This story could have ended very badly.
Cold and agitated on a January day in 2011, Lilly, 13, was warming her hands on a tail-pipe when Marblehead police approached her. The girl, used to people restraining her, was prepared this time. She pulled a knife from her sleeve. Police pulled their guns.
Confrontation was nothing new for Lilly, whose mental illness emerged when she was 7. Mundane arguments with her sisters Elsie and Hannah quickly became horror shows. Lilly would throw anything that wasn’t nailed down, attack her sisters, hurt herself. Sometimes she would climb to the ceiling and drop to the floor, just to feel the rush.
“We had a safety plan,” says her mother Kate. “When Lilly would rage, Elsie would make the call to police and run to a neighbor’s house with Hannah, and I’d hold Lilly.”
By the time police drew their guns, her whole family was on the edge. Her older sister Elsie, who has a milder form of bipolar disorder than Lilly, was coming undone under the pressure. Her younger sister Hannah was anxious and afraid to come home after school. Poor and desperate for services, Kate found herself wondering if she should neglect Lilly so the state would step in.
Last year’s arrest saved them all. Lilly was taken to a residential treatment center. Years ago, that’s where she would have stayed for years. Some kids — with behavioral issues, mental illness, abusive living situations — need to be removed from their families for long periods, or permanently. But the aim these days is to keep kids at home. For many kids, being separated from their loved ones for long periods worsens their problems: Their behaviors can escalate, and re-entry can be all but impossible.
So, after a couple months, Lilly came back her little house in Marblehead, and the state sent in Youth Villages, a nonprofit that equips families in crisis to manage their problems. Funded with state money, it’s an intensive program, with a caseworker visiting the home as often as five times a week.
“We were so low,” Kate says. “We were up for anything to keep our family together.”
The Youth Villages caseworker taught Kate how to lock up medications and sharp objects so Lilly couldn’t hurt herself. She helped the family see the warning signs before Lilly’s eruptions, and help calm her. She coordinated Lilly’s care with her school, therapists, and the legal system. She worked with Lilly and her sisters to set goals, to make their lives about more than the next eruption. Most importantly, she trained the family to do all of this for themselves.
A year after Youth Villages met Lilly’s family, here is where they are: Lilly, now 15, will soon finish ninth grade; she has thrown herself into art and photography and wants to be a mechanic; and she knows when her emotions are getting away from her, can talk about it, and rebalance herself. Elsie, 19, and Hannah, 12, can be safely alone in a room with their sister. The family just took their first-ever vacation, to Hershey, Pa.
“Until now, I wouldn’t entertain the thought,” Kate says. “To go someplace and be out in public?”
The family no longer needs the intensive help Youth Villages provides. Lilly is still ill, and they have their trials. But few of their achievements would have been possible if she were in residential treatment.
During the past couple of years, the Department of Children and Families has expanded its contracts with Youth Villages and similar outfits, even as its overall budget has shrunk, says Commissioner Angelo McClain. Those services cost half of what residential programs do.
Sitting with this happy, loving family in their cramped living room on a recent morning, it’s easy to see what a huge bargain that is.