BOSTON (AP) — Rhode Island violated the civil rights of hundreds of children with mental health or developmental disabilities by routinely and unnecessarily segregating them at Bradley Hospital, an acute-care psychiatric hospital, federal prosecutors said Monday.
Zachary Cunha, U.S. Attorney for the District of Rhode Island, said the multi-year investigation found that — rather than complying with its legal obligation to provide services in the most integrated setting appropriate to the needs of the children — the state left them hospitalized at Bradley for months and in some cases for more than a year.
The findings have been sent to Gov. Dan McKee and the Rhode Island Department of Children, Youth and Families.
“It is nothing short of appalling that the state has chosen to warehouse children in a psychiatric institution, rather than stepping up to provide the community care, support, and services that these kids need, and that the law requires,” Cunha said. He hopes the investigation will prompt the state to take swift action to meet its obligations under federal law.
The findings have been sent to Gov. Dan McKee and the Rhode Island Department of Children, Youth and Families.
“This troubling report identifies long-standing issues where improvements are clearly needed,” said Olivia DaRocha, an aide to McKee, “issues that are exacerbated by the national shortage of home and community-based behavioral health services.”
“While the administration has taken actions to improve our current placement system, we understand that more must be done, and we support DCYF’s continued cooperation with the U.S. Attorney and the U.S. Department of Health and Human Services,” she added. “Together, we will continue to seek short- and long-term solutions to provide each child with a behavioral health disability the appropriate services in the most integrated setting.”
Although inpatient admissions at Bradley are designed to last only one to two weeks, the federal investigation concluded that children with behavioral health disabilities in DCYF’s care were often forced to languish in the hospital despite being ready for discharge, and despite the fact that the children would be better served in a family home, investigators said.
From Jan. 1, 2017, through Sept. 30, 2022, 527 children in the care or custody of DCYF — or receiving services voluntarily through the agency — were admitted to Bradley Hospital. Of these, 116 kids were hospitalized in a single admission for more than 100 consecutive days, 42 were hospitalized for more than 180 days, and seven were hospitalized for more than one year.
Many of the children were subjected to avoidable and unnecessarily lengthy hospitalizations because DCYF failed to provide the community-based services they need, according to investigators, who said keeping a child hospitalized for an extended period when their needs could be served in a less restrictive setting only exacerbates the child’s acute needs.
DCYF takes these findings very seriously, according to Damaris Teixeira, a public information officer for the department.
Starting in November 2022, the department has worked with Bradley Hospital and Hasbro Children’s Hospital to expedite discharges to appropriate placements as quickly as possible, he said. The state also launched a new Mobile Response and Stabilization Services program to provide time-limited, on-demand crisis intervention services in any setting in which a behavioral health crisis is occurring, including homes, schools and emergency departments.
To date, 90% of the youth in the program did not end up requiring psychiatric hospitalization, he said.
The state is also investing about $45 million to expand in-state residential capacity, including a facility in Exeter that will serve 16 youth. The state Legislature also appropriated $11 million for the building of a 12-bed psychiatric residential facility to address in-state capacity need.
The investigation, which was also conducted by the U.S. Department of Health and Human Services Office of Civil Rights, also found that DCYF’s failure to look for placements in a family home setting with services could lead both to delayed discharges and to inappropriate placements post-discharge, which, in turn, often leads to subsequent hospitalizations.
Office of Civil Rights Director Melanie Fontes Rainer said the investigation reinforces the agency’s commitment to continue to protect the right of individuals to live in their own homes and communities.
“We must do better by our children and the communities we serve, and states and others must follow federal civil rights laws to ensure every child can access care free from discrimination,” she said.