The school district where kids are sent to psychiatric emergency rooms more than three times a week — some as young as 5
SALISBURY, Md. — Three times a week, on average, a police car pulls up to a school in Wicomico County on Maryland’s Eastern Shore. A student is brought out, handcuffed and placed inside for transport to a hospital emergency room for a psychiatric evaluation.
Over the past eight years, the process has been used more than 750 times on children. Some are as young as 5 years old.
The state law that allows for these removals, which are known as emergency petitions, intended their use to be limited to people with severe mental illness, those who are endangering their own lives or safety or someone else’s. The removals are supposed to be the first step in getting someone involuntarily committed to a psychiatric hospital.
But advocates say schools across the country are sending children to the emergency room for psychiatric evaluations in response to behaviors prompted by bullying or frustration over assignments. The ER trips, they say, often follow months, and sometimes years, of the students’ needs not being met.
In most places, information about how often this happens is hidden from the public, but in districts where data has been made available, it’s clear that Black students are more frequently subjected to these removals than their peers. Advocates for students with disabilities say that they, too, are being removed at higher rates.
“Schools focus on keeping kids out rather than on keeping kids in,” said Dan Stewart, managing attorney at the National Disability Rights Network. “I think that’s the fundamental crux of things.”
In 2017, as part of a settlement with the Department of Justice intended to address widespread racial disparities in how students were disciplined, schools in Wicomico County agreed not to misuse emergency petitions. But while the number of suspensions and expulsions declined, mandated trips to the emergency room ticked up.
Last year, children were handcuffed and sent to the emergency room from Wicomico schools at least 117 times — about once per every 100 students — according to data obtained from public records requests to the Wicomico County Sheriff’s Office.
At least 40 percent of those children were age 12 or younger. More than half were Black children, even though only a little more than a third of Wicomico public school children are Black.
In interviews, dozens of students, parents, educators, lawyers and advocates for students with disabilities in Wicomico County said that a lack of resources and trained staff, combined with a punitive culture in some of the schools, are behind the misuse of emergency petitions.
One Wicomico mom, who asked for anonymity because she feared retaliation from the school, recalled the terror she felt when she got the phone call saying that her son’s school was going to have him assessed for a forced psychiatric hospitalization. When she arrived at the school, she said, her son was already in handcuffs. He was put in the back of a police car and taken to the hospital.
“He said his wrists hurt from the handcuffs,” the boy’s mom said. “He was just really quiet, just sitting there, and he didn’t understand why he was in the hospital.”
The use of psychiatric evaluations to remove children from school isn’t just happening in Wicomico. Recent data shows that New York City schools still call police to take children in emotional distress to the emergency room despite a 2014 legal settlement in which they agreed to stop the practice.
A Kentucky school district was found to have used a forced psychiatric assessment on kids more than a thousand times in a year.
In a settlement with the Education Department’s Office of Civil Rights, , the Stockton Unified School District in California agreed to protocols that require other interventions before referring students with disabilities for psychiatric evaluation.
In Maryland, Wicomico uses emergency petitions more often per capita than almost every other Maryland district where data is available. Baltimore City, for example, last year had 271 emergency petitions from schools, compared with Wicomico’s 117, according to data obtained from law enforcement agencies through public records requests. But Baltimore City’s student population is five times as large.
‘Trying to get him out of school’
Wicomico parents describe struggling to get support from the schools when their children fall behind on basics like reading and math in early grades. These gaps in learning can lead to frustration and behaviors that are challenging for teachers to manage.
The Wicomico mother whose son was handcuffed said she fought for years with administrators to obtain accommodations for her child, who is autistic, an experience echoed by other parents. Her son, who also has ADHD, was several years behind in reading by the time he got to middle school. The mother said he was sent to the hospital after an outburst rooted in frustration, not mental illness.
She recalled school officials telling her, “‘He doesn’t have special needs, he just has anger issues.’ They were trying to get him out of the school.”
Her son had grown increasingly discouraged and agitated over an assignment he was unable to complete, she said. The situation escalated, she said, when the teacher argued with him. The student swiped at his desk and knocked a laptop to the floor, and the school called for an emergency petition. After being taken to the hospital in handcuffs, he was examined and released.
