Alberta's child advocate says 'checking boxes' approach to child welfare needs overhaul

Some of Alberta's most vulnerable children are struggling to access care in a system focused on "checking boxes" and meeting deadlines, says the province's child advocate.

In his latest report, issued Tuesday, Child and Youth Advocate Del Graff says the child welfare system needs to measure its success based on the individual social outcomes of each child, not on "hitting targets." 

"Governments are able to count quite effectively ... but there is a greater challenge, and that relates to the quality of the services provided," Graff said in an interview.

"The system is able to quantify the number of children served and how many days they've been in care and those type of measures, but they don't look very closely at how well those children were served." 

Graff's report details the deaths of nine young people between the ages of two years and 20. They died in a 14-month period of 2018 and 2019.

The report also documents feedback from more than 100 service providers in a series of virtual town halls held this spring.

Graff is calling on the government to review and change the way caseworkers track and evaluate children in their care. He recommends that access to, and awareness of, training be improved for all service providers.

Targets missing the mark

"During the town hall meetings, we heard that 'the symbols of achievement' — checking boxes that an assessment is done — sometimes sideline or displace what is actually supposed to be achieved," Graff wrote.

He said the focus of publicly reported quality assurance measures appears to be "primarily quantitative," with reporting focused on meeting timelines, readmission rates, recidivism rates and caseload volumes.

"Targets, such as meeting legislated or policy timelines, indicate that an activity has occurred, but provide limited insight into whether interventions were successful in achieving the desired social outcomes." 

Services are often tailored to a specific concern without considering the longer-term safety and well-being of the young person, Graff wrote.

"Young people have histories and challenges beyond the presenting concern, and their circumstances are also likely to change over time," he wrote.

"Service providers should assess young people's circumstances within the context of their histories, families and communities, so they can respond to changing needs."

The children whose deaths Graff reviewed are identified with pseudonyms.

Many were exposed to substance abuse. All had been exposed to family violence. Seven of the nine were Indigenous.

Whitney, Josh, and Greg, three Indigenous siblings, died with their grandparents in a house fire.

Camden, a First Nation boy born with a heart condition, was cared for by relatives after his mother's suicide. He died of sepsis when he was eight.

Natalie, who struggled with addiction and suicidal thoughts, died at 20 after developing an infection in her heart valves.

Three others died of suspected or confirmed drug overdoses.

Trevor, a young First Nation man who dreamed of owning a construction company, was stabbed to death after joining a gang. He was 20.

Under Alberta law, the child advocate must conduct reviews into the deaths of young people who die in care or within two years of receiving care. Trevor was receiving child intervention services when he died. The other eight had received services within two years of their deaths.

In the report, Graff said the children received care that often failed to account for their family history, past traumas, or previous interactions with the child welfare system. Each involvement "appeared to be viewed as a singular event," he wrote.

"Interventions did not appear to be holistic and appeared to be focused on the mandate of each service provider. At times, the physical, emotional and mental health needs of these nine young people did not appear to be met." 

The report highlights another ongoing weakness within the system, Graff said: a lack of information sharing among care providers.

He said consultations showed many workers were uninformed about how they could collaborate with other departments when serving the same client.

Consistent, cross-ministry training is critical so that care providers are working together to serve the needs of children and youth, he said.

"It is systems that serve these children and those systems have to have the capacity to talk."

Graff will retire next March. A search for his replacement is ongoing.