When jail becomes a mental health center- a horror story
Posted Jan 12 2010 11:02am
This story is a horror story. It is a story about what is going on in one state for the kids of that state. It is not for the weak of stomach to read. It is testimony to what happens when the mental health needs of people are put on hold. It is testimony to the utter bankruptcy of the idea that the mentally ill are treated well or effectively in jail.
It may not be the story of your state. I hope it is not the story of mine. But the reality of what it means to be mentally ill and to be in jail are laid out clearly.
Suicidal Tendencies: The Arizona Department of Juvenile Corrections Is a Bloody Mess
The girl has a history of pulling out chunks of her own hair and drawing on the walls with her feces and blood, then wiping herself with pages she’s ripped from a Bible. And she’s a cutter. The scars from her self-abuse are visible on her arms and legs.
The details of juvenile cases aren’t public, but according to someone close to her, she threatened family members and then a judge; that’s how she ended up at the Arizona Department of Juvenile Corrections.
She clearly requires constant supervision, but on September 21, staff at the ADJC’s Black Canyon facility in Phoenix left the girl alone in a bathroom for at least eight minutes. When a guard finally asked what was taking so long, the girl replied that she was constipated. She emerged from the stall covered in blood and deep cuts she’d made on both arms with a piece of a broken light bulb, then ran through the grounds “with blood squirting everywhere,” according to the agency’s internal documents.
“It was like CSI meets like a horror movie,” one eyewitness tells NewTimes, adding that some of the cuts “were so bad, to where you could almost see the meat in them.”
The girl was handcuffed and taken to a local hospital, where she refused treatment. On the way back to the agency, she bit a staff member who tried to make her wear a seatbelt.
It took two days to clean up the mess in the bathroom.
• On February 14, a boy at the Adobe Mountain facility in Phoenix was found in his room unconscious with a pair of pants tied around his neck. Staff loosened the pants, and the boy gasped for air; later, he admitted he’d had a Valentine’s Day fight on the phone with his girlfriend before trying to kill himself. • On April 3, staff at Black Canyon noticed a girl lying on the floor; another kid admitted she knew the girl was trying to choke herself. A guard cut a ripped T-shirt from around the neck of the girl, who had covered the evidence with a towel after taking a shower. • On April 4, a boy at the Catalina facility in Tucson jammed his door shut, and it was only when another kid begged a guard to check on him that any adult noticed that the boy was turning red and then blue, with a towel wrapped around his feet and neck to choke himself. Staff eventually kicked down the door and cut the towel off with a knife.The guards seemed surprised, even though it had been discovered earlier that day that the boy was already making a rope; he was angry that he couldn’t make a phone call when he wanted to.
• On May 17, a boy at Adobe Mountain claimed he fell and hit his head, causing a bloody injury, but another kid admitted to guards that the boy had purposely smashed his skull into a metal bar on his bunk bed. Guards then found a bloody staple that the boy had been using to cut his thigh. When he was escorted away, the boy announced, “You haven’t seen nothing yet!” asking, “You wanna see blood?”The guards put the boy in solitary confinement, removed his clothes, and gave him what’s called a “suicide suit” to wear. He refused, and stood undressed, hitting his wound and punching the wall with his fist, ’til staff calmed him down.
• Staples are a popular cutting implement for kids at the ADJC. On April 14, staff found that a girl at Black Canyon had hidden a staple under her upper lip. She admitted she’d hidden other staples around her housing unit, and showed them where. She’d also used lead from a pencil to carve into her skin, and showed them where she’d hidden that, too. She told staff she’d made a drawing in science class she was proud of; in it, she’s hanging herself.The staff counseled the girl “about setting goals for herself to keep herself motivated,” according to the agency’s report on the incident.
“Youth replied, ‘If I make a goal for myself it would be to kill myself.’”
The Arizona Department of Juvenile Corrections is supposed to educate and rehabilitate juvenile delinquents. Instead, the agency has become the state’s adolescent mental hospital, a job it’s clearly not equipped to handle.
Things are literally a bloody mess. Staff find screws, nails, and broken pencils in kids’ rooms. But self-abuse gets more creative. One boy recently bit off his entire fingernail in front of a guard. A girl in solitary confinement was so desperate to hurt herself that she was seen rubbing her wrist against the rough paint on the floor hard enough to draw blood. The kids are sometimes put into suicide suits so they won’t try to hang themselves with their shirts or pants, but the Velcro on the suits presents a challenge; you can draw blood with that, too.
