- This is Rachel.

She was about three years old here.

- [Steph] For years, Mary McDonough has spent more time visiting her daughter than living with her.

- It was very disturbing to be away from her.

- [Steph] 15-year-old Rachel was diagnosed with autism when she was six.

- She was one of those that was hard to diagnose.

She was very social, cracked jokes, you know, she talked a lot, she gabbed, and she didn't present as a typical child with autism.

- [Steph] Her mental health and behavioral problems started as young as three years old and only got worse as she got older.

- As the years went on, she became very aggressive.

She was doing a lot of self-injury, headbanging, biting herself.

She started throwing things and breaking things, and it got to be, you know, when she was really in a rage, we had this thick, heavy wooden table, and she would, like, lift it up and throw it.

You know, she seemed to have, like, this strength that was incredible.

- That's how Rachel landed at Bradley Hospital for the first time back in 2017 when she was nine.

It's the only psychiatric hospital for children in Rhode Island.

When you got to Bradley, how long did you think she was gonna stay there?

- Well, so when you walk into Bradley into the admission section, there's a sign that says how long your child's gonna be there, and it's seven to 10 days.

So that was my understanding, seven to 10 days.

- [Steph] The reality was much different.

- She was in and out of Bradley for lengthy stays.

I'm talking, you know, six- to nine-month stays.

- [Steph] Mary says Rachel spent more than 1,000 nights at Bradley Hospital, over a dozen admissions in five years.

- She essentially lived there.

She was there more than she was home.

When she was able to come home, it was just the same thing, you know, it didn't seem like anything was working for her.

And so there was no services because there wasn't any available.

And we tried, we tried to keep her home.

We did it for as long as we can, but as she got bigger, you know, she was throwing me against the wall and she was pushing me onto the floor.

- [Steph] Eventually, her parents were confronted with a difficult choice: to discharge Rachel to a residential treatment center rather than continuing the cycle of repeat hospitalizations.

- To find a residential was, you know, what they told us was just turning out to be impossible.

There was nothing in Rhode Island available.

There was no girls' residentials.

And so they started, you know, towards the end, looking, like, all over the United States.

That was just one of those things that I had a hard time with because how can you mother your child in California?

- [Steph] Mary says it took a year for the Department of Children, Youth, and Families, or DCYF, to find a spot for Rachel at a residential facility in Massachusetts.

For most of that time, she languished at Bradley.

- As it turns out that Bradley Hospital is just like a nursing home for children waiting for residential placement.

- It is an appalling failure.

- [Steph] Rhode Island's US Attorney Zachary Cunha says the Department of Justice started investigating the situation at Bradley in 2022.

- We looked at a time period between 2017 and 2022, and in that time, we found there were 527 kids who were housed longer than they should have been at Bradley.

The idea that you're basically, instead of living the normal life of a kid, you're in a locked room in a psychiatric hospital, the potential consequences of that are terrible.

- [Steph] Cunha sent his findings to state officials in May, accusing the state of violating the civil rights of hundreds of children, some of whom were at Bradley for more than a year.

- The Supreme Court has said for over 20 years, and going on 30, that basically individuals with disabilities need to be treated in the least confining setting appropriate to their condition.

So you have kids who require hospitalization 'cause they're in crisis and they need to be stabilized, but when that crisis is over, they're supposed to be cared for in a less restrictive setting, and that's what's not happening here and that's what our case is about fundamentally.

- [Steph] Cunha says he does not place blame on Bradley Hospital.

- Bradley Hospital definitely did identify some of these issues here.

They flagged some of these cases to DCYF.

In fact, part of the problem here is that you had professionals at Bradley Hospital telling DCYF, "These kids are ready to go.

They're ready to move on from our care."

And DCYF failed to place them in less restrictive contexts.

- Both the DCYF director, Ashley Deckert, and Governor Dan McKee declined to be interviewed for this report about what they are doing to try and solve this crisis.

