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9486 in the collection
Safe Haven: a Mother's Agonizing Choice
Media accounts of parents
leaving older children in the state's care
under Nebraska's safe haven law often made a
joke of it. Here is a look at the desperation
and heartbreak.
By Elizabeth Bernstein and Dionne
Searcey
LINCOLN, Neb. -- On the morning of Oct. 28,
police here found a 17-year-old boy stumbling
around a busy intersection. His mother, Sue
Quakenbush, says that when she picked him up
from a detox center later that day, she drove
him to the nearest hospital.
In the emergency room, she says, the boy
started cursing: "You're not going to f- do
what I think you're going to do." Mrs.
Quakenbush silently walked her son up to the
front desk.
"I am here to invoke the safe haven law," she
recalls telling a nurse. "We are not abandoning
our kid. We are trying to get him help."
On July 18, Nebraska became the last state to
institute a safe haven law, aimed at preventing
mothers from harming or killing their unwanted
newborns. The law allowed parents to leave a
child in the care of a hospital. But unlike
other states, Nebraska's law had no age limit.
Since its inception, about three dozen children
have been abandoned at Nebraska hospitals. Most
were teenagers. None were newborns.
On Friday, the governor signed a new law
revising the safe haven statute, establishing
an age limit of 30 days to ensure that it
applies only to infants.
The courts are still deciding what to do with
the children relinquished under the original
law. Many have histories of severe psychiatric
or behavioral problems.
A recent analysis by the Nebraska Division of
Child and Family Services shows all but three
of the first 30 dropped off had received
mental-health treatment in the past. According
to parent and guardian statements in court
documents, some of the situations were dire:
One 11-year-old was "extremely violent" and had
assaulted his grandmother and twin brother. A
12-year-old "steals girls' underwear and
inappropriately touches the neighbor girls." A
15-year-old made repeated suicidal statements.
His guardian, an uncle, invoked the safe haven
law after a hospital refused to admit the child
to its psychiatric ward.
The division has maintained that the state
provides adequate mental-health and social-
service resources for children. "The role of
the state's child-welfare system is to protect
children who are fundamentally unsafe," Todd
Landry, director of the state division, said in
testimony this week as the Nebraska Legislature
met in a special session on lowering the age
limit in the law. For children who are
otherwise safe, he said "it is not the role of
government to intervene" in families' lives.
Some mental-health and child-services advocates
say the unexpected use -- by parents of older
children -- of Nebraska's safe haven law
highlights a poorly funded, fragmented and
insufficient system of mental-health care for
children. The problem is not limited to
Nebraska. Five of the children dropped off in
Nebraska under the Safe Haven law arrived from
other states: Iowa, Indiana, Michigan, Georgia
and Florida.
"The reality is that these parents are coming
to get services because there is nowhere else
to go," says Darcy Gruttadaro, director of the
Child and Adolescent Action Center at the
National Alliance on Mental Illness, an
education, support and advocacy group.
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A report issued last December by the Nebraska
Legislature's Children's Behavioral Task Force
found the state has no single point of
accountability for mental-health services for
children, no uniform manner to assess needs,
and funding that is "inconsistent, fragmented,
and inefficiently allocated."
Mental-health experts say that families needing
care for severely disturbed children -- in
Nebraska and elsewhere -- often come up short.
Resources are scarce, especially in rural
areas, and parents frequently don't know where
to turn. Even when they do locate resources,
through hotlines or state referral services,
they often end up on long waiting lists.
Money presents an even bigger problem.
Intensive care is expensive, and even parents
who are insured can find it unaffordable. Most
insurers limit the number of visits to a
mental-health professional and the number of
days of psychiatric hospitalization they will
cover. And not all treatment programs accept
private insurance. Some state programs prefer
to take Medicaid, leaving families who are not
eligible or children who are not state wards
out of luck.
Lavennia Coover had taken her mentally ill 11-
year-old son to the emergency room in Omaha
several times after he flew into a rage. Each
time, says the kindergarten teacher, he was
admitted but discharged days later when her
insurance ran out. All told, she says, he had
been through three psychiatric hospitalizations
and extensive outpatient treatment by the time
she left him at Immanuel Medical Center in
Omaha in September under the safe haven law.
