10-year-old boy with psychiatric problems is stranded in Children’s Hospital


Progress reports from the hospital, contained in its filings, show that the boy’s mother was “at a loss” for how to help and is afraid that he will hurt someone. (JEWEL SAMAD/AFP/GETTY IMAGES)
October 26, 2011

The 10-year-old boy is trapped.

He spends his days locked in a psychiatric ward at Children’s National Medical Center in the District because he stabbed his cousin in the eye with a pencil and has said he wants to kill himself. He has been violent, depressed, and a danger to himself and others. Now, the hospital wants someone else to take care of him.

Lawyers for Children’s Hospital plan to go to court Thursday to ask a judge to have the boy’s mother or Prince George’s County come and get him. They argue in court papers that the child has been abandoned in the emergency psychiatric unit since he arrived Sept. 15 and that no one is willing or able to free him. His mother has refused to bring him home; Prince George’s Child Protective Services has not accommodated him; the boy’s father, recently reunited with him in the hospital, has no legal right to take him.

The hospital, in court papers, likens the fifth-grader to “a trespasser” who is taking up needed bed space.

His emergency treatment has long since run its course, and the boy — identified in court papers only as “L.F.” — now finds himself the subject of a maddening bureaucratic trap: He needs ongoing help but has nowhere to go.

L.F.’s predicament is extremely rare, pitting a hospital against a county government and the mother of a child in one of its beds. Children’s Hospital has even made the drastic suggestion to a D.C. Superior Court judge in court papers that he order the boy to be placed in an ambulance and dropped off at a Prince George’s County social services office.

Kenneth Rosenau, an attorney for the hospital who filed the court papers, declined to comment Wednesday, as did Milton McIver, the associate county attorney representing Prince George’s.

The boy’s mother agreed to meet with a Washington Post reporter Wednesday night but did not arrive for the appointment.

The Post generally does not name troubled juveniles without a guardian’s consent, and in this case it is not naming the boy’s parents because doing so would identify him.

Hospital officials wrote in court documents that the child has a history of behavioral problems and that staying in a ward with a heavy rotation — children generally spend no more than about a week there — has reinforced his sense that something is wrong with him. They argue that he was ready to leave nearly a month ago and needs to move out, both for his sake and for the hospital’s.

But the hospital can’t transfer him without a guardian’s approval.

Children’s Hospital “is not a hotel in which one can check in and stay so long as one pays,” its attorneys wrote.

Even though the boy is covered by insurance, the hospital has asked a judge to force Prince George’s to take custody of him, perhaps to place him in therapeutic foster care or a residential treatment center. The county has indicated to the hospital that it would like 60 to 90 more days to find a suitable facility, according to court papers.

Lavette Sims, a spokeswoman for the Prince George’s County Department of Social Services, said she could not comment on the case because it is pending. Typically, Sims said, her agency acts when a child is abandoned in Prince George’s. L.F. is in the District.

Almost everyone agrees that the boy needs help. He has been given diagnoses of attention deficit hyperactivity disorder, manic depression and bipolar disorder, according to the court papers. The boy is not able to control himself when he gets angry, scared or sad. He destroys things, throws things, curses and bullies, the papers say. A week before he landed in the hospital, he stabbed a relative in the eye and said that he found hurting people “funny,” hospital officials wrote.

The boy was admitted to the facility after he was suspended from school Aug. 31, stabbed his relative and later threatened suicide, the court papers say. A source close to Children’s Hospital said it was the fourth time he had been admitted there.

He was at times kept in a windowless room in a windowless unit and has received daily psychotherapy, schooling and visits from social workers. The unit also has televisions, books and games, but it is not meant to be a long-term-care facility.

Progress reports from the hospital, contained in its filings, show that the boy’s mother was “at a loss” for how to help and is afraid that he will hurt someone. The boy, according to the reports, shows no remorse for his behavior.

After he spent less than two weeks in the unit, doctors recommended that he be released from inpatient treatment because the “acute phase” had passed, court papers say. They said that he has ongoing behavioral issues but that his violent tendencies stopped Sept. 25.

Ronald Federici, an expert in child neuropsychology, said it is quite unusual for a hospital to turn to the courts to resolve such an issue. Overall, he said, it is a bad situation for the boy.

“He’s warehoused, which is very detrimental to the child,” Federici said. “He’s probably feeling isolation and abandonment, and he probably doesn’t know what’s going on. The kid is the biggest victim in all of this.”

Hospital officials think that the boy should be put in the care of his mother for outpatient services or enter a residential treatment facility.

“It is in the interests of L.F. to be removed, not to a sidewalk or by eviction, but to an appropriate care facility, as opposed to the acute care hospital he is currently in,” hospital attorneys wrote.

Although the boy was “anxious to go home,” his mother didn’t think that he was ready for discharge, according to court documents, and she skipped discharge meetings. She said a month ago that the hospital should contact social services, the documents say.

Court documents show that the boy has had tension at home, in part, he told hospital workers, because he has never known his father and believes he has been kept from him. He told hospital officials that he gets angry when disciplined by his stepfather and starts “destroying stuff.” The boy’s stepfather, reached by telephone, declined to comment.

The boy’s father said in an interview Wednesday that he has not been a consistent part of his son’s life because he has been prevented from seeing him. He said he learned last week that the boy was at Children’s Hospital and that he has visited him nearly every day since.

“When I see him, he’s so happy,” the father said. “He runs up and hugs me real tight. I tell him that I’m here and I’m not going anywhere.”

The father said the boy is playful and active. He said he would jump at the chance to take him home and realizes that he might have to go to court to make it happen.

“That’s all I want,” the father said. “I don’t want him in the place he’s in. That’s not a place for him.”

The boy’s maternal grandmother, who has been visiting him during his stay, said the boy wants to leave the hospital.

“He does want to go home, somewhere,” she said. “It breaks my heart.”

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Staff writer Keith L. Alexander and staff researchers Magda Jean-Louis and Jennifer Jenkins contributed to this report.

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