A spokesperson says the state is in confidential talks with the Department of Justice and it would be premature to talk about next steps.

- The state has reached out to us, we've begun discussions.

We have heard and seen things in the course of our investigation that suggest that DCYF is aware of this issue and is amenable to making change.

- [Steph] In a one-page letter responding to Cunha on May 22nd, Director Deckert said, quote, "Ensuring the safety and wellbeing of Rhode Island's children is DCYF's top priority," while also blaming the issue on, quote, "nationwide mental health staffing challenges."

- If the state needs to revise how it conducts these programs structurally, if it needs to revisit how it does discharge planning, whatever the cause, the state needs to fix it.

- So the options are, you come to some sort of settlement or agreement with the state or you sue?

- Basically, yes.

I am hopeful, I am always hopeful.

It's always in everyone's best interest to try and resolve issues without litigation.

The goal here is to get these kids the care they need, not to wind up in court for many years, but we're gonna see where these discussions go.

- In Rhode Island, there is not meaningful discharge planning going on because there are not meaningful supports in the community to go to.

- [Steph] Morna Murray, the executive director of Disability Rights Rhode Island, was not surprised by the DOJ's findings.

- There is a dearth of community services available, there are not enough providers, there is not enough money being spent on community-based services.

And while we're talking about community-based services, just to demystify that word, it's just services that are available to children and families where they live rather than having to go to a residential setting, which is the, you know, option of last resort when we're talking about vulnerable kids.

They don't belong in hospitals.

- [Steph] DCYF says they contract with residential facilities, group homes, and in-home services, all options for children being discharged from Bradley.

But the DOJ says there are not nearly enough, and the state has pulled children out of the only psychiatric residential facility in the state, St. Mary's Home in North Providence, amid allegations of abuse, neglect, and dysfunction.

The use of residential facilities is a hotly debated topic in the child welfare world.

- There's all kinds of not only anecdotal evidence but hard evidence across the country that these kinds of residential settings are harmful for children.

Far from being an answer, they actually exacerbate distress and other behavioral health challenges that children are experiencing.

- [Steph] Currently, 76 children in DCYF's care are placed out of state, including Rachel McDonough, because of the lack of facilities here.

Responding to the need, two years ago, lawmakers approved $45 million for a 16-bed residential facility for girls.

Construction is set to begin this summer in Exeter.

- Adding more beds so that you can long-term institutionalize more kids who can be adequately cared for in the community, that's not the solution.

That's exacerbating the size of the problem.

- We would advocate for taking some of the money, a significant portion of the money that's going towards residential beds, and putting that towards community services, because not only are community services more effective, more compassionate, creating more connections for children, which is what they need, but they're far cheaper, far less expensive.

They are a fraction of what residential care costs.

- [Steph] One of those options is called therapeutic foster care, where foster parents are trained and paid to care for children with special needs.

The DOJ found that the state cut the pay to those foster parents in 2020, which over time led to fewer families being available that could have taken in children waiting to be discharged from Bradley.

- Of course, we're outraged by that and we can't understand that.

At the same time, state governments are constantly robbing Peter to pay Paul.

- [Steph] In the most recent legislative session, lawmakers funneled millions of additional dollars to DCYF, including for foster care and for workforce development so mental health providers can hire more staff.

- My ideal scenario would be Rachel would be home with her family, I would have staff here to take care of her.

- And does that scenario not exist?

- It does not.

- [Steph] Mary McDonough says Rachel is doing better at the residential treatment facility in Massachusetts, where she also receives rigorous schooling after missing so much education while living in the hospital.

But she is only allowed to see her parents for short visits.

- Well, we want her home, you know, we want her back home.

If services become available where we can take her home, that would be great.

But the school systems here, even the private schools, have been, in the past, unable to deal with her, so she didn't really get an education.

She's missed most of her childhood.

- Do you believe the state of Rhode Island has failed Rachel?

- The state of Rhode Island has failed her miserably, has failed our whole family.