Patrick Lawler Reflects on Forty Years at Youth Villages

Pat Lawler (left) stands with staff and participants at Memphis Boys Town in the 1980s, before the organization was merged with Dogwood Village to create Youth Villages. Photo: Youth Villages.

In 1980, Patrick Lawler was a young probation officer in Tennessee’s Shelby County. Lawler had started his career at just 18 working with boys in a local group home, which is why his experience caught the attention of Memphis judge Kenneth Turner.

Turner asked him to evaluate the long-term prospects of a residential program called Dogwood Village because Lawler had worked in similar in group home settings with boys as an 18-year-old entering the youth work field. Lawler ended up becoming administrator of the organization, which six years later merged with Memphis Boys Town to form Youth Villages (YV).

That year, in 1986, YV employed nine people with a budget of about $125,000. Today, the organization operates a full continuum of services in 21 states and the District of Columbia on a $230 million annual budget, and holds assets north of $384 million. The program once operating only in the Memphis area is on a path to what could end up being a $200 million investment to expand its reach around the country.

In the decades between, Lawler realigned the operation to make Youth Villages a leader in the movement to downsize group care and emphasize community responses to child welfare cases. “Solving the Puzzle,” a study of the child welfare strengths and weaknesses of Western Tennessee published by YV in 1993, found that quality residential care was the second highest need – right behind in-home services aimed at keeping families together.

“He was an early in recognizing the tragedy of kids languishing in residential care aging into homelessness and hopelessness,” said Jeremy Kohomban, CEO of The Children’s Village in New York, another longtime residential provider that moved aggressively toward more community contracts. “Pat also embraced data and evidence and in doing so, transformed his organization and was a standard bearer emulate.”

Lawler chatted with Youth Services Insider last month about the 40-year journey from his meeting with Turner to today.

You worked for the Memphis probation department before this all started. What at that point was the law enforcement perspective on kids, like how does it compare to now do you think?

In 1973, kids didn’t have guns. It was rare to have anything related to guns. Authority was very punitive. Controlling. Not at all, I don’t know, it was strict and rigid, the staff were adults and they were in charge. And the kids had much more respect for authority than today.

In those days we didn’t really recognize the mental health needs of the young people. The kids just needed to behave.

Pat Lawler with youth and staff in the early days of the organization. Photo: Youth Villages

What do you see as the most significant changes in child welfare since you started in this field?

In the 1970s and 80s, the court system was not removing kids because they had family problems or minor behavior problems. The majority of kids brought in were neglected youth, not unruly youth. But there has been a dramatic increase now [in removals due to the behavior of children]. Some people believe we can do a better job taking care of kids than their families.

If we can’t help their families, often kids don’t have a chance.

What is the biggest organizational mistake YV has made, and what did you learn from it from a management perspective?

We basically determined in 1995 that we were going to change direction as an organization. From the 1980s to 1994, we were only providing residential treatment and that was not working for most kids. We were returning them to families after that residential stay with not great outcomes.

We had to have an impact in the community. So we did “Solving the Puzzle” [the 1993 study on child welfare system needs], and that’s the approach people are talking about a lot more today.

My greatest regret is that we were not much more aggressive about sharing data and what we were going to do. We should have been more aggressive in the 1990s. I think the country would have been much further along if we had done better sharing the data and what we learned, but we didn’t have resources and we were still a young organization.

How do you decide to enter a state? Is there a litmus test for how much work it wants you to do, or is YV open to relatively small roles in certain states?

We will go in small. Of all states we’re in now [currently 21], we’re really only large in Tennessee, Mississippi, Massachusetts and North Carolina.

We have an extensive process we go through. A lot of it is dependent around leadership in the state, who are about trying to keep kids in community as much as possible. You’ve got to have that.

You’ve got to have some outside force helping provide necessary motivation to be in that position. Often that’s a lawsuit. Maybe in some cases horrific things happened, so media is on them making a change. Has to have some force.

That’s interesting. YV’s run has completely unrelated coincided with the phenomenon of child welfare class-action lawsuits. You operate, by my count, in about nine states that have been sued or are being sued, including Tennessee. So you actually see the presence of a lawsuit or a settlement as an opportunity to start working with a state?

Yes, I do. It creates an atmosphere of, “We’ve gotta do something. We have got problems.” The legislatures get involved, the governors get involved, and the advocates.

According to your annual report, 80 percent of the kids who come in contact with YV have a behavioral disorder. How in general does YV patrol the use of medications and mental health services with kids in its care? Has this changed over time, and do you have a flat policy organization-wide or is it based on contracts?

Yes, back in the 1970s and 80s, kids [in foster care] were rarely on psychotropic medications.

First of all, we have our own medical staff and they are very anti-psychotropic medication. That doesn’t mean some kids aren’t on them, but as few as possible. We don’t numb kids up. We don’t try to control kids with medication. There is strict supervision.

We designed a clinical portal, called Guidetree. We’re helping around 5,800 children and young people every day, and every one has oversight from a licensed expert.

Along with that regular oversight, Guidetree has every presenting issue. We have all the data and evidence on how best to work with young people. Bedwetting, not going to school, you can’t find home for family … In Guidetree, you can find, what are best choices to provide this intervention?

That’s how we have consistent outcomes, and 88 percent of kids living at home two years later. Most of our staff frontline are kids! They’re 22 to 30. These are complex mental health issues. They need guidance and supervision, and they might not have clinical expertise.

Pat Lawler presents to a conference audience about YVLifeSet, the organization’s approach to supporting youth aging out of foster care. Photo: Youth Villages

What makes you certain that YV is using these drugs on as few kids as possible?

Our programs range from in-home prevention services to intensive residential treatment and the severity of the children’s mental and behavioral health  issues vary. No matter what the program, there is a detailed process and procedure for frequent reviews of every child’s health and well-being and that includes monitoring prescribed medications. Some children need medication to address mental health issues, but we carefully monitor what medications are prescribed and that they are medically necessary.

The Blue Meridian group has already committed $36 million to help expand your Lifeset model, which links transition-aged youth with specialists who help them prepare for adulthood. What has the experience been like of participating in this “big bet” philanthropy?

It’s been overwhelming, and remarkable. It’s given us, I’ll say, a level of enthusiasm and new life we never knew existed out there. When you don’t have the resources, that’s painful.

We’re very grateful for the big vision. I couldn’t have imagined thinking of that level of support.

Is there one person who is assigned just to handle that aspect of the organization now?

We took one of our top staff members – Jessica Foster [chief strategy officer], went to Brown then Wharton, has been with us for 10 or 12 years – and put her in that role five years ago. And she’s slowly built a department.

You campaigned hard for Family First Act. What’s your take on the yearlong leadup and first few months of the law? Are you surprised at how many states took a delay?

No, not at all. It’s a great piece of legislation, I’m excited. When you’re changing a system dramatically, especially a change involving the whole country, that takes time.

States are learning along the way. All of us in the field would rather they take time, not rush through it. I applaud [U.S. Children’s Bureau Associate Commissioner] Jerry Milner and his staff, they also have done a lot to improve the legislation.

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John Kelly, Editor in Chief, The Chronicle of Social Change
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