Thousands of parents across the country have
surrendered their parental rights in recent
years in an attempt to get their children
adequate mental-health care. (Nebraska's first
iteration of the safe haven law had been the
latest legal outlet for parents seeking to do
this.) Seventeen of the first 30 children
dropped off under the law had at various times
been wards of the state, according to
Nebraska's Division of Child and Family
Services.
Mrs. Quakenbush's son, Tyler, spent the early
years of his life in Adams, Neb., a small town
nestled in the rolling farmland of the state's
southeastern plains. He was a smart, sensitive
child, who loved books and competed in the
Nebraska State Fair arm-wrestling
championships.
At age 6, she says, he stopped sleeping through
the night. His mother would sometimes wake at 2
a.m. to find him leaping down the stairs with a
blanket tied around his neck, pretending he was
Superman.
Around this time, Tyler's teachers began
calling home, Mrs. Quakenbush says, complaining
that the boy would not sit still. The boy's
pediatrician recommended a psychologist, who
diagnosed him with attention-
deficit/hyperactivity disorder. The doctor also
prescribed Ritalin, a stimulant. The medicine,
says his mother, helped for a while.
When Tyler was 9, his parents divorced, and he
moved with his mom and two sisters to Lincoln,
Neb. He began having more sleep problems --
tossing and turning so much that he sometimes
fell out of bed.
The boy had been seeing his psychologist
weekly; now he began regular visits to a
psychiatrist as well.
Tyler's situation -- according to his mother as
well as an extensive review by the Wall Street
Journal of numerous court, school and other
records provided by Mrs. Quakenbush -- would
only continue to deteriorate.
At school, says his mother, he had temper
tantrums -- screaming fits, slamming doors,
refusing to get up off the floor -- and spent
much time sitting in the "quiet room." At home,
he refused to do chores, sneaked out of the
house and lied about his whereabouts.
Mrs. Quakenbush, who remarried when Tyler was
12, took her son to more doctors. (His
biological father has had limited contact with
his son over the years, according to his mother
and other relatives. He could not be reached
for comment.) Tyler continued to see therapists
and was given various diagnoses over the years:
oppositional defiant disorder, depression and
anxiety.
In eighth grade, says his 39-year-old mother,
Tyler kicked in the glass on the front door of
his middle school. "I was sad and frustrated
and heartbroken," Mrs. Quakenbush says. "I felt
like I was failing him as a parent." Tyler's
therapist recommended he be sent to a
residential treatment center for kids.
Mrs. Quakenbush and her new husband began
looking for a facility that would take Tyler.
Both work for the city of Lincoln and have
health insurance. Nevertheless, Mrs. Quakenbush
says, Tyler was rejected by many facilities
because he hadn't been in trouble with the law
and wasn't a ward of the state, and therefore
was ineligible for Medicaid.
Two of the facilities Mrs. Quakenbush says she
contacted -- Boys Town and Masonic-Eastern Star
Home -- said they had no records of her
inquiries but that it was possible she had been
turned away. A spokesman for Masonic said that
the home takes private placements and offers
discounts for parents who can't afford to pay,
but that it often has waiting lists as long as
two years. A spokesman for Boys Town national
programs in Omaha said that children are
sometimes turned away if administrators believe
they will not benefit from the services the
programs offer. He also said that in recent
years, the center had fewer resources and thus
accepted fewer children.
Eventually, Tyler was accepted at the Omaha
Home for Boys, a nonprofit facility that does
not charge for its services. Tyler moved there
in December 2004, and stayed for 14 months,
attending high school nearby, joining 4-H and
going to church on Sundays. He regularly saw
therapists and a psychiatrist, who adjusted his
medication.
In February 2006, Tyler overdosed, taking six
pills of his medication at once. Administrators
at the Omaha Home for Boys sent him to a nearby
hospital and did not allow him to return to
their facility.
Mrs. Quakenbush says that Tyler denies that he
was trying to commit suicide and that he
insists he forgot to take his medication for
days so he took it all at once. Kevin Orr,
director of youth and family services for the
Omaha Home for Boys, says Tyler was not allowed
to return from the hospital because the
facility is not equipped to care for children
who need intensive care. "We do not have 24-
hour awake staff," he says. "If kids
demonstrate unsafe behavior, then they need a
higher program."
Mrs. Quakenbush says the family was nervous to
have Tyler home. He enrolled in high school
nearby, but within a month he was in trouble,
racking up multiple suspensions in three months
for behavior such as disrupting class and
breaking a window in a vehicle in the school
parking lot.