“After that, he went from angry to terrified,” she said. “Every time he saw the police, he would start panicking.”
A spokeswoman from the Wicomico County Public Schools said that emergency petitions “are used in the most extreme, emergency situations where the life and safety of the student or others are at risk.”
“[Emergency petitions] are not used for disciplinary purposes and frequently do not result from a student’s behaviors,” Tracy Sahler, the spokeswoman, said in an email. “In fact, a majority of EPs are related to when a student exhibits suicidal ideation or plans self-harm.”
Schools did not respond to questions about why the rate of emergency petitions was so much higher in Wicomico than in other counties in Maryland. The Sheriff’s Department declined to share records that would show the reasons for the removals.
Educators stretched thin
By law, certain classroom removals must be recorded. Schools are required to publicly report suspensions, expulsions and arrests — and the data reveals racial disparities in discipline. Those statistics are what state and federal oversight agencies typically use to judge a school, and they often serve as triggers for oversight and investigations.
But with the notable exceptions of Florida and New York City, most places do not routinely collect data on removals from schools for psychiatric assessments. That means oversight agencies don’t have access to the information.
Without insight into how often schools are using psychiatric removals on children, there is no way to hold them accountable, said Daniel Losen, senior director for the education team at the National Center for Youth Law.
“The civil rights of children is at stake, because it’s more likely it’s going to be Black kids and kids with disabilities who are subjected to all kinds of biases that deny them an educational opportunity,” he said.
Families who have experienced emergency petitions say that the educators who can best communicate with their child are stretched thin, and measures that could de-escalate a situation are not always taken. The day that her son was sent to the hospital, the Wicomico mother who requested anonymity recalled, the administrator who had consistently advocated for him was out of the building.
In another instance, a middle schooler said that the required accommodations for his learning and behavioral disabilities included being allowed to take a walk with an educator he trusted. The day he was involuntarily sent to the hospital, that staff member was unavailable. When he tried to leave the building to take a walk on his own, an administrator blocked him from leaving. The student began yelling and spat at the staffer. He said that by the time police arrived, he was calm and sitting in the principal’s office. Still, he was handcuffed and taken to the hospital where he was examined and released a few hours later.
Because emergency petitions happen outside the standard discipline process, missed school days are not recorded as suspensions. For students with disabilities, that has special consequences — they are not supposed to be removed from class for more than 10 days without an evaluation on whether they are receiving the support they need.
“If you use the discipline process, and you’re a student with a disability, your rights kick in,” said Selene Almazan, legal director for the Council of Parent Attorneys and Advocates. With emergency petitions, the same rules do not apply.
In many places around the county, the resources needed to support students with disabilities are scarce.
“‘He doesn’t have special needs, he just has anger issues.’ They were trying to get him out of the school.”
Wicomico, Maryland, mother whose autistic son was sent to hospital in handcuffs
On Maryland’s Eastern Shore, lawyers and advocates for families said the spectrum of alternatives for students is limited by both money and geography. Those can include private, out-of-district placements and specialized classrooms for specific needs like dyslexia, for example.
“If it’s a resource-rich school system, you can provide services and supports,” said Maureen van Stone, director of the Maryland Center for Developmental Disabilities at Kennedy Krieger Institute. “If you need a walk, if you need a sensory work break, if you need to go see the school counselor, those kinds of things can prevent some of this escalation of getting to the point that you’re … emergency petitioning.”
When children need targeted services that are unavailable in the local district, the district must allow them to be educated outside the school system — and pay for it.
“You’re stuck between a rock and a hard place because you’re like, ‘This kid needs more services,’ but you can’t get the school to agree,” said Angela Ford, clinical director at Maple Shade Youth and Family Services, which serves children with emotional and behavioral disabilities in Wicomico.
Last year, only one student was placed in a private day school, according to data from the Maryland State Department of Education.
ER trips increased after settlement
The 2017 settlement with the Justice Department required the Wicomico district to reduce the significant racial and disability-related disparities in suspensions, placements in alternative schools and other discipline measures.
The district agreed not to use emergency petitions when “less intrusive interventions … can be implemented to address the behavioral concern,” and not to use them “to discipline or punish or to address lack of compliance with directions.”
