Georgia parents who voluntarily give up their children to foster care aren’t necessarily abusive, neglectful or unloving, numerous speakers have told state lawmakers in a series of public hearings that concluded this week. Oftentimes, they’re simply out of options for securing the critical mental health treatment their children need.
“This is an act of desperation — parents do not want to abandon their children,” said Joe Sarra of the Georgia Advocacy Office, one of the many experts who’ve testified.
The Abandoned Child Placement Following Hospital Discharge committee has been investigating the crisis since September. The third and final hearing was held Wednesday in the state capitol complex.
At present, the Georgia Division of Family & Children Services estimates there are 500 children who have been “relinquished” by their parents and turned over to the agency due to complex behavioral or psychiatric needs.
Many, if not most of the cases, involve parents who say they cannot bring their child home from in-patient treatment in a psychiatric facility. They fear that violent or unpredictable behavior cannot be safely managed at home. In those instances, child protective services is called, and Georgia’s child welfare agency becomes legally responsible for the child’s care and custody.
To date, child welfare officials, family advocates and mental health professionals have testified for more than 10 hours. This Wednesday marked the final public hearing before lawmakers compile policy recommendations in a report.
Those who’ve testified at all three hearings largely agreed: Relinquishment doesn’t involve “bad” kids or parents. The real driver is a growing mental health crisis and a fragmented health care system that is too under-resourced to adequately meet the needs of teenagers in acute distress, whose families — financially or otherwise — cannot meet their needs.
“This is an act of desperation — parents do not want to abandon their children.”
— Joe Sarra, Georgia Advocacy Office
The pivotal decision to relinquish is typically made when hospitals and residential treatment centers set a discharge date.
“Parents are feeling they can’t carry forward and bring that child home for so many reasons — guilt, exhaustion, feeling they’re not a good parent. They’ve lost hope,” state Sen. Katie Dempsey said in the Sept. 15 hearing.
Waiting lists for treatment
The hearings laid bare some systemic problems plaguing mental health care in Georgia, problems that to varying degrees are evident nationwide: a severe shortage of psychiatric and residential treatment beds, restrictive insurance coverage plans and poor coordination between child welfare staff, mental health providers and insurers.
Caught in the middle are families, who often face their own hardships — unstable housing, lack of childcare or transportation — on top of the emotional challenges of caring for a child with complex needs. The kids often have multiple psychiatric diagnoses and can exhibit violent, aggressive behaviors toward parents and siblings.
In Sarra’s advocacy work, he receives desperate calls from parents struggling with isolation, guilt and burnout. He said many are forced to leave the workforce, spending their days calling treatment facilities and insurance companies while trying to keep the rest of the household afloat.
When the state child welfare agency is forced to step in as a last resort, parents are often determined to have abandoned their children. This form of neglect is vaguely defined and can involve any conduct on the part of the parent showing “an intent to forgo parental duties or relinquish parental claims.”
State child welfare leaders here and nationwide say these situations put their agencies in a bind, and they do not encourage the practice of leaving kids stranded in medical settings. Georgia officials have stated publicly that most relinquishment cases don’t meet the abuse and neglect criteria that is typically applied when removing kids from their families.
“For a child that is abandoned, there were so many other ways to prevent that, so many other options along the way to get them care or to keep them in their home with other interventions, instead of them becoming an orphan or a child of care,” Georgia Department of Human Services Commissioner Candice Broce said last month.
“Parents are feeling they can’t carry forward and bring that child home for so many reasons — guilt, exhaustion, feeling they’re not a good parent. They’ve lost hope.”
— Georgia state Sen. Katie Dempsey
For parents, foster care can appear to be the only path to long-term treatment after a psychiatric crisis. Doctors, hospital staff and even police will tell them so, advocates and child welfare staff testified.
But social workers often confront the very same problems as parents. Georgia operates six residential facilities for youth, with waiting lists that delay care for weeks and months. Not all facilities will accept children presenting with aggressive behaviors and certain co-occurring diagnoses such as some forms of autism. What’s more, Georgia families aren’t just competing with each other for placement — about 40% of the state’s residential treatment beds are filled with out-of-state children.
“Ultimately, you are looking for recommendations for change,” Broce said. “I don’t have a list for you, but I know that if I were to poll case managers, they would say that they wish there were more beds, especially for residential care.”
‘We’re all flying blind’
Because high-level care is so elusive, the first place kids in psychiatric distress end up is the emergency room. Often, over and over again.
Between 2015 and 2022, the number of visits to the Children’s Healthcare of Atlanta’s emergency department primarily for a behavioral or mental health concern more than doubled.
“We’re all flying blind,” said Dr. John Constantino, the hospital’s chief of behavioral and mental health.
But hospitalizations last just roughly three to seven days. If the child is no longer deemed a danger to themselves or others, they can be discharged. Long-term or outpatient care is still nowhere in sight, he said.
The problem was evident in a recent 14-year-old patient. Constantino recounted that the girl has struggled to access treatment outside the ER, despite being hospitalized 18 times for mental health crises. She harms herself and once attempted to end her life.
“No one would ever say that residential treatment is a panacea for all of these youth, but the right kind of residential programs that deliver the right kind of care at the right time is extremely important,” Dr. Constantino said.
Still, through all three recent public hearings it’s been made clear: More residential treatment isn’t the catch-all solution. Commissioner Broce and advocates for families called out facilities for releasing kids without plans for follow-up care at home and failing to include parents when deciding discharge dates.
“When no one shows up, that begins to communicate to them that ‘I’m unloved, I’m not valued.’ The sense of hopelessness begins.”
— Tanya Anderson, Youth Villages
Treatment providers who’ve testified before lawmakers defend their practices, saying they’ve spent their organizations’ own funds to create new staff positions focused on family engagement, and continue services for children left in their care after insurance coverage runs out.
“We continue to serve them every day,” Tanya Anderson, executive director of Youth Villages Georgia told lawmakers on Wednesday.
The nonprofit runs a residential program in Douglasville, with 144 beds for youth ages 6 to 18. Anderson testified on Wednesday that the facility had five cases of young people who were left in care between 2023 and 2025. The longest stay was more than six months.
While providers are forced to become temporary caregivers of sorts, the impact on the children is the most devastating, Anderson said. They know what is happening, but struggle to process it — particularly after completing what can be lengthy stints in regimented institutional programs, far from family life.
“They have done a really good job in improving their behaviors to the point where the provider is saying that they are discharge-ready,” Anderson said. “When no one shows up, that begins to communicate to them that, ‘I’m unloved, I’m not valued.’ The sense of hopelessness begins.”
Still, Anderson and other experts see solutions — including boosting state funding for in-home mental health services, residential beds and step-down care options to help kids transition home from months-long stays in treatment. Other suggestions included creating uniform, statewide policies on abandonment and leaning more heavily on voluntary placement agreements, which can provide parents with CPS case management for up to 90 days while they retain custody.
“The experience of abandonment is not something new,” Anderson said. “But I think that this conversation is certainly on time, because there’s continuing to be a rise in kids being abandoned.”
The lawmakers’ final report on the issue, which could include state funding and policy changes, is set to be released in early December.
