When Toni and Jim Hoy adopted their son Daniel through the foster care system, he was an affectionate toddler. They did not plan to give him back to the state of Illinois, ever.
"Danny was this cute, lovable little blond-haired, blue-eyed baby," Jim said.
Toni recalled times Daniel would reach over, put his hands on her face and squish her cheeks. "And he would go, 'You pretty, Mom,' " Toni said. "Oh, my gosh, he just melted my heart when he would say these very loving, endearing things to me."
But as Daniel grew older, he changed. He began to show signs of serious mental illness that eventually manifested in violent outbursts and nearly a dozen psychiatric hospitalizations, starting at age 10. Doctors said he needed intensive, specialized care away from home -- institutional services that cost at least $100,000 a year.
The family had private insurance through Jim's job, and Daniel also had Medicaid coverage because he was adopted. But neither insurance would pay for that treatment. Exhausted and desperate, the Hoys decided to relinquish custody to the state. If they sent Daniel back into the foster care system, the child welfare agency would be obligated to pay for the services he needed.
"To this day, it's the most gut-wrenching thing I've ever had to do in my life," Jim said. He went to the hospital and told Daniel, then 12, that they were legally abandoning him so child welfare could take over. "I was crying terribly. But it was the only way we figured we could keep the family safe."
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Two-thirds of states don't keep track of how many families give up custody to help a child get mental health services. But a study by the Government Accountability Office found that, back in 2001, families in 19 states relinquished nearly 13,000 children.
Today in Illinois, state records show that dozens of children enter state custody this way each year, despite a 2015 state law aimed at preventing it. And new data collected by the University of Maryland for the federal government finds that Illinois is not alone in failing to address this issue.
Mental health advocates say the problem is one of "too little, too late." Even when states try to help children get access to treatment without a custody transfer, the efforts come too late in the progression of the children's illnesses.
The advocates blame decades of inadequate funding for in-home and community-based services across the country -- a lack of funding that has chipped away at the mental health system. Without that early intervention, children deteriorate to the point of being needlessly hospitalized and requiring costly residential care.