Posted on 03/22/2004 1:10:09 PM PST by tang-soo
At Ohio psychiatric centers, workers molested children, denied them food or gave them alcohol and drugs. Some kids suffered broken bones. Others lived in homes so dirty they urinated on the floor by their beds.
Taxpayers shell out $160 to $1,000 a day for each mentally ill child who lives in these private treatment centers.
But a Cincinnati Enquirer investigation reveals that kids don't always get the help they're promised. Some struggle just to survive.
"You have kids secluded, restrained and injured over and over again," says Carolyn Knight, director of the Ohio Legal Rights Service, a state-funded agency that investigates how children are treated inside facilities.
"It's like Dante's Inferno: 'Abandon all hope, ye who enter here.'"
Whether a child ends up in a troubled treatment center or one that helps is largely a gamble, state records and interviews show. A review of the 10 largest facilities statewide shows that conditions were so bad in the past three years that the government ordered three not to admit new children and a fourth to stop putting kids in seclusion.
Yet with demand high and space short, county officials who send more than 7,000 children into treatment each year say they place kids wherever they find an opening. These children include abuse victims, anorexic girls, teen sex offenders and youths who repeatedly cut themselves or are suicidal. Most are mentally ill. Some are as young as 3 or 4.
Michael Hogan, director of the Ohio Department of Mental Health, acknowledges that some centers are troubled, but says that most improved in the past few years after state inspectors cited them for failing to protect kids.
"We've never found gross and willful neglect. We have found disturbing patterns of problems," he says. "We've worked to correct those."
Hogan says the state tries to help facilities change rather than shut them down because Ohio desperately needs homes willing to take in the most difficult kids.
"Any child being hurt is unacceptable, but when you ask, what are the norms, there are no norms for what is acceptable. Are we satisfied?" he says. "We're never satisfied, but I'd say we're realistic about how complicated this is."
Knight says the system is so complex that many families can't figure out who's in charge of watching over their children, and many kids are sent to centers that can't help them.
"We saw overworked, undertrained staff in very volatile, high-burnout situations," Knight says. "Parents send their children there thinking, 'Johnny is going to get better, and some day he's coming home.' But all too often they just end up back in another facility."
Kids 'deserve better'
Advocates say it's difficult to find good care for mentally ill children in Ohio because the state closed most of its mental institutions in the late 1980s and early 1990s - and created few programs to replace them.
Ohio once operated 17 mental hospitals caring for more than 20,000 children and adults. Today, the state runs nine hospitals caring for 1,100 adults - and no children.
As a result, thousands of mentally ill kids seek help outside state institutions. But severe shortages persist, and children routinely wait three months or more just for an office visit with a psychiatrist.
Those who don't get therapy, or turn violent, depressed or suicidal, often end up in Ohio's privately run treatment centers. Twenty-two companies operate licensed centers in Ohio, providing 937 beds.
"Residential treatment centers have kids that 10 years ago would have been in psychiatric hospitals," explains Penny Wyman, director of the Ohio Association of Child Caring Agencies. "We serve children who, if they don't get help, end up homeless, in juvenile detention or prison."
To be sure, not all treatment provided by centers is suspect. Many children live in well-maintained facilities with supportive, trained staff. They have access to psychiatrists, medication, group counseling and other critical help.
But thousands of kids are caught in a system so confusing that even officials in the state Department of Mental Health and Department of Job and Family Services struggle to explain how it works.
State officials don't even track how many investigations of abuse and neglect are done or their outcomes. At times the two departments argue over which agency should inspect which center.
With state oversight spotty and confounding, much of the burden for funding and operating the mental health care system falls to 88 different counties. As many as five agencies in one county might share responsibility for a child - who may be in treatment several counties away or even out of state.
"For some kids, the practical effects of the licensing system can be devastating," says a 2002 report by the Ohio Legal Rights Service. "Families don't know who is responsible for their child or their child's rights, and parents frequently aren't told when their child has been abused, injured or is ill."
'Blatant abuse'
Much of what happens inside facilities that house children is secret because of federal and state privacy laws. But extensive interviews and an examination of state inspection records, court documents and government studies provide a glimpse into how the system works.
For example, an inspector in the Mental Health Department cited the Cleveland Children's Aid Society in 2002 for failing to report injuries to children, calling it "blatant abuse."
The report also found that a worker grabbed and broke a boy's right arm, the home was dirty, staff was poorly trained and there was only one bathroom for 15 children so some kids urinated in their bedrooms. The center also failed to show that it followed 14 state rules to care for children and keep them safe, the inspector said.
"It was apparent from the documentation that staff aggravate daily situations which in turn escalates children," the inspector wrote. "This has and will continue to result in injury to staff, ineffective mental health treatment, child injury and child abuse."
Roberta King, chief executive officer of Children's Aid, says the worker who broke a boy's arm was suspended and retrained. She says the company corrected problems, but restraints are sometimes necessary to keep children safe.
"The Ohio Department of Mental Health, they don't think a child should be restrained at any time," King says. "I quite frankly think some folks at the mental health board need to spend a couple hours or a day at some of these facilities for kids."
'A pincushion'
Mental health regulators also found serious problems at Belmont Pines Hospital in Youngstown, which they put on probation for five months and banned from admitting any more children.
The action came after Ohio Legal Rights Service wrote to the state complaining that workers gave children too many shots of powerful drugs to control their behaviors.
"We are concerned about how frequently the facility uses emergency medication shots," an April 2002 letter by agency worker Beth A. Oberdier said. "Our further concern is the use of Haldol and Thorazine on children."
