|
 Reformers
Push to End Restraint, Seclusion
Death, injuries prompt training of workers in more
positive methods.
Encarnacion Pyle, The Columbus Dispatch, April 24, 2005
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Matthew Goodman,
an autistic teen, spent the last 16 months of his life heavily
sedated, in arm splints and a helmet, at Bancroft NeuroHealth in
New Jersey. The restraints were supposed to keep him from
picking at an injury, but his mother thinks they contributed to
his death at age 14.
Children who fight, throw tantrums or threaten workers while in
residential care in Ohio are more likely to be tackled or
dragged to a ‘‘seclusion room" than given a psychiatric drug.
In the first six months of 2004, kids were held down or isolated
9,920 times, according to logs the treatment centers gave the
state.
But some say a movement to reduce the use of these practices has
been slowly sweeping the country since the Hartford Courant
documented 142 deaths during or after restraints between 1988
and ’98.
‘‘Seclusion and restraint should no longer be recognized as a
treatment option at all, but rather as treatment failure," said
Charles Curie, who heads the federal Substance Abuse & Mental
Health Services Administration.
Seclusion rooms can be a single bedroom or a small room with
only a bed and a window where staff members keep watch.
Restraints can vary from holding a patient’s arms to pinning
someone to the floor.
Under Curie’s watch as deputy secretary of mental-health
services in Pennsylvania, state hospitals there cut the number
of hours children were in seclusion or restraints by more than
90 percent between 1997 and 2001.
In May 2003, Curie issued a national call to eliminate these
methods, and last fall his agency awarded $5.3 million to
agencies in eight states, not including Ohio, to come up with
alternatives to calm people of all ages who are acting out.
The danger is more than emotional.
In Ohio, more than 150 children and 55 residential workers have
suffered bruises, broken bones or other injuries during
seclusions and restraints the past two years.
In 1999, a 14-year-old boy in foster care died in a Fairfield
County home while wrapped in a mattress like a hot dog in a bun.
But since 2003, the Ohio Department of Mental Health has taught
more than 270 residential-center and psychiatric-hospital
workers nonviolent ways to control aggressive children and
adults.
The agency also has created three groups of professionals to
promote other ways to defuse potentially fiery situations.
‘‘They’re like supernannies, giving helpful hints to staff whose
buttons are being pushed by sick, challenging kids," said Penny
Wyman, executive director of the Ohio Association of Child
Caring Agencies.
Leading the charge in central Ohio are Buckeye Ranch in Grove
City and St. Vincent Family Centers, which has residential and
partial hospitalization programs on the Near East and West
sides.
The threat of force can backfire by making children resistant to
future treatment, said Michelle Ward, president and chief
executive officer of St. Vincent, which specializes in troubled
kids age 12 and younger. The center also works with teens.
‘‘You don’t use a fire hose to put out a trash-can fire," Ward
said.
Residential workers need to learn how to intervene when children
show the first signs of being upset or under stress, she said.
At age 42, Sondra Williams is still living with the effects of
being frequently bound, held down and overmedicated during years
spent in psychiatric units.
‘‘It’s left me with a lifetime of emotional scars that will
never heal," said Williams, of the North Side, who was in and
out of institutions until doctors discovered recently that she
was autistic instead of mentally ill.
Buckeye Ranch has cut its restraint use from a high of 1,029
incidents in 2002 to 766 last year, said Rick Rieser, president
and chief executive officer.
But it still ranked third highest among the state’s 52
children’s residential centers for the first half of last year,
according to Department of Mental Health records.
Buckeye officials said their figures are high because they
report restraints ‘‘to the letter of the law," and it’s a big
center. It has 84 beds.
Still, not everyone thinks Buckeye and St. Vincent are doing all
they can.
Last year, Ohio Legal Rights Service sued both for allegedly
failing to share records of children who had been restrained,
including a 13-year-old whose wrist was broken by a Buckeye
worker. The independent state agency investigates potential
abuse of disabled residents.
On April 13, U.S. District Court Judge James L. Graham ordered
Buckeye to provide all records relating to the fractured wrist,
as well as all seclusion and restraint records since the suit
was filed in May 2004.
The St. Vincent case is pending.
Since August 1999, the federal government has recorded 130
deaths nationwide, including five in Ohio, related to restraints
and seclusion. But Ohio Legal Rights says the correct figure for
the state is nine deaths.
Either way, the numbers show that people are still being hurt
and killed, despite progress in the use of other techniques.
Saudia McGuire couldn’t agree more.
The 33-year-old single mother of three boys simply has to look
at the photos in her purse.
Instead of her 9-year-old son’s shybut-devilish grin, she sees
dark, deep bruises covering his arms and legs and a rug burn on
his neck.
‘‘Devin was hurt twice while restrained at St. Vincent’s two
years ago," said the East Side resident. ‘‘One time, he ran out
of line and down a hallway and was dragged by the collar of his
shirt by a worker."
Franklin County Children Services, which has temporary custody
of Devin Chrysafis, investigated both incidents but didn’t
substantiate any charges.
McGuire called police the second time he was hurt but was told
residential treatment centers are held to a different standard.
‘‘If I had given him those bruises, my other two children would
have been taken away from me and I would have been hauled off to
jail," she said.
In the end, Children Services moved her son to another center.
He’s now at the Children’s Aid Society in Cleveland, where
McGuire is happy with his treatment.
Janice Roach isn’t so lucky.
Her 14-year-old son, Matthew Goodman, died in February 2002, a
day before he was scheduled to leave a New Jersey institution
that Roach feared had been abusively restraining him.
‘‘They killed his spirit long before his body," said Roach, now
an advocate against restraint and seclusion who lives in a
suburb of Philadelphia with her two other children.
In 1996, Roach and her ex-husband enrolled their severely
autistic son at Bancroft NeuroHealth, once considered one of the
nation’s top institutions for the disabled.
Things went well for Matthew, who had other medical problems.
But in the spring of 2000, he developed a blood infection in his
leg from an open sore.
After a summer confined to a bed at Children’s Hospital in
Philadelphia, he went into the medical unit at Bancroft, which
is in Haddonfield.
Matt sometimes picked at his injuries and, without classes,
friends and recreational activities to distract him, his
self-destructive behavior worsened.
Workers put him in arm splints and a hockey helmet and heavily
sedated him.
‘‘He spent his days lying on the floor of Bancroft’s NeuroHealth
unit barely conscious," Roach said. ‘‘It was 16 months of cruel
torture."
After a long search, Roach found a Florida rehabilitation center
willing to take her son. She visited him the weekend before his
scheduled transfer.
‘‘He was on the floor, totally out of it," she said. ‘‘I laid
down next to him and told him, ‘Just hang in there, Mattie.’ "
Two days later, a nurse at Bancroft called her. They couldn’t
find his vital signs, and they were driving him to Children’s
Hospital.
He arrived at the emergency room comatose — still in restraints.
‘‘My baby was dying, and they kept him tied up like a monster,"
Roach said.
He died the next day of pneumonia, blood poisoning and an acute
respiratory infection.
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