that they had been told that institutional placements were the last resort placement.” And if institutions were their final option, “most young people felt like a world without them would mean homelessness or worse.”
When interviewers followed up by asking the young people to imagine a scenario where alternatives existed that did not include homelessness, she said, “many began to change their perspective in favor of a world without group homes and more family placements.”
Of the 44 former foster youth who participated in the participant peer review, she added, “the overwhelming majority of the participants that reviewed our draft findings and recommendations which call for family-based alternatives to institutions agreed with eliminating institutional placements.”
In the place of group facilities, the report released Wednesday recommends greater use of family preservation to avoid foster care removals in the first place; better support of placements in the homes of relatives and family friends; and ensuring that foster homes, when necessary, are “more stable and culturally appropriate.”
The report’s release comes just months before a federal law takes effect that limits funding for the use of group homes and institutions. The Family First Prevention Services Act, which was signed into law in 2018, limits federal funding for such placements to two weeks, with exceptions for youth with acute health needs, pregnant or parenting teens, youth at risk of sex trafficking and young adults in extended foster care who are ages 18 through 21.
Most states took advantage of a permitted two-year delay on the new restrictions, but it will take effect nationwide on Oct. 1.
Grüber-Pérez said the exceptions in the Family First Act reflect the consensus she and other advocates were able to achieve in the bipartisan bill, though many still wanted to “go farther” in restricting federal funds for congregate care altogether.
She noted that staff at residential care facilities are often underworked, underpaid and lack qualifications to work with youth.
“The idea that these are settings providing clinical care, there’s a logical gap going on there,” Grüber-Pérez said.
At Wednesday’s press conference, founder and CEO of Think of Us Sixto Cancel, whose organization published the study released Wednesday, dedicated the “Away From Home” report to the memory of Cornelius Fredericks, who died in April 2020 after staff at a Michigan residential treatment facility violently restrained him for throwing a sandwich in the cafeteria.
Michigan has since ended its dealings with Sequel Youth & Family Services, the for-profit provider that ran the facility. California, which sent some of its foster youth to the Michigan campus and other locations run by Sequel, recently banned the practice of sending youth to out-of-state residential treatment facilities.
As part of his message that all group facilities should be banned, Cancel said of Fredericks: “He should be alive today.”