A month later, Judy Jackson-Winston, a Cuyahoga County Mental Health Board official, also complained that Belmont Pines improperly drugged kids. She said one father told her that his son and other children were sedated whenever they got upset.
"The treatment the father had in mind did not include his son being used as a pincushion," Jackson-Winston wrote the Department of Mental Health. "He is concerned that nearly every encounter ends with (his) son receiving a shot."
Drugs commonly are used to treat mental illness. And sometimes, even children need several strong drugs administered at the same time, authorities say.
But Patricia Goetz, a child psychiatrist with the state, wrote the Mental Health Department that the medications used on Belmont Pines children "have effects that last far longer than required for a patient to regain self control."
Mental health department records show that Belmont Pines, a 65-bed facility, changed its policies, and the state took it off probation.
Officials at the home wouldn't comment. But the facility's parent company, Nashville-based Ardent Health Services, said in a statement that it's committed to operating the home according to state and federal regulations.
Other centers also use powerful drugs to control children's behavior, according to a 2002 Legal Rights Service review of medical charts at four, unnamed centers.
The report found children as young as 10 on six different kinds of psychotropic drugs at once, including an 8-year-old on eight medications that caused serious adverse side effects. It said most weren't approved for use in children.
In another case, a 13-year-old boy was given three shots of Haldol and three shots of Ativan in one five-hour-period. A 12-year-old girl, born addicted to crack cocaine and alcohol and sexually abused until she turned 3, was given six shots of Thorazine, restrained by two or three men 31 different times and put in seclusion 23 times during a nine-month period.
"These children aren't combative anymore, they're just drugged out. They do well to just get out of bed," says Knight, the agency's executive director.
"Who can really fathom yet what the side effects are? The cumulative effects of multi-meds and heavy doses can just gnaw away at a child's life."
No state action
Psychotropic medications aren't the only drugs improperly given to children. At a treatment center in Parma, Ohio, a police investigation two years ago found that a worker gave kids laughing gas, Ecstasy and marijuana before having sex with a 13-year-old girl and watching two other kids have sex together.
Another former youth counselor, Michael Brown, 49, of Cleveland, got sexual favors from six boys at the center by letting them drink liquor, taking them on field trips, giving them expensive gifts, or promising to adopt them.
Brown and five other workers at Parmadale, a 48-bed treatment center near Cleveland, were indicted on 110 charges ranging from corruption of a minor to rape.
Four workers await trial, one was sentenced to six months' probation for importuning, and, in August, Brown pleaded guilty to kidnapping, gross sexual imposition and tampering with records. He was sentenced to eight years in prison.
One 17-year-old victim told Brown in court: "I thought you loved me, but you hurt me and some of my friends. You will no longer have control of me after today."
Cuyahoga County, which pays Parmadale $2 million a year to house its troubled children, stopped sending kids there during the investigation but started again last March after the company moved administrators and therapists into buildings to better supervise children.
Child-welfare director Jim McCafferty says the county steps in because it's not always clear if or when the state will take action. "It's a disjointed system," he says.
Kids at risk
Inspectors also put the Oak Ridge Treatment Center near Ironton on probation after determining the center housed young sex offenders with boys under 12.
When children complained they were being sexually abused, Oak Ridge couldn't show it offered them medical care or treatment. State officials in 2001 also faulted Oak Ridge staff for taking away children's belongings, including their clothes, and for denying kids food, drinks and access to the kitchen - except to clean it.
Oak Ridge's director, Dr. W. Michael Dowdy, disputes claims that his facility admitted child sex offenders. "These are issues that are behind us and that we've more than adequately addressed," Dowdy says. "We've never had issues like that again."
The state lifted the probation three months later after the 75-bed facility said it created a new policy to handle and report accusations of sex abuse, hired more workers and better trained them.
State officials also took action against a Springfield treatment center after getting complaints that it put kids in a time-out room 134 times in a two-month period in 2002 - and left them there for as long as nine hours.
The state ordered the facility, Oesterlen Services for Youth, to stop the practice after Ohio Legal Rights brought it to officials' attention.
Donald Warner, director of the 52-bed facility, says the home opted to stop using time outs because it would cost too much to remodel the rooms. He disputed the claim by Ohio Legal Rights that some children spent hours in them.
"Some of that had to do with our staff not filling out the paperwork correctly," Warner says.
He says the issue looked more serious on paper than it actually was. "No one, to my knowledge, alleged that Oesterlen was ever mistreating kids."
'Short-changed'
Advocates for the mentally ill say kids and their families will continue to suffer until the state sets clear standards for treatment and establishes a single state licensing body in charge of oversight.
Ohio Legal Rights has urged the state to better track abuse and neglect, evaluate treatment centers and publish the results. Under the current system, "Families are left out, and kids are short-changed."
Advocates like Gayle Channing Tenenbaum of the Ohio Public Children Services Association agree that children need help now. "The system is unfair and wrong. What could be worse for a family than to have a child who is abused, or who can't get access to good treatment?" she says.
"If I felt like some official at the state was agonizing or losing sleep over this, I'd feel a lot better," she adds. "But right now, I just don't think anybody is."
And there're actually people who'd seriously suggest the LTC industry be taken over by the government too, eh?
Well here ya go *why* that's not such a bright idea.
"We tried to find a "Christian" facility near central Ohio without much success. Stories like this one is why we were trying to convince them to not use a state run facility. I call "Focus on the Family" and was told about a place named RAMA in Louisville."
Good you found someone to refer you to a place; however, there was another source you could've gone to also, for *just* such info HERE, too.
No kidding, he's a couple of youngsters he's chronically who needed to be removed from their enviroment & placed into facilities just like those you were seeking.
...the man really seems to care.
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