A small number of children in the care of the Director of the Department of Child and Family Services (DCFS) present with severe and complex mental health, psychiatric, behavioral, and educational needs. These are not routine cases. They involve levels of risk and complexity that require specialised intervention that cannot be provided locally, to protect the child and, in some cases, others.

Under the Children Act 1998, when a child is in the care of the Director, the Government has a legal duty to protect that child and to ensure their health, safety, and well-being. That duty requires action when a child’s needs cannot be safely met through existing local services.

As Minister of Youth, Social Development and Seniors, Tinee S. Furbert JP, MP, stated:

“When the Director has care of a child, the Government has a duty to act. These decisions are carefully made, based on professional assessment, with the child’s safety, well-being, and dignity being paramount. Overseas therapeutic services are used only when a child’s needs cannot be met here at home, and when delaying care would place that child or others at risk.”

The Government’s position is clear. Children should be supported as close to home as possible, with family, cultural connection, and community support. Overseas therapeutic services are not a first option and are used only when professional assessment confirms that the level of care required is not available locally.

Bermuda is a small jurisdiction. While there are committed professionals across health, education, and social services, there are limits to the highly specialised, intensive services that can be provided at all times. The rarity and intensity of these cases mean that the required level of specialised care cannot always be sustained locally.

In 2025, there was an increase in the number of children requiring overseas therapeutic support, with many requiring longer periods of care due to the severity of their circumstances. As diagnostic tools improve and earlier intervention becomes more common, more children with complex needs are being identified. Referrals to DCFS come through established processes involving Child and Adolescent Services, the Ministry of Education, the Department of Health, and the courts, and are managed through professional oversight.

When overseas care is required, children are referred only to licensed and accredited facilities that have been rigorously vetted. DCFS works with a limited number of approved overseas providers, each selected for specific clinical, behavioral and therapeutic expertise. These facilities are subject to ongoing monitoring and review. Placements are also subject to regular progress monitoring and planning for eventual reintegration into the local community.

Overseas placements typically begin with comprehensive multidisciplinary assessments. These assessments establish diagnosis, stabilise the child, and develop structured treatment and education plans.

The level of care required in these cases is intensive and may include constant supervision, specialised therapeutic intervention, individualised education, and secure arrangements in the best interest of the child. This reflects the seriousness of the child’s condition and the risks involved if appropriate care is not provided.

The overseas therapeutic programme within DCFS has been in place for more than twenty years and exists because some children’s needs cannot be met safely within Bermuda despite best efforts across services. As clinical understanding improves, more children with complex needs are being identified earlier.

The Government continues to strengthen local mental health, therapeutic, and educational supports through sustained, cross-ministry work and long-term capacity building. Strengthening local capacity remains a priority, with the long-term aim of reducing the need for overseas placements wherever possible.

When local options cannot safely meet a child’s needs, the Government must act.

The safety, dignity, and future of Bermuda’s children remain paramount.