Revelations of abuse and drugging in children’s homes spur demands for reform
ounting evidence of abuse in Florida’s foster children homes in 2001 has made the system the focus of statewide reform.
During the years from 1997 to 2000, child abuse investigators found evidence of abuse or neglect inflicted on at least 55 children in state-licensed psychiatric treatment centers, many of whom were in foster care. And news reports throughout 2001 have so far revealed that some 600 children on Medicaid in Florida, including foster children, have been subjected to powerful, psychiatric drugs — substances not indicated for use by children at all — to restrain and make them more manageable.
The pill pushing has yielded grim and at times shocking effects, including one widely publicized case of a boy who began to produce breast milk.
In response to such reports, Kathleen Kearney, secretary of the Florida Department of Children and Families (DCF), appointed two doctors to investigate use of psychiatric drugs on foster children. Further, as a result of public concern, the department forbade state workers from approving psychiatric drugs for foster children without parental or judicial consent.
While the abusive drugging must be stopped, it is not the only form of abusive psychiatric practice being wielded on children in state care. Psychiatric workers using improper restraints have caused rug burns, bruises and even broken bones, state officials have reported. But determining whether a child’s injury resulted from abuse or accident can be difficult, as it comes down to the word of a child “mental patient” against that of an employee or psychiatrist.
Some reformers are seeking a complete overhaul of the foster care system, including oversight and the means used to investigate reports of abuse.
Fundamental Flaws
Child-care authorities on a national level working to reform abuses in the mental health system say a fundamental problem exists in the way many children arrive to such facilities.
Some youth who start on psychiatric treatment for reported behavioral or educational problems worsen during that “treatment”, prompting admittance into a residential program.
According to Fred A. Baughman Jr., M.D., neurologist, child neurologist and a Fellow of the American Academy of Neurology, the problem is that the “mental illnesses” many of these children are said to suffer from do not exist, and are fraudulent. “Not one of the ‘disruptive behavior disorders’ has been validated as a disease, or as anything biological or organic,” he said. Consequently, unneeded “treatments” and psychiatric drugging actually create the problem in many cases.
In other cases, children are removed from their homes based on reports of abuse, and become wards of their respective states. According to the Family Advocacy Center, a national group working to correct injustices which occur in removing children from homes, as many as 80 percent of the child abuse and neglect reports which lead to such removals turn out to be false.
Once out of the home, suffering the trauma and upset of being torn from their families, many youngsters exhibit anti-social behavior or severe emotional upset at the foster center. They then are placed on drugs or funnelled into psychiatric treatment centers — only compounding the problem, now being drugged, unpredictable and still upset.
And in either case, a consensus exists amongst some authorities that children are up to 10 times more likely to be abused or neglected once placed in a mental health institution than they would have been in their own home.
No Oversight
In Florida, youth psychiatric treatment centers are licensed as child care agencies through the Department of Children & Family Services. They are not licensed with the Agency for Health Care Administration (AHCA), and thus are not monitored, inspected and regulated as health care facilities — even though the youth are given powerful psychotropic drugs, restrained, and subjected to other forms of psychiatric “therapy” behind their walls. Youth residential facilities also do not have to be accredited by national groups that monitor and inspect hospitals.
Nationwide, child advocates say that the care of children in residential psychiatric treatment facilities is the most unregulated aspect of the health care industry.
Oversight is also virtually non-existent.
DCF Secretary Kearney was quoted in one Florida newspaper stating that the DCF has “not done a good job of monitoring children in residential treatment centers,” and the agency wants to keep children out of the centers whenever possible.
She said that no research exists to demonstrate these psychiatric centers are effective. In fact, independent research only confirms that children placed in them more often get worse.
While some institutions have taken action to dismiss those responsible for abuses of youth, the lion’s share of evidence shows that regular incidents including battery and sexual assaults are being ignored — raising serious questions as to the actual extent of abuse.
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A large part of the problem, some child advocates and industry observers say, is that those responsible for investigating abuses are essentially investigating themselves.
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In a review released by the Department of Children and Families in 1999, for example, the agency found that abuse investigators often did not interview children who may have been witnesses, nor talk to the alleged victims’ family members, nor did they ask essential questions of those they did interview.
A large part of the problem, some child advocates and industry observers say, is that those responsible for investigating abuses are essentially investigating themselves — that is, their own zones of responsibility.
Tampa Lawsuits
Events surrounding one Tampa Bay mental health facility detail a lack of response by the mental health system to reports of abuse.
The facility, Tampa Bay Academy, came under increasing scrutiny in the late 1990s following a series of reports and lawsuits charging battery and sexual assaults of youth under their charge.
