Perspectives on Transition and Aftercare Support

Many children and youth need support during transitions between residential care settings and after exiting residential care. Lack of support has been documented in several previous reviews of residential services. In the Blueprint for Fundamental Change (2007), MCYS acknowledged the need for cross-sector collaboration during discharge planning in order to maximize residential stability and connections with caregivers and other supports. Collaboration is required among young people, service providers, and families in order to organize the necessary formal and informal supports for children and youth as they transition between care settings or out of care altogether.

The Panel heard that young people returning to their families of origin after discharge from mental health treatment had difficulties maintaining gains from those services. In many instances, support from the residential service provider was withdrawn after discharge. This concern was also noted in CMHO’s 2015 report, which indicated that contact with services is often lost as children and youth move in and out of residential treatment, leaving them on their own with little aftercare support and treatment guidance. Likewise, Kinark’s 2015 report noted that young people who are placed in high quality treatment programs thrive in the therapeutic milieu but often struggle once removed from that environment. Kinark called for an emphasis on preparing children and youth for life beyond residential treatment.

Young people who spend time in custody/detention require support when transitioning back into the community. The Youth Criminal Justice Act mandates reintegration supports and, although MCYS is currently piloting two reintegration centres for this purpose and utilizes a Single Case Management Model in which youth have one Probation Officer assigned who has the responsibility to plan for release, there is a critical need for more support for young people transitioning into the community. Like in the children and youth mental health sector, the Panel found that families were often excluded during a young person’s time in custody or detention, which left them without the tools needed to support the young person upon their return home.

Given that families were often excluded from the plan of care and the daily life of the child or youth while they received residential services, it is unsurprising that some families felt it was impossible to provide the level of support required after discharge. With no assistance in helping the young person transition into a different living, school and community environment, families felt at a loss. The Panel also heard that for the many young people who had negative and sometimes traumatic experiences while in care, treatment, or custody/detention, the return home or to another residential setting was particularly challenging. Some parents expressed that they did not know who their child was anymore after residential services, and they felt unprepared to cope with the mental health and relational challenges that had been exacerbated while in care, treatment, or custody/detention.

Researchers and advocates have highlighted the challenges associated with “aging out” of child welfare and other forms of out-of-home care. As the Provincial Advocate for Children and Youth has stated in the report 25 is the New 21 (2011), young people in the care of the province simply do not obtain the same access to resources as their peers outside of care, and they do not have the same sense of connection to family and community. These vulnerabilities are compounded by often highly traumatic histories of abuse and neglect and mental health difficulties. Although the province has provided greater levels of support to transition-aged youth in recent years, it was clear to the Panel that young people leaving care feel unsupported and unprepared for adulthood. Consistent with an overwhelming body of research evidence, the Panel heard that youth leaving care are vulnerable to entering the shelter system or becoming homeless, struggling with chronic unemployment and dependence on social assistance, and suffering from mental illness.

The Panel heard from children and youth across multiple sectors that they do not feel that they acquire the life and social skills in residential care needed to function independently when they transition to the community or age out. In some cases, young people felt their life and social skills had deteriorated while in residential care, treatment, or custody/detention, because of the rigid rules present in the residential setting that did not come close to resembling regular life. Rules such as not being able to speak during meal times or movie nights were harmful to the development of social skills, and the use of institutional terms (e.g., “CT” or “Community Time” to refer to an outing to the mall or a walk in the park) made young people feel as though they were getting further and further away from regular life. Children and youth desperately wanted to learn the skills and abilities that other young people learn while living in home environments, and above all, they wanted trusting and long lasting relationships to help sustain them into independence.