But since the settlement, many parents, teachers and community leaders said the district has seemed more concerned with keeping suspension numbers down than providing support for teachers to help prevent disruptive behavior.
“If we know how to handle and deal with behaviors, then we will have less EPs,” said Anthony Mann, who was an instructional aide at Wicomico County High School last year and is a Wicomico public school parent.
“The civil rights of children is at stake, because it’s more likely it’s going to be Black kids and kids with disabilities who are subjected to all kinds of biases that deny them an educational opportunity.”
Daniel Losen, senior director for the education team at the National Center for Youth Law
Tatiyana Jackson, who has a son with a disability at Wicomico Middle School, agrees teachers need more training. “I don’t think they have a lot of patience or tolerance for children with differences. It’s like they give up on them.”
Wicomico school officials said ongoing professional development for staff includes the appropriate use of emergency petitions.
“Each school has a well-trained team that includes a social worker and school counselor, with the support of school psychologists,” said Sahler. “All supports that may be beneficial to assist the student are utilized. However, the safety of the student is paramount, and the determining factor is ensuring that there is no unnecessary delay in obtaining aid for the student.”
But Denise Gregorius, who taught in Wicomico schools for over a decade and left in 2019, questioned the feasibility of the discipline and behavior strategies taught during professional development.
“The teachers, when they said they wanted more discipline, really what they’re saying is they want more support,” she said.
“You’re stuck between a rock and a hard place because you’re like, ‘This kid needs more services,’ but you can’t get the school to agree.”
Angela Ford, clinical director at Maple Shade Youth and Family Services
Under the terms of the settlement, Wicomico was under federal monitoring for two years. Since then, the number of suspensions and expulsions has declined markedly — for both Black and white students.
But the number of emergency petitions, which don’t appear in state statistics and are often only revealed through FOIA requests, has edged up. And other measures of exclusionary discipline remained high, including school arrests. In 2021-22, Wicomico had 210 school-based arrests — the second-highest number in the state, while they were 15th in student enrollment. More than three-quarters of the children arrested were Black, and 80 percent were students with disabilities; 37 percent of Wicomico students are Black, and 10 percent of Wicomico students have disabilities.
“Monitoring the numbers doesn’t bring you the solution,” said Losen, from the National Center for Youth Law. “If you’re going to a district where they’re resistant, and they have sort of draconian policies that they can’t justify educationally and there are large racial disparities, the problem is more than what they’re doing with discipline.”
The Department of Justice declined to comment.
Black parents point to culture problem
Some Wicomico parents and educators point to an insular culture in the school district where problems are hidden rather than resolved.
They are frustrated, for example, that there is no relationship with the county’s mobile crisis unit, which is often relied on in other counties to help de-escalate issues instead of calling the police.
Many Black parents say they believe their children are more often viewed as threats than as children who need support.
Jermichael Mitchell, a community organizer who is an alum and parent in Wicomico County Schools, said that teachers and school staff often do not know how to empathize with and respond to the trauma and unmet needs that may lead to children’s behavior.
Last year, among children sent to the hospital on emergency petitions by Wicomico schools, at least 40 percent were age 12 or younger and more than half were Black children..
“A Black kid that’s truly going through something, that truly needs support, is always looked at as a threat,” he said. “You don’t know how those kids have been taught to cry out for help. You don’t know the trauma that they’ve been through.”
Studies have found that Black and Latino children who have a teacher of the same race have fewer suspensions and higher test scores. Such educator diversity is lacking in Wicomico County: Its schools have the largest gap in the state between the percentages of students of color and teachers of color .
Wicomico school officials said they do not discriminate against any of their students.
A Wicomico teenager described a years-long process of becoming alienated from school, with an emergency petition as the ultimate break. He said he was bullied in middle school over a series of months until one day he snapped and hit the student who had been taunting him.
The school called the police. He told the officers not to touch him, that he needed to calm down. Instead, the officers grabbed him and shoved him onto the ground, he said. He was handcuffed and transported to the emergency room. But when he returned to school, he said the only thing that was different was how he felt about the adults in the building.
“I got used to not trusting people, not talking to people at school,” he said. “Nothing else really changed.”
This story about emergency petitions was produced by The Associated Press and The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education.