A lawsuit against the Academy filed in June 1999 claimed that a boy who was in the treatment center from June 1996 to February 1997 was “beaten, abused, sexually assaulted and/or caused to engage in sexually inappropriate activities by one or more other [Academy] patients.”
Academy staff could have predicted assaults and inappropriate sexual conduct, the suit charged, because of their failure to maintain adequate physical supervision of youth in their custody and control, and their knowledge that some of the perpetrators had a past history of similar conduct. Further, the suit alleged the offenses were ongoing for a sufficient enough period of time that knowledge either existed, or should have existed, that such offenses were taking place, particularly when the Academy knew that similar activities had occurred in the past.
Just three months earlier, in March, two lawsuits were filed by parents against the Academy alleging that their children were beaten, abused and/or sexually assaulted by other residents in the facility.
In one of the complaints, filed in Hillsborough Circuit Court on March 23, a father charged that the Academy negligently roomed his 10-year-old son with a youth who had a history of sexual misconduct, and said that the Academy tried to cover up the abuses that happened to him.
Very similar allegations were raised by a woman who filed suit in March 1999 for abuses suffered by her 5-year-old son at the Academy.
The 1999 lawsuits followed that of a suit filed in 1998 by a Jacksonville father who said his son, 11 at the time he was in the Academy, was raped and sexually abused while residing there.
Complaints
The alleged abuses raised in lawsuits against the Academy are not isolated. Incident reports filed with the Sheriff’s office detail battery and lewd and lascivious acts against the children kept in the center.
In one report, a female juvenile was physically attacked by another juvenile in December 1997 while in the bathroom, brutally punched six times in the face, causing profuse bleeding. According to the Sheriff’s department report, the perpetrator admitted to striking the victim in the face numerous times.
Another minor, according to an incident report, was a wheelchair-bound amputee who was battered in February 1996 by another resident. The victim was struck in the face while reportedly an Academy counselor observed the incident, taking no action to prevent or stop the assault.
Other complaints detail various incidents, including one in which a minor was punched in the head and body, resulting in four arrests for battery, and another in which four male minors were involved in lewd and lascivious sexual acts.
Complaints filed by the Citizens Commission on Human Rights with AHCA were either not responded to or not acted upon. The group has filed scores of complaints since 1998.
Child advocates say the system is improperly set up for investigating treatment centers, as social services officials charged with responsibility for abuse complaints wind up investigating centers housing kids in their custody — providing a conflict of interest.
Further, reports that go to the Agency for Health Care Administration, when deemed needful of investigation, are referred to a board, which in turn consults psychiatrists hired to review the evidence — opening the door to conflicts of interest.
A number of complaints were reportedly dropped in 1999, citing that incidents were “not abuse” or lacked legal sufficiency.
No other reasoning was given, but CCHR points to other evidence that complaints may simply be being ignored on the word of psychiatrists alone. Argall points out that in reply to one of the civil lawsuits for battery and sexual abuse filed in June 1999 against the Tampa Bay Academy, psychiatrist Heather Rohrer alleged that the minor “knowingly and voluntarily consented to the alleged sexual acts” and that he “was himself negligent which proximately caused or significantly contributed to any alleged injuries or damages” he may have sustained.
“Were these children not placed in the Tampa Bay Academy in the first place precisely because they were ‘knowingly and voluntarily’ involved in acts deemed to be behavioral problems, and because they were ‘negligent’ in terms of handling them?” said Argall.
The problem is systemic, he said. Following a well-publicized case of abuse in which a 17-year-old girl died while undergoing psychiatric restraint in a West Palm Beach treatment center in November 1998, DCF’s annual report of the institution failed to even mention the death.
Reforms Needed
Attorney Karen Gievers of Tallahasee had already filed suit once against the state in 1990 on behalf of foster care children suffering abuse in the foster system, bringing about statewide reforms to that sector. News reports said she is planning on bringing another class action suit on behalf of children who are being neglected or receiving inappropriate handling in residential treatment centers.
In the wake of the reports drawing attention to the plight of children in Florida psychiatric centers, two independent private groups in the state have launched plans to inspect facilities and pressure officials to bring about reforms. State legislation was also introduced, designed to provide more legal protection for children to prevent them from being inappropriately admitted or held in psychiatric facilities.
The prevention of future abuse, however, will depend first on holding psychiatrists and state officials fully accountable for all that occurs in youth psychiatric facilities of any kind in the state.
Secondly it will depend upon ending the fraudulent practice of labeling an increasing number of children with “mental illnesses”, leading to unnecessary psychiatric treatment to begin with.