For some kids, the cutting and suicidal talk is almost certainly copycat behavior. But every suicide threat is supposed to be taken seriously. And some kids arrive very sick.
On April 24, a boy arrived at Adobe Mountain. Here’s an excerpt from his intake report
Youth states he was hearing voices and crying. Youth indicated he had been hearing voices for quite some time and instructed him to kill himself. On Tuesday 04/21/09 youth jumped off a second floor balcony at the direction of his voices . . . Youth further indicated he has asked his father for medications the other day and his father had refused and would not take him for medical assistance. Youth was attempting to get to a hospital for assistance when he was arrested. Youth was informed by his cousin that he had burglarized a home without any memory of the incident. He appears to be suffering from some type of psychosis and needs to be closely watched and evaluated ASAP for medications.
For this story, New Times reviewed hundreds of pages of agency reports on suicidal behavior, threats, and injuries, obtained through a public-records request. Other reports — such as the one involving the girl who ran through the grounds of Black Canyon, dripping blood — were obtained from sources inside the agency. About a half-dozen current ADJC employees from three of the agency’s four facilities were interviewed extensively, some over the course of several months. In almost all cases, names of youth were redacted from reports; New Times will not name any youth in this story, or the employees, who fear for their jobs.
New Times examined six months’ worth of reports of suicidal behavior at the ADJC in 2009, and the incidents mentioned in this story only scratch the surface of what is clearly a gaping wound. The agency has documented cases of kids self-abusing by cutting, scratching, choking, and hitting themselves on pretty much a daily basis.
It’s hard to know exactly what’s going on, and how it compares nationally, without formal statistic-gathering. An organization called Performance Based Standards does just that on a host of issues, including suicidal behavior, for participating juvenile corrections facilities across the country. The Arizona Department of Juvenile Corrections participated in PBS in the past but hasn’t for years. (Department administrators say it’s not cost-effective to take part in the national comparison; the ADJC uses its own system to measure data, which they say is more precise.)
National and local experts on mental-health care for teens were interviewed for this story. The general consensus is that services are sorely lacking, both in the private and public sectors, as well as at correctional facilities. To further complicate matters: Once a child is sent to the correctional system, legally, the public health system will no longer cover mental healthcare.
Problems appear to be particularly serious in Arizona, but the state is far from alone. Parents everywhere are at a real loss as to how to help their kids.
Earlier stories in this series explored one family’s successful attempt to place their son in a government-paid residential treatment facility that can address his serious mental illness and violent tendencies (“Saving Alex,” October and another family’s less-successful efforts to save their daughter from substance abuse and mental illness by sending her to a private wilderness-therapy camp (“Losing Erica,” November 5).
The truth is that both Alex Varlotta and Erica Harvey could easily have ended up at the Arizona Department of Juvenile Corrections. The department estimates that 30 percent of the children in its care suffer from serious mental illness, with a diagnosis falling under the rubric of the DSM-IV, the American Psychiatric Association’s official manual of mental disorders. Even more have suicidal tendencies, and about 84 percent of all the children at the ADJC have a substance abuse problem.
While conditions have improved somewhat at the ADJC, following a federal investigation several years ago, the agency is clearly unable to provide adequate care for seriously mentally ill kids. And yet it is the agency’s legal mandate to take these kids.
“We have to be responsible for what comes through the door,” says Kellie Warren, the ADJC’s deputy director in charge of mental-health services.
“It’s not an appropriate place for these kids,” she admits. “Those kids that are significantly mentally ill, they end up decompensating here.”
And yet, Warren acknowledges, this is where they land — at an increasing rate. “You’re seeing the justice system becoming almost the new asylums,” she says.
She’s not exaggerating. The state recently closed the adolescent unit at the Arizona State Hospital. Maricopa County has no comparable unit for adolescents at its own facility. If you qualify for Medicaid, you can get your mentally ill kid services — maybe. If you don’t qualify for Medicaid, the private options are even more limited. If your kid is violent, services may be all but non-existent.
Warren says juvenile court judges hear of the compendium of services her agency provides (and she certainly does a good sales job on it, if her interview with New Times is any indication), and they figure it’s the best option for the mentally ill kids who come through their courtrooms.
Even that option could go away.
This summer, Governor Jan Brewer asked state agencies to submit a plan describing how they would cut 15 percent of their budget over a six-month period. The ADJC’s plan includes closing three of its four facilities, as well as its mental-health unit for boys. It’s widely believed that the plans the governor asked for are designed to be a scare tactic for the Arizona Legislature, which is eager to avoid raising taxes — but you never know.