Amanda Sweden moved into her first foster home at age 9 – a yellow ranch in Bradford –  scared and wishing that she would soon reunite with her mother. Sweden said state child protection workers told her that would happen within days or weeks.

Instead, Sweden spent the rest of her childhood in foster homes, group homes or homeless. At the age of 16, she ran away from a group home twice.

“In foster care, no space is ever yours. It’s always someone else’s,” said Sweden, 28. “By the end, foster care to me was the prison, and I would rather be homeless than be there.”

Sweden, of Bangor, is not alone in spending a long time in foster care.

In Maine, the median stay in the foster care system is 21 months at the time of exiting the system, third-highest among all the states and well above the national median of 14 months, according to U.S. Department of Health and Human Services data from 2017, the most recent year available. Maine trailed only Illinois and the District of Columbia, where the median stays are 33 months and 24 months, respectively.

At the other end of the spectrum, in New Mexico the median stay in foster care is 5.6 months, and in several other states the median time children spend is less than a year.

Research shows that extended time in foster care produces worse outcomes for children, including increased risk of behavioral and mental health problems, homelessness and poor school performance, according to Casey Family Programs, a national nonprofit think tank. Reunification with parents, when it can be done safely, is best for children.

The Maine Department of Health and Human Services, which oversees the foster care system, prioritizes family reunification, and officials point to recent gains that have been made in reuniting families sooner or, in some cases, finding adoption placements.

But the state faces enormous challenges. Reports of child abuse and neglect have escalated, and the opioid epidemic has pushed more children into the foster care system at a time when the number of foster homes has declined.

“This is not going to be a quick fix, as our resources had become very thin,” said Chris Bicknell, executive director of New Beginnings in Lewiston, a nonprofit that serves homeless youth and helps foster children who are aging out of the system. “They have to rebuild a department that had been demolished from the inside out during the LePage administration.”

Sweden, who entered the foster care system because of her mother’s drug use and legal problems, wouldn’t share a home with her mother again until after she turned 16.

At her first foster home, she cried herself to sleep every night and kept a photo of her mother with her at all times. She remembers the hunger – the intense cravings emanating from the pit of her stomach when her foster family refused to feed her, which was often.

If she didn’t finish her dinner because she was a picky eater – and she didn’t like meatloaf and squash, among other dishes – her foster mother withheld food. Or if she broke a minor rule, like missing curfew by a few minutes or arguing with other kids, she knew that meant she would go hungry.

“We weren’t troublemakers, but any little thing we did wrong, we weren’t allowed to eat the next day,” Sweden said. “Sometimes we went days without eating and would get so hungry we would throw up bile. Then (my foster mother) would get angry with us and give us a piece of toast.”

One time at the home, Sweden saw other hungry foster children sneaking into the kitchen in the middle of the night to scrounge for food. The next morning, her foster mother had locked the kitchen cabinets.

The Bradford home was run by a now-deceased senior couple fostering several children, Sweden said, and it was one of eight foster homes or group homes she lived in before aging out of the system at age 18.

PERSISTENT PROBLEM

The length of time in foster care has been a persistent issue in Maine, spanning Democratic and Republican administrations. In 2008, Maine had the fourth-highest median time spent in foster care of all states, at 21.7 months.

Child welfare experts say limiting the amount of time in foster care is, in general, best for children.

“Longer stays in foster care increase the chance of multiple placements, which are associated with problems of attachment, poor school performance and behavioral difficulties. Those who stay in care the longest are at risk of becoming one of more than 20,000 young people who leave the foster care system each year with no achieved permanency outcome, at risk of homelessness, unemployment, pregnancy, and poor educational achievement,” according to the Seattle-based Casey Family Programs, which advocates for public policy that benefits at-risk children.

The longer a child stays in foster care, the chance of being reunified with the biological family plummets. One quarter of foster care placements that lasted 25 months or longer were reunified, compared to 54 percent who were reunified within one year, according to a 2016 study by the U.S. Department of Health and Human Services.

Several factors may be contributing to the lengthy stays in Maine’s foster care system. Staffing levels in the state Office of Child and Family Services dropped significantly during the LePage administration, leaving fewer caseworkers to handle the job of assessing abuse and neglect cases, placing children and evaluating whether reunification was appropriate.

The opioid crisis has afflicted thousands of Maine families, forcing intervention by public officials to protect children from abuse or neglect while their parents struggle with the disorder and seek recovery in treatment programs.

Bottlenecks can occur in the foster care system, such as in the courts and because there’s a shortage of foster parents.

Determining why Maine children have historically spent so much time in foster care is difficult because the underlying reasons may change over time, said Shawn Yardley, CEO of Community Concepts in Lewiston, a nonprofit that works closely with Maine DHHS on child welfare programs.

It’s not just the number of caseworkers but what they are working on. If cases that were once considered low-risk are elevated to middle- or high-risk, that could take more time away from busy caseworkers who otherwise would be working on a reunification, he said.

Yardley said if a child is placed in a stable foster home, caseworkers may put those situations in the “low priority” pile because they have to attend to emergency situations. That could make the reunifications take longer.

And many of the cases are judgment calls, trying to assess the stability of the parents for reunification.

“It’s not a science; it’s an art,” said Yardley, a former DHHS caseworker. “There are so many variables, and it’s so complicated, that it’s hard to draw any sweeping conclusions.”

