It was the hardest letter John ever had to write.
After weeks of trying to find a facility for his 17-year-old son before the teen was discharged from a youth academy, the Roselawn resident had lost hope. John penned a letter to the academy and Indiana Department of Child Services to let them know he would not be picking up his son — even though it would lead to a finding of child neglect against the father.
It was a desperate scenario — but John's best option to get mental health services for his son, according to some mental health professionals.
Parents, judges, prosecutors and other officials in Indiana say there is a multiagency failure to provide mental health services to the children who need it most. Children who don't get appropriate services can end up in the juvenile delinquency system.
As a last resort, some region parents told The Times they were advised to "abandon" their children to obtain mental health services.
John's son, Zachary, has been diagnosed with Asperger's syndrome, attention deficit hyperactivity disorder, pervasive developmental disorder and oppositional defiant disorder. Mental health officials said Zachary was defiant and had been exposing and fondling himself publicly.
A therapist warned that Zachary's behaviors could lead him to become a sexual predator. John said he couldn't risk the safety of the rest of his family — including 5-year-old triplet daughters — by bringing Zachary home.
John's private insurance wouldn't cover residential placement, state agencies had denied his requests for assistance and his family couldn't afford the $200 to $300 per day cost for a residential facility for troubled youth. A mental health official told John that Zachary could receive mental health services as a ward of the state.
John's letter to the academy and state officials was a last plea for assistance.
"How do you tell someone you're leaving your kid? How do you do that?" John asked. "(My son) doesn't understand it either. He thinks we gave up, and we don't want him home. That couldn't be further from the truth. We want him to get the help he needs in the right way."
More than a dozen region parents told The Times they've had difficulty navigating that same maze of state agencies.
A tangled network
A recent report published by the National Center for State Courts found there are more than 30 Indiana-based entities, committees or groups that focus on various issues affecting children.
The Bureau of Developmental Disabilities Services, Division of Mental Health and Addiction, Indiana Department of Education, Medicaid and DCS are among those that share responsibility for Indiana children who need mental health services.
The National Center for State Courts report found a lack of communication among key agencies that causes duplicated efforts, divisiveness and extra costs to taxpayers. It also found that most people are unclear about the purpose of each entity.
The result is a tangled network of agencies that can be difficult to navigate for parents like John — and for those who work in a mental health profession. While many Indiana children receive mental health services, child welfare advocates say an increasing number are falling through the cracks.
'I stand here broken'
A Lowell woman said her 16-year-old niece has been hospitalized eight times, attempted suicide four times and is in her third residential placement in three and a half years.
Sharon, who became her niece's legal guardian nearly 10 years ago, said she has struggled to find appropriate mental health services for the girl.
Sharon said her niece has been diagnosed with major depressive disorder, post traumatic stress disorder, social phobia, generalized anxiety disorder, bipolar disorder and borderline personality disorder. The teen's difficulties have been exacerbated by drug and alcohol use.
Sharon said DCS officials have investigated her for child abuse three times since 2009 because of her niece's false claims. Officials did not substantiate abuse against her, she said.
But Sharon said the allegations could have cost her employment at a local hospital.
"I'm just going to sit here and stare at you and tell you how much I hate you," Sharon recalls the 16-year-old saying in April. "I'm glad you lost the baby because you don't know how to care for a child. I hope you lose your job, and I'm going to do everything in my power to make that happen."
Sharon said her niece's behavior brought her to the edge.
"I can't do this anymore," Sharon said. "I stand here broken."
Sharon said she had called DCS' child abuse hotline four times since April 10 to plead for help, but they told her it sounded like she was the one being abused, not her niece.
"We're for child abuse, not adult abuse," Sharon said they told her. One person gave Sharon the phone number for a crisis center, but that number was disconnected.
Sharon said she considered refusing to pick up her niece from a local hospital in May, but DCS officials said they would charge her with neglect. A child welfare advocate told Sharon that she also would have to pay the hefty hospital bill.
"I was backed into a corner, and I had to go pick her up," Sharon said.
She said a transition place for children who leave the hospital and are waiting for residential placement is needed — rather than sending troubled children home with no resources. Sharon's niece was home for nearly two weeks before Medicaid approved her residential placement.
"There's a gap in the system somewhere," Sharon said. "There should be a middleman — a middle place between hospitalization and Medicaid approval."
A Crown Point resident named Jill said a mental health official advised her several years ago to leave her son at Options Treatment Center in Indianapolis to get him services. She refused.
"I didn't like it, and I didn't think that was right," Jill said.
Jill's son, Bryan, has been diagnosed with bipolar disorder, attention deficit hyperactivity disorder and pervasive developmental disorder. He also was diagnosed as mildly mentally disabled.
The 12-year-old has been in and out of psychiatric residential treatment facilities since he was 7.
In August, Bryan was placed back in Options Treatment Center after he tried to burn down his mother's house, Jill said. He remained there until March, when Medicaid said it would no longer pay for Bryan's residential placement because he hadn't shown enough progress.
He was sent home without resources for the family. Since then, multiple state agencies have denied Jill's requests for help.
'We've really gone too far'
Thomas Pavkov, director of the Institute for Social and Policy Research at Purdue University Calumet, said he is disturbed by the idea of parents abandoning their children in order to secure services.
"Any time you have to make a choice about getting your kid what they need and retaining your parental rights ... if we've gotten to that point as a society, we've really gone too far," Pavkov said.
Pavkov, who has done research on mental health services for children, said he believes there is much room for improvement in how the various state agencies work together.
State officials and child welfare advocates also have recognized the need for improvement. They said services for children with mental illness or developmental disabilities has been a problem for more than 40 years.
The National Center for State Courts report published earlier this year recommended Indiana create a statewide commission to establish partnerships, drive policy and identify common goals.
The state Legislature created interim study committees to look at DCS-related issues and the unmet mental health needs of children.
In the meantime, some parents who are desperate for services believe abandoning their children is the only available option.
'I would do it again in a heartbeat'
John's son, Zachary, is receiving therapy and services as a ward of the state.
After John wrote his letter to the academy and DCS in December, a DCS caseworker visited the family's home and asked him to reconsider his decision not to pick up Zachary.
They contacted Zachary's grandparents, who refused to take him for more than a few days because of his aggressive and sexual behavior, Newton Circuit Court records show. Foster care wasn't an option for the same reason.
So DCS officials picked up Zachary from the youth academy on Dec. 17 and placed him at ResCare residential facility in Greencastle. Officials substantiated neglect against John for leaving his son, records show.
The judge put John and the rest of the family on a schedule of visits and phone calls to maintain the family's relationship. The family also pays the state for Zachary's care.
But John said he is relieved his son is getting the services he so desperately needs.
"For me to take this neglect charge ... I would do it again in a heartbeat for any of my kids if that's what it takes," John said. "It's a shame I had to take a charge like that to get him the help he needs."