When 18-year-old Alex Gervais leapt from the window of a Fraser Valley hotel in September 2015, cutting his turbulent life tragically short, he allegedly hadn't seen his caregiver in 10 days.

Gervais had also complained that same caregiver, who was being paid more than $8,000 a month to look after him, was pocketing money that should have been spent buying meals and clothes for the mistreated Metis teen.

As a result, Gervais exited the world "largely alone, without adequate food or clothing or support."

Those are just some of the troubling findings of a new report by B.C.'s Representative of Children and Youth, which makes several recommendations aimed at helping young people in the province's care gain a sense of permanence and stability in their lives before it's too late.

"In many ways, Alex was abandoned by the system," acting representative Bernard Richard said in a statement. "Early on, it was determined he would simply be left to 'age out' of care and not enough effort was made to pave the way for a better future for him. Government must certainly do much better than it did for Alex."

Before his suicide made headlines and sparked outraged across B.C., Gervais's life, as told in the report, was marked by desperation, neglect, trauma and instability.

As a boy, he was abused at home by his biological parents, both of whom had significant mental health issues. He then spent 11 years bouncing through 17 different care placements before he was, for an apparent lack of suitable alternatives, placed in the Abbotsford Super 8 hotel where he would spend his final 49 days. 

The report found most of his time in care was under one residential care agency where he was poorly supervised by staff, including some workers with questionable credentials and concerning backgrounds.

Among them was an unnamed respite caregiver with a history of gun violence, gang connections, drug use and drug dealing – the same man who would eventually, through a contract with a separate agency, look after Gervais at the hotel where he took his own life.

According to the report, the caregiver was hesitant to take over Gervais's case, but was convinced with a contract for $8,000 a month, or roughly 11 times the rate a restricted foster parent would receive.

No treatment for mental health issues

Gervais's own mental health suffered tremendously over the years. Toward the end of his life, the teenager experienced long bouts of depression and would sometimes act out violently.

The report found that through all his time in care, Gervais had not formed the kind of stabilizing long-term relationships and connections all youths need to thrive. In his own words, "everyone [had] fucked off."

Yet for some reason, B.C.'s Ministry of Children and Family Development opted not to pursue chances to place the teenager with his stepmother in the province, or with his aunt in Quebec – even though either option would have been much less expensive than keeping him with strangers.

“Alex was looking for what every child needs and has a right to – the security and permanence of a home and a lasting connection to family. He didn’t get those things, nor did he get the kind of mental health or planning supports he needed as he faced the frightening prospect of aging out of care," Richard said.

The ministry blamed Gervais's behaviour for many of his moves, according to the report. He suffered from anxiety and attachment issues from a young age, and in his teens became a cocaine user and alleged drug dealer.

A psychiatric assessment completed when he was 10 years old emphasized the need for a stable foster placement to repair the damage that had already been inflicted. Sadly, that advice was not followed, and the report found the constant movement from home to home was actually part of the reason for his persistent and worsening problems.

"The moves were actually inflicting even more trauma on this boy," Richard said.

Apart from that, social workers failed to fulfill the ministry's legal obligation to connect Gervais with his Metis heritage, which could potentially have helped steer him away from his destructive path, or to connect him with the robust mental health treatment he needed – despite five separate referrals to Child and Youth Mental Health services.

Call for ‘timely and uninterrupted’ services

The report makes four recommendations for the Ministry of Children and Family Development, including an increased focus on placing youth who can’t be returned to their birth parents with extended family or another adult with whom they have bonded.

It also calls for the province to take immediate steps to ensure children and youth with mental health issues receive "timely and uninterrupted... services, regardless of any changing circumstances in their lives," and for caregivers to abide by existing standards for keeping aboriginal children connected to their heritage.

The final recommendation aims for more oversight of the residential care agencies contracted through the ministry.

On Monday morning, shortly after the report was released, Children's Minister Stephanie Cadieux issued a response accepting each of the recommendations and promising to improve.

The government pledged $2.7 million toward culturally specific care plans that will be tailored to different communities, and promised to start conducting criminal record checks on all residential caregivers, including the ones who work for the province indirectly through contracted agencies.

"I completely agree with the findings in the new representative's first report," Cadieux said in a news release.

"The report is fair, balanced and its call to action achievable. I've told the [Representative for Children and Youth] that I believe more can and should be done, and I hope that his office and the ministry will support each other, in our respective roles, on delivering the additional measures I'm announcing today."

To read the Representative for Children and Youth's full report, titled Broken Promises: Alex's Story, click here.