The state’s child welfare system is ‘infected with dysfunction’

Despite repeated investigations and vows of reform after tragedies, nothing seems to change

IT IS AN unfortunate truth that Massachusetts, with all of its famous hospitals and prestigious universities, has among the most abysmal track records of any state of caring for children in state custody. These vulnerable children, many of whom are in the system due to allegations of abuse or neglect, are revictimized by the highly defective child welfare system that puts their very lives at risk.

They are, in truth, prisoners of a system so dangerously infected with dysfunction that child fatalities, maltreatment, and neglect from inside the system have become the rule rather than the exception. Commenting on child fatalities, the Massachusetts Friends of Children organization summed it up best declaring, “It’s a cycle of child-death incidents followed by investigations, reports, audits, apologies, promises, and reforms—and then the cycle repeats yet again.”

Truer words have never been spoken.  

The recent $7 million settlement against the state and others by four former foster children who were brutally abused and tormented in a “house of horrors” in Oxford by the-now charged foster parents is emblematic of the failed Massachusetts child welfare system. Even the most basic services necessary to ensure the emotional well-being of children in the system are simply not available, much less the requisite level of oversight necessary to keep children safe in care.  

Few people in the public know that for 15 years Massachusetts was embarrassingly under strict federal oversight with a court monitor to oversee a mandate to make psychiatric and supportive mental health services available to Medicaid-eligible children to keep them out of psychiatric hospitals and residential facilities. The availability of mental health services in Massachusetts was so appallingly lacking that a federal judge, right up until 2021, had to force changes to protect poor children in a state that boasts the finest health care in the world. Frankly, very little changed. 

In that famous case, called Rosie D. v. Mitt Romney, US District Court Judge Michael Ponsor ordered the state “to restructure the children’s mental health system in Massachusetts by developing a coherent system of care.”

Judge Ponsor wrote, “Children with serious emotional disturbance are among the most fragile members of our society.” These “fragile” children, many of whom are in state custody on child abuse and neglect cases, still have little, if any access, to therapeutic services ,with waitlists that are months long.

The case of Harmony Montgomery is one example of a child with disabilities who required significant emotional support and a therapeutic foster home, according to the investigation by the Office of the Child Advocate. Yet, the Department of Children and Families left her on a waitlist for months, causing her emotional and physical well-being to deteriorate dramatically. No one, including her father, even discussed her need for treatment and services for her disabilities at the custody trial, according to the child advocate office. Now he is indicted for her murder.  

Studies have long shown that children with disabilities are far more likely to be victims of severe abuse and neglect than children who are not disabled. Yet, Massachusetts has done little to provide the appropriate therapeutic supports and oversight for these children, and some, like David Almond, have paid with their lives.

The affable autistic triplet was slowly and painfully starved to death by his father and stepmother who are both serving life sentences for his murder. And then there is Jeremiah Oliver, the 5-year-old boy whose family was monitored by the state, tragically found dead in a suitcase on the side of the road. It is as the Friends of Children wrote, “a cycle of child-related deaths.”  

Sadly, the cycle of denying children badly needed services continues in the beleaguered Massachusetts child welfare and mental health systems, overrun with children in desperate need of therapeutic services and emotional support.

Frantic parents are forced to bring their children to hospital emergency departments where they are warehoused, waiting for a residential bed or, alternatively and unceremoniously, discharged back to their families with no treatment or follow-up. Hospital staff often tell parents to file a “stubborn child” petition in the Juvenile Court, promising them that the court will find a placement for the child. What they do not tell the parents is that they must relinquish custody of their own child to the Department of Children and Families so the agency can search for a bed which is rarely available.

This happened countless times in my court, as I had to explain to desperate parents who hit roadblocks trying to get residential beds for their child that,  in Massachusetts, parents are often unfairly forced to relinquish their constitutional rights to raise their own children in order to get long-term mental health placements. No parent should ever be in that situation.  

In the most recent annual report of the Massachusetts Child Fatality Review Program  released in 2021, statistics revealed that between 2018 and 2020, 45 children in Massachusetts between the ages of 10 and 17 died by suicide. What the report does not provide is information about whether these children were receiving the necessary services or were in state custody. How many were on waitlists or discharged from the emergency departments with no follow-up?   

In the Rosie D. case, Judge Ponsor, highly critical of the Massachusetts mental health system and the lack of services, wrote,  “Without such services, a child may face a stunted existence, eked out in the shadows and devoid of almost everything that gives meaning to life.”

Meet the Author

Carol Erskine

Retired First Justice / Adjunct professor, Worcester County Juvenile Court / Anna Maria College
Sadly, thousands of children in Massachusetts, especially those in state care, are living the stunted existence the judge wrote about, devoid of almost everything that gives meaning to life and in truth, sometimes devoid of life altogether. It’s unconscionable.  

Carol Erskine is the recently retired First Justice of the Worcester County Juvenile Court, where she presided over cases involving criminal matters, runaways, child welfare cases, sexually exploited children, and mental health and medical issues in children, including petitions to medicate children in state custody in connection with child abuse and neglect cases. She is currently an adjunct faculty member of the criminal justice program at Anna Maria College.