Teen placed in CFS 46 times before death by overdose; report calls her care 'very disturbing'
This story contains disturbing information about child abuse
A 17-year-old girl who died of an accidental drug overdose was the victim of repeated sexual exploitation and didn't get the help she needed during her time in the child welfare system, Manitoba's children's advocate said Thursday.
The advocate released a photo and the first name of the girl, Angel, who died in September 2015, with a report that gives the Manitoba government six recommendations to address the "massive deficiencies" evident in her care and to help prevent such tragedies in the future.
"Her story as you read it is one that stands out as a shocking reminder that too many children and youth in our communities are subject to immense trauma and taken too soon," Daphne Penrose said Thursday morning after releasing a 117-page report into Angel's death that she called "very disturbing."
Angel was subject to abuse from the time she was an infant and her death could have been prevented if she had received the services and treatment she needed, Penrose said in her report.
Penrose went through a heartbreaking timeline and detailed repeated trauma in the little girl's life, which included being sexually assaulted by a man when she was just 21 months old.
Men continued to exploit her throughout her life as she went in and out of the child welfare system.
By the time Angel turned 12, she already had been apprehended 14 times. Each time, she was returned to her mother, who was living with chronic substance abuse that put her children's safety in jeopardy.
Angel needed therapeutic supports but they weren't given to her, Penrose said.
Asked for help at age 8
She asked for help when she was just eight years old, saying she wasn't able to cope with what was going on at home.
"At eight years, she was brave enough to ask for help but none was forthcoming," Penrose said.
Professionals in the child welfare system also identified that Angel needed intensive mental health therapy, but no sustained supports were ever offered.
"She was forced to endure and shoulder the weight of her trauma alone."
Recommendations for mental health supports were made at least 24 times, but the advocate couldn't confirm Angel had gotten help aside from some sporadic appointments, though she may have seen a mental health worker in her home community.
It was crystal clear adults were sexually exploiting Angel by age 11 because she was displaying 14 of the known 15 sexual exploitation indicators, Penrose said. While workers documented the symptoms, they did not identify the abusers in her life.
She also was just 11 when she tried to commit suicide.
The report says she started using solvents between the age of nine and 11.
When she was 14 or 15, she was sexually assaulted when she went home for a visit. Charges were stayed in that case and she was sexually exploited again with no followup intervention or investigation, the report says.
'Labelled by her workers'
Her attempts to cope with her trauma resulted in negative labelling, Penrose said.
"Angel was labelled by her workers as disruptive, disrespectful, and workers noted that she threw tantrums when she was disappointed or upset, and really, what they were seeing was a little girl who was in pain and suffering trauma."
There was a lack of compassion for Angel and her family, the advocate said.
While some may be quick to blame a child's mother, when parents struggle, public systems have a role to intervene, and they failed to in this case, Penrose said.
"When public systems are involved in the life of the family, we rightly expect the services are fulfilling their responsibilities. In Angel's case, the public systems that should have protected her did not," she said.
46 different placements
Child welfare officials did not complete any long-term planning or demonstrate an understanding of their legal mandate to protect Angel, Penrose said. She was moved through 46 different placements as she went in and out of care.
Angel died after taking pills from a man she and her foster sister had just met, the report says.
The man pleaded guilty to criminal negligence causing death and was given a three-year suspended sentence for his role in Angel's death, the report says. The medical examiner determined her death was accidental and caused by taking oxycodone.
Report calls out RCMP
The report also called out a Manitoba RCMP officer for using "concerning" language during an incident in Steinbach in February 2015, when Angel, then 16 and reported missing, was found lying on a bed in a home with an older male on top of her. The man on top of Angel was in a position of power, the report says.
Angel was unable to legally consent because she was intoxicated, but instead of focusing on that, police detained her and another foster child and charged them with underage drinking.
The officer is quoted as saying Angel was "almost sexually assaulted."
That officer is no longer with the RCMP.
Penrose said in meetings with child welfare officials in provincial government departments, including Health, Education, Justice and Families, there was a consensus that public services didn't identify Angel's needs properly.
A press secretary for Manitoba Families Minister Heather Stefanson said Thursday the minister hadn't seen the report and would be unavailable for interviews because she was in meetings, but gave the CBC a statement.
"We brought in the Advocate for Children and Youth Act to expand the advocate's mandate, and it gave the Manitoba advocate for children and youth power to publicly release their investigation findings to help us learn from experiences and improve government services for vulnerable youth. We thank the advocate for her work and the government departments involved will review the recommendations," Stefanson said in the emailed statement.
The statement said the department of families is finalizing sexual exploitation research for public release in the weeks ahead and is doing a third-party review of street teams that work with youth who are at risk of being victimized through the sex trade.
Penrose said the government was given an embargoed copy of the report on Wednesday and some senior officials had already seen it.
"The government has had a few weeks with this report already."
Her recommendations call for provincial officials to engage with experts in childhood trauma to develop trauma prevention strategies and ensure appropriate interventions are made to address "the trauma crisis" in Manitoba.
She recommends culturally appropriate services in First Nations and rural and remote communities and a review of Manitoba's sexual exploitation strategy.
She also wants the province to create public education campaigns that denounce the sexual exploitation of children and youth and raise awareness about the demand for sex from exploited children.
Existing provincial service standards should be updated and province-wide measures used to ensure they are consistent throughout Manitoba.
The province should also review and reform treatment programs for children and youth, and create safe and secure facilities for youth who are sexually exploited and use substances, she said.
Her final recommendation is to ensure children get medically supported withdrawal management services they need based on best practices for addiction to substances like alcohol, meth and opioids.
The Assembly of Manitoba Chiefs was quick to reiterate a call for changes to the child welfare system following the release of the report.
"The child welfare system in Manitoba has set our children up for failure, just like it is still doing with the thousands of children still in care," Grand Chief Arlen Dumas said in a news release.
The child welfare system must change, Dumas said, and he hopes First Nations are closer to being able to get jurisdiction over Indigenous families and children.
The federal government recently proposed legislation that would let Indigenous governments have control over child welfare.