Tali Stone was 9 years old when her foster mother brought her to North Star, an acute psychiatric facility in Anchorage. Stone said she had been refusing to go to bed and got in a fight with her foster mom. She said her foster mom had talked about North Star before, as leverage sometimes if one of her nine foster kids wasn’t behaving.
“She always described it to me as a prison,” Stone said. “She said that they'll lock you up. She said that it was moldy inside the building, like an actual prison.”
But this time it wasn’t an empty threat. Typically, to be admitted to a psychiatric facility someone needs to be at risk of suicide or violence, experiencing psychosis, or unable to care for themselves. Stone said during the intake, her foster mom exaggerated her behavior and lied that she was seeing ghosts.
“Even the staff said, themselves, ‘I'm not sure why you're here,’” Stone said. “And I was like, ‘I'm not sure either.’”
Stone was at North Star for four weeks, according to her psychiatric records. And over the next two years, she was admitted to North Star a total of four times, each stay several weeks at a time.
Stone was one of the thousands of kids under the care of the Office of Children’s Services in Alaska, or OCS, who have spent time, sometimes unnecessarily, in acute psychiatric facilities. OCS is under-resourced, with a high staff turnover rate, and a serious shortage of foster families. The Department of Justice reprimanded the state in 2022 for overreliance on psychiatric hospitals and residential treatment, and the office has made improvements since then.
OCS officials did not agree to an interview for this story, but commissioner Kim Kovol from the department that oversees OCS, wrote over email that there is a lack of appropriate placements nationwide for youth with serious behavioral and emotional challenges. She wrote that they will continue to use “all existing services to the greatest extent possible,” and work towards the least restrictive care settings.
But Amanda Metivier, who runs the nonprofit Facing Foster Care, said that lack of placements means foster kids stay in psychiatric facilities for too long.
“They do an intake at a hospital, they get a diagnosis, and then they linger there,” Metivier said. “(It) used to be for months on end, but because of court cases, it's now weeks.”
Right now kids have the right to a court hearing within 30 days of admittance, but the bill passed by the state House March 26 would reduce that timeline to seven days. That’s still much longer than many states, which require a hearing within 72 hours.
Timeliness is important because kids say these facilities are traumatic.
“What happens in these facilities?” Metivier said. “Children are physically restrained, chemically restrained, put in quiet rooms or in seclusion.”
She said even if kids in facilities don’t experience those directly, just witnessing them can be traumatic.
If the bill passes, when a child does get a court hearing, all people invested in the child’s care would have to be there: birth parents, foster families, tribes, behavioral health care providers and OCS. Every kid over age 10 would also have a lawyer who could advocate for them being in the least restrictive setting appropriate.
State Rep. Andrew Gray, D-Anchorage, who sponsored the bill, said there’s a lot at stake.
“The absolute human rights violation of having your freedoms completely taken away and no one coming to help you, that alone is enough that we have to fix it,” Gray said. “But, if you want to just look at it from a fiscal perspective, we're wasting tons of money on keeping a child in the most expensive possible placement.”
He said inpatient care can cost more than a thousand dollars a night per child, a cost that is usually shared by the state and federal government.
The legislation didn’t pass last session when it included a shorter 72-hour time period before a required hearing, but Gray is optimistic it will pass this year. He said it’s important kids don’t get stuck in these places.
Metivier worked with kids in foster care to help draft the bill, and said it would add a sense of urgency to the process of assessing the care.
“We need to act quickly on either identifying a higher level of care or different therapeutic intervention, or releasing them,” she said.
Tali Stone didn’t get that kind of grace. She said she never got a hearing at all to assess whether she should be at North Star. And she said her experience there, totaling about four months, changed her from an outgoing kid to one who was reserved and numb.
“I didn't have anyone else to tell me that you're just a kid,” she said. “You're just dealing with stuff that's natural, if you're going through this situation, telling me that I'm not a bad kid, that I’m loved, stuff like that.”
Stone said now, at age 19, about nine years after her last stay, she still feels the effects. She struggles with self esteem and self hatred.
But she recently got a job she loves, she said, with a coworker she admires.
“Every day, he's just being himself, and I look up to him,” Stone said. “I want to know how that feels one day.”
She said she really hopes this bill passes. It now heads to the state Senate. She wants foster kids in institutions to know they’re not forgotten, and there are people out here looking out for them.
