Probe finds ‘bureaucratic black hole’ played role in teen’s suicide
Kyleigh Crier was able to hang herself thanks in part to group home recommendations disappearing into “a bureaucratic black hole,” a fatality inquiry has found.
The inquiry, conducted by provincial court Judge F.K. MacDonald, also found Crier’s significant mentalhealth issues — and the teen’s previous suicide attempts — were not disclosed to workers at the home.
Crier was 15 when she took her own life in April 2014. She was living in Crossroads at the time, a group home for troubled teens, and had spent the majority of her life involved with the childwelfare system.
McDonald’s inquiry found that although Crossroads provided Crier with stability that had been absent from her life for many years, there was an information gap about the teen.
That gap came from two factors.
When Crier’s case file was transferred to a new, parttime worker, the worker didn’t thoroughly review it, relying instead on a summary. Information about Crier’s hallucinations and attempts to take her own life weren’t provided to Crossroads, “notwithstanding there was ample information on file detailing both,” MacDonald wrote.
MacDonald made three recommendations in her report.
First, that high-risk youth such as Crier should not be assigned to a part-time caseworker.
If a worker in the high-risk youth initiative isn’t available, McDonald wrote, the youth should be assigned a full-time caseworker who has had training on highrisk youth.
MacDonald also recommended that a concise, detailed and current suicide profile accompany every child in care to, and between, every care placement.
The final recommendation stemmed from the role another teen at Crossroads played in Crier’s death. The two didn’t get along, and Crier named the girl in her suicide note.
MacDonald wrote that any facility housing highrisk youth needs policies that recognize a change in dynamics between youth housed there, or a youth’s high-risk behaviour may justify the termination of a placement.