Now, Tyler began getting in trouble with the
law, receiving a citation for stealing a lock
from a school desk. At home, he crawled out the
window at night.
Mrs. Quakenbush was despondent that her son was
spiraling downward. "We were trying to find
help for him, and every step we took we were
being told he's not a state ward, he's not on
Medicaid," she says. "We were basically beating
our heads against the wall."
Tyler's problems escalated. In September 2006,
he was ticketed by the police for disturbing
the peace. At a court hearing, a judge sent him
to a juvenile detention center and Tyler
subsequently became a ward of the state.
In December 2006, Tyler was sent to Cedars, a
nonprofit facility for at-risk youth. While
there, he attended high school and received
individual and family therapy.
Yet during the next eight months, Tyler was
suspended from school for fighting and other
troubles. He stopped attending school, and had
brushes with the law. Around this time, he lost
his home-visitation rights.
By September 2007, the state had decided that
Tyler needed a more restrictive environment and
transferred him to another juvenile-detention
facility, the Kearney Youth Rehabilitation and
Treatment Center. He stayed there for eight
months, where he continued his studies and
earned his General Educational Development, or
GED, certificate.
Last May, Tyler was sent home from Kearney. In
July, authorities sent a letter to his mother
saying that her son had successfully completed
their program and that he was no longer a state
ward.
Mr. Landry, of the Nebraska Division of Child
and Family Services, stresses that there are no
quick-fix solutions for children requiring
mental-health care. "Making change is not
necessarily easy," he says. "The resources are
available to help these families through
difficult times. But there is no easy formula."
He adds: "There does seem to be a misconception
that when a child or youth becomes a ward of
the state, through safe haven or any other way,
the state has access to some different set of
services that would otherwise be available."
Over the summer, Tyler had a few failed job
stints at a burger joint and a pizza parlor.
His parents say he ignored his curfew, and they
told him he could find somewhere else to live.
For the next several months, he moved back and
forth between his grandmother's, his uncle's
and his parents' homes.
Around 9 a.m. on Oct. 28, Ms. Quakenbush says
the police called her home and said a concerned
citizen had discovered Tyler wandering near a
busy intersection, appearing to be under the
influence of alcohol or drugs. The police,
after contacting the family, sent him to a
detox center.
That day, Mrs. Quakenbush says, something "just
snapped." She had heard about the state's safe
haven law on TV, and she decided to use it.
Mrs. Quakenbush packed Tyler's backpack with
clothes and medication and brought along a
large binder with his records. Then she and her
husband picked up Tyler at the detox center and
drove him to BryanLGH West Medical Center. Once
in the emergency room, Mrs. Quakenbush says,
Tyler started screaming and begged them to let
him go home or move in with friends.
Mrs. Quakenbush gave her son his backpack and
tried to explain to him that he needed more
help than she could provide. The police,
summoned by hospital staff, led her from the
room. As she left, she could hear Tyler's voice
raised in anger at the staff. A spokeswoman for
BryanLGH West declined to comment.
The vague nature of the original law presented
some thorny issues for both parents and
legislators. On the one hand, safe haven
protects parents from criminal charges for the
act of dropping off a child at a hospital. But
that does not completely exempt parents: county
attorneys have made civil findings of neglect
against at least some of the parents, including
the Quakenbushes. Officials at the Department
of Health and Human Servicessay these findings
are not punitive, but are part of the legal
mechanism necessary to allow the state to take
custody of the child.
After staying at a youth shelter, Tyler was
recently sent by the state to live with a
relative on his father's side. The relative
declined to allow the child to be interviewed,
saying it was a condition of Tyler's placement
with his family. State officials also declined
to make Tyler available.
Mrs. Quakenbush says she has seen him only
once, in a tearful meeting earlier this week at
a therapist's office. The state, as it does in
any case where a child's custody is surrendered
to its care, has begun an investigation to look
for signs of abuse or neglect in the Quakenbush
family. They have interviewed Mrs. Quakenbush's
11-year-old daughter at school and sent an HHS
worker to their home.
"There are many days when we regret doing what
we did," Mrs. Quakenbush says. "We were
expecting this to open some eyes and get Tyler
some help; now we just feel like the state is
against us."
— Elizabeth Bernstein and Dionne Searcey
Wall Street Journal
2008-11-22
INDEX OF OUTRAGES
Pages: 380
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