MIAMI -- Deb and Doug Carlsons' adopted sons have trashed bedrooms, stolen credit cards and threatened to kill them. One drew a disturbing picture of beheading the southwest Florida couple and throwing a party.
When the Carlsons adopted the now teenage boys from foster care in 2007, they were handed a slim file with few details except that the two suffered from attention deficit hyperactivity disorder. No one told the empty nesters the boys had severe mental health issues and had bounced between foster homes. Now teenagers, the boys are living in separate therapeutic group homes.
Therapists say one son needs to be in a supervised residential facility, which the state will no longer pay for, unless the Carlsons turn back custody to the state.
"We love him and he's part of our family. To have to make such a difficult decision to get him the care he needs is ludicrous. It sends a horrible message to him," said 55-year-old Deb Carlson. "You really feel like once you sign on the dotted line you're on your own. You're totally abandoned by the state."
While the overwhelming majority of adoptions end happily, some families like the Carlsons say they weren't told about their new child's psychological problems and can't get help from the government agencies that recruited them.
Their complaints come amid a nationwide push to find homes for older foster care children and those with serious behavioral and mental health problems, which can emotionally and financially drain adoptive families. Most states focus money on recruiting parents but once a child is adopted few funds are directed to supporting the new families, some experts say. About 50,000 foster children are adopted annually in the U.S., almost double the number in the 1990s.
"We place them in an adoptive home and we don't support or train the parents ... we sometimes set families up to fail and then those children are placed back in the system," said Rita Soronen, president of The Dave Thomas Foundation for Adoption. The Ohio nonprofit estimates more than 20 percent of the nearly 6,300 foster children it has served came from a failed adoption.
But there's no national data to show how many adoptions fail or track how many children need additional help, and states aren't required to track or report the figures. Florida is among the few states tracking so-called disrupted and dissolved adoptions, which happens when adoptive families return children to foster care while in the process or after finalizing the adoption. Florida had nearly 200 dissolved or disrupted adoptions in 2008-2009. There were 3,777 total adoptions that same year. However, most of the dissolved adoptions each year are actually adoptions that took place in previous years.
In Oklahoma, one child advocate said half the 14 boys in the group home where she worked had been adopted and returned to the system. Legislators there pushed for a law in 2009 fearing there was little transparency in the process.
A Pennsylvania adoption program estimates about 60 of the 200 foster children they work with come from failed adoptions.
A majority of failed adoptions involve older children with trauma issues, including reactive attachments disorder, or RADS, where children struggle to bond and act out against their adoptive families. Some have been victims of sexual abuse and, in turn, act out sexually on other siblings in the home. States typically cover a portion of care, but that coverage can run out quickly. The costly services can drain private insurance, leaving parents forced to pay out of pocket or return their child to the state to access government-funded mental health services.
Many states have relinquishment policies that force parents to choose between keeping their children and getting them help. Those who do relinquish their children may face criminal abandonment charges and may not be eligible to adopt again, said Mary Boo, assistant director of the North American Council on Adoptable Children in Minnesota.
"States could fund the treatment and not bring the kids back into foster care but they don't. It's a way to keep the states from having to pay the bill," Boo said.
The demand for more post-adoption services comes as most state child welfare agencies are already slashing budgets. Programs vary widely across the country, from telephone assistance lines that link parents with services to intensive family therapy sessions and respite care. There's little research evaluating which programs work best, making it difficult to get funding.
Florida's Department of Children and Families has trained more than 150 therapists to work with adoptive families. More than a dozen of the agency's private contractors have hired case managers to work with families after the adoption.
Ohio's program offers adoptive parents up to $10,000 for services -- a drop from $20,000.
A few states, including Pennsylvania and Illinois, offer robust programs and are even increasing services.
Casey Family Services, covering New England and Maryland, has expanded over the past three years after hearing from more families in crisis. Diakon Adoption and Foster Care in Pennsylvania, which specializes in finding homes for hard to place foster children, also had an increase in failed adoptions. Diakon connects families with a case manager to help with school problems and links them with therapists and other medical help. Services also include support groups and respite care, but families can only receive them for one year.
But in Florida, the Carlsons encountered problems when they tried to get counseling and other post adoption services for their boys: The organization's waiting list was so long they eventually told the Carlsons they couldn't help anymore.
The boys can't be left alone or play in the neighborhood like normal teens. Each week brings new crisis. Deb Carlson quit her job as a payroll manager to deal with the chaos. She spends hours on the phone navigating the system. A nonprofit advocate recently agreed to take one son's case in hopes of getting the state to pay for more residential care.
Deb Carlson doesn't understand how a loving family's noble ambition to help neglected foster children could turn into such a nightmare.
"You have these idealized visions, you treat them nicely and give them things and make up for all the things they didn't have in their life," she said. "All of the resources I've found I did on my own."
In May, several child welfare organizations lobbied Congress for more post-adoption services to help families like the Carlsons. Sen. Amy Klobuchar, D-Minn., introduced a bipartisan bill that would have required states to spend a portion of the federal dollars they already receive on adoption services and accurately report failed adoptions, but the bill stalled in committee.
"The minimal services could make a big difference for these families. They feel very abandoned sometimes. We don't even have the statistics to look at when it goes wrong, how and why," Klobuchar said. "It's very hard to improve things if we don't have that data."