From their modest home in Ingleside, Ill., Toni and Jim Hoy draft a letter to their son, Dan. He last lived with them three and a half years ago.

Dan and his brother Christian are adopted. They joined the Hoys and their two biological children 15 years ago.

The adoption decision had been risky, especially given the children’s troubled history.

“It was very chaotic,” Toni explained, citing the boys’ young birth mother. “There was prenatal substance abuse: alcohol and drugs. And there was post-natal physical abuse. Severe neglect where the children did not have food to eat. The neglect was probably worse than the abuse.”

It didn’t take long for Toni and Jim to see the childhood abuse manifest in the kids’ actions. “Soon after, we realized, probably after two years of having them in our homes, even being untrained, these were not normal kid issues,” recalled Jim. “But we had already brought them in our homes, and we made a promise to them that as long as they wanted to be here, they would always be a part of our family. And I’ve tried to always honor that promise to those children.”

Christian had manic rages and was diagnosed with bipolar disorder at the age of nine. Medications helped stabilize him.

But Dan was getting worse. Around the time he reached the fifth grade, he exploded.

“There were times where I would pick him up from school, he would wait to get in the car where he thought no one could see him, and he would basically attack me, where he knew he could get away with stuff,” Jim remembers. “He’d throw stuff at the drivers, he’d grab the steering wheel and direct us into oncoming traffic, and he thought it was funny.”

Dan was diagnosed with post traumatic stress disorder. The Hoys tried all sorts of therapies to treat Dan’s condition, including psychiatry and medications. But, according to Toni, “none of that worked either.”

The Hoys tried between 20 and 30 different medications, but Dan’s behavior became more unstable. His therapist recommended he be placed in a residential treatment center—a home with intensive therapy and specialized care.

But residential treatment is expensive. Despite looking everywhere, they were denied the family funding.

Treatment would cost over $10,000 a month. Their insurance wouldn’t cover it, and neither would the Medicaid Dan received as part of his adoption package.

The Hoys scrambled to buy time while they looked for funding. But it all came to a head when Dan was 14.

Violent behavior takes hold

Jim described the situation in detail. “By that time, we had to have Danny residentially placed because he was trying to hurt the other kids—threatened to stab them, tried to push one of his siblings down the stairs.”

They brought Dan to a nearby hospital for one of what would become countless psychiatric evaluations. By this time, hospital visits were becoming more frequent.

According to Toni, the situation was dire. “He was in the hospital, the hospital was wanting to discharge him. We were trying to stall, and we were asking if they’d hold him for just a couple of days. And they refused and told us that if we didn’t pick him up they were going to call the [Department of Children and Family Services] child abuse hotline and report us for child abandonment, and yet DCFS told us if we brought him home they were going to try us for child endangerment for failing to protect the other children.”

It was a lose-lose situation. “I thought at that time we were at our worst point, and it kept getting worse and worse and worse,” recalls Jim.

Out of the Shadows will explore the fractures in mental health care for children in Illinois and illuminate how it affects our youth.

The problems encountered by the Hoys are not typical. According to a report from DCFS, 95% of adoptions remain stable after five years. DCFS also offers a variety of post-adoption support services for families in need, but that offered little comfort to Toni.

“Ultimately, you know, it really came down to safety. When you really think about a vision of one of your children holding a knife to the other one’s throat knowing that he’s going to kill him, you know, can we go on living like that?”

Neglect charges and state red tape

Taking the advice of a therapist, the Hoys decided to leave Dan at the hospital.

“I went there and told Danny that I wasn’t going to pick him up. I mean it was the hardest thing I ever had to do in my life,” Jim remembers through tears. “For the first time since I had made that promise to Danny and to Christian that we would always be there, I wasn’t sure I was going to be able to fulfill it. It’s very, very tough.”

Toni and Jim relinquished custody of Dan and were charged with neglect. They later had the finding amended to no-fault dependency, which meant while legally they were still Dan’s parents, the state of Illinois had guardianship rights over him. As such, he was able to access residential treatment at the expense of DCFS.

But not everyone was pleased with the decision.

Kendall Marlowe is a spokesperson for DCFS. “Adopted children are not returnable, like an ill-fitting garment,” Marlowe says. “There’s a reason they call it permanency.”

Marlowe says that families seeking treatment like the Hoys place an undue burden on a department that was never designed to handle such requests.

“There have been academic studies that show that a high percentage of children who enter child welfare systems throughout this country, are, at the root cause of it, entering those systems because of unmet mental health care needs. And that’s just not the best way to get help to children and families,” says Marlowe.

Marlowe thinks families should be more vigilant about getting early preventative treatment through health service systems. “Broadly speaking, we will be more effective at delivering mental health services when it comes from the health service system. And that is not something that state will be able to conquer on their own. It will need a federal role to truly be effective.”

But it was too late for the Hoys to seek preventative treatment at the time of the relinquishment. Over the next two years, Dan would live in two different residential centers. Toni and Jim ultimately regained custody of Dan, but he’s in juvenile detention after an incident at his last residential center.

His future remains uncertain as the Hoys work towards obtaining funding for his treatment.

“You know, hope is like the air we breathe. I mean, to me I will never be out of hope for Danny. But at the same time, we gotta be somewhat…have reality and focus too,” Jim says. “Right now, if anything, Danny is worse than when he went into the residential system. That being said, my family was made complete when Danny and Christian came into our lives. Like we said, from day one when they came, if they wanted us to be mom and dad forever, we would be. And we’re here.”