A BALANCING ACT

Melissa Hackett, outreach associate for the Maine Children’s Alliance, said many reasons can go into why the trend is long-running, such as a lack of prevention programs or access to substance use treatment that would give parents a chance to recover and reunite with their children. Without treatment, the parents may never stabilize or take longer to get to the point where the children could return.

“Ideally, children would never get removed from the home,” Hackett said. “If they must be removed, they should be reunited with family as quickly as possible, when it’s safe.” The next best option is for foster children to be adopted, if reunification isn’t possible, Hackett said.

The median time in state care is only one of a number of metrics used to evaluate the functioning of a foster care system, such as the strength of prevention programs and what percentage of children enter foster care, which in Maine, at 3.5 percent, is about the national average. In one area – placement with relatives – Maine does better than the national average, with 42 percent of foster children placed with a relative compared to the national average of 32 percent. Casey Family Programs has reported that research shows kinship placements are superior to those with non-kin foster parents.

Also, in recent years, the percentage of Maine children who re-enter the foster care system within a year after being reunited with their parents is among the best in the nation – between 3 and 5 percent. The national average is about 12 percent.

Yardley said it’s a balancing act, weighing whether the parents are stable enough for a child to return versus the harm of longer stays in foster care.

“There’s always these competing struggles,” Yardley said. “Children do better if they are able to reunite with their family, even if there’s some dysfunction in the family.”

Sweden said she should have had a chance to reunite with her mother much sooner than age 16.

“She has always treated me like I’m her favorite person,” Sweden said.

Dorothy Sweden, Amanda’s mom, said she feels bad her daughter went hungry and had traumatic experiences in foster care. She said she had problems with drugs, and was in jail for nine months, but she improved her life and should have gotten a chance to have her children returned.

“Nobody loves a child like their mother,” Dorothy Sweden said.

Yardley said extended time in foster care can weaken the bonds between parent and child and make reunification more difficult.

Some young Mainers had relatively good experiences in foster care.

Stephanie Gerard, 27, of Canaan said when her mother died when she was 15, she was without a family and ended up in foster care. In the first two placements, there were some personality conflicts, but the third foster family was “extremely supportive” during her last two years of high school at Erskine Academy.

“They took me in with open arms. They told me that you are part of this family now and not a foster family. They treated me the same as they would their own daughter,” said Gerard, who will enter the nursing program at Kennebec Valley Community College next year.

Although long stays in the foster care system are a chronic problem, the state has an array of programs to help teens when they age out of that system. This includes programs that help pay for higher education, rental assistance and day-to-day expenses until age 21 or 22.

There are also state caseworkers devoted to helping young adults who aged out of foster care become independent, teaching them things that they might not have learned in a foster home, such as balancing a checkbook or applying for a driver’s license.

“I feel like the world opens up to you once you age out,” said Mariah Knight, 22, a Westbrook native who entered foster care at age 12.

MORE DEMANDS ON SYSTEM

While family reunification when safe is a goal of the administration of Gov. Janet Mills, many challenges persist.

DHHS is hiring 33 more caseworkers, and Todd Landry, the new director of the Office of Child and Family Services, is advocating for doubling that number. If approved, that would bring the total to 380 caseworkers. The agency is also hiring 29 additional support staff and managers.

Yet while the state is ramping up hiring, reports of suspected abuse and neglect are climbing – from 7,463 in 2016 to 11,831 in 2018.

Also, more children are in state care, increasing from 1,724 in July 2018 to 2,195 in September 2019, according to DHHS. Nationally, the number of foster children declined slightly in 2018, from 441,000 in 2017 to 437,000 in 2018, the latest year for which national statistics were available.

Child welfare experts attribute the increase in abuse reports to more awareness after the highly publicized abuse deaths of two girls, 10-year-old Marissa Kennedy of Stockton Springs in 2018 and Kendall Chick, 4, of Wiscasset in 2017.

Meanwhile, there aren’t enough foster families for placements. The number of households that have signed up to be foster families has declined from 1,621 in 2015 to 1,536 this year.

Bette Hoxie, of Adoptive and Foster Families of Maine, an Orono nonprofit, said most foster parents are good people who want to help children, but the system has become overwhelmed with demand for services. There are not enough foster families and caseworkers have too many cases, causing bottlenecks and frustration for people trying to help children who have suffered from trauma.

“Most people are in it for the right reasons,” Hoxie said of foster parents and herself, a long-time foster parent. “A very small percentage are found to have abused or neglected a child.”

Jackie Farwell, DHHS spokeswoman, said the department is working to increase the number of foster families willing to take on teenagers and other difficult placements.

“While children of all ages in out-of-home care need support, there is a particularly urgent need for families who can parent adolescents and teenagers, sibling groups with more than two children, and infants born affected by drugs or alcohol,” Farwell said in an email response to questions.

Farwell also said that, despite the increased demand, the agency is making strides.

“The increased workload within Office of Child and Family Services has challenged our staff, but we remain dedicated to the safety of the children in the department’s custody. OCFS’ data is indicative of this commitment, with 31 percent of children reaching permanency within 12 months of entering state custody as of September 2019. That number was 29 percent in September of last year. Despite the increase in the number of referrals, assessments, and children in care, OCFS has made gains in this area.”

Landry, the office director, is also proposing to revive a near-dormant family therapy initiative as a prevention program to help head off problems before they become acute.

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