A preliminary review by the Office of the Child Advocate of conditions at the state’s controversial locked treatment program for troubled girls in Middletown raises concerns about the improper use of restraints, inadequate access to mental health services, and inconsistent reporting of abuse and neglect.
The report, which was distributed to members of the Connecticut Juvenile Training School (CJTS) Advisory Committee and obtained by the Connecticut Health I-Team, cites concerns that youths in both the 12-bed girls’ Pueblo Unit and the larger CJTS facility for boys have been subjected to inappropriate or unsafe restraint, including the use of “prone restraint” on youths with respiratory problems. Prone restraint means that a person is laid in a facedown position.
“I know that DCF (the Department of Children and Families) shares our concern regarding the use of potentially dangerous restraint for children with contraindicated medical conditions,” Child Advocate Sarah Eagan wrote. “Our review of these incident reports raises questions regarding the adequacy of staff training on the use of restraint (and de-escalation strategies), and the effective dissemination of critical information regarding children’s special health care needs.”
The report echoes concerns about the CJTS’ use of restraint that were cited in a report a decade ago by the former child advocate and attorney general’s office. The new review comes just six months after the girls’ facility opened — and as state agencies seek to reduce the unnecessary use of restraint among children.
Some members of the CJTS advisory committee said Thursday they will push for an independent review of procedures at Pueblo and CJTS, saying that DCF Commissioner Joette Katz recently rejected as unnecessary recommendations for an independent ombudsman to be hired, or for the facility to undergo a performance-based standards review.
DCF spokesman Gary Kleeblatt and CJTS Superintendent William Rosenbeck said Thursday that Eagan’s concerns should be seen in a larger context. The Pueblo facility, which handles the most challenging cases, is still relatively new — and problems that come to light are being addressed, they said. At a meeting in August, Katz told the advisory committee that DCF staff were reviewing the concerns raised in the letter.
But Eagan and several members of the committee said Thursday that they support an independent review of programs and policies, including what kinds of clinical services are available to youths.
“My concern is, is it really functioning as a treatment facility (as DCF had assured), or is it a girls’ prison?” Eagan said.
Kleeblatt and Rosenbeck said the clinician-to-resident ratio at the 12-bed Pueblo was 1-to-5 –- lower than the 1-to-9 ratio at CJTS – and that girls were getting individualized treatment.
In the report, Eagan’s office cited “several videotaped encounters of the use of restraint at Pueblo from April through July” which raised concerns about the use of restraints to ensure “compliance,” rather than safety; reliance on handcuffs to control youths; and inadequate access to clinical support services. The preliminary review also raised questions about how incidents of rough or inappropriate restraints are documented and reported.
James Connolly, a supervisory assistant public defender who chairs the advisory committee, said Eagan’s report “raises red flags” about the treatment of residents, and he favors an outside review. He said he was troubled by both the potential overuse of restraints and the facility’s reporting procedures.
Abby Anderson, director of the Connecticut Juvenile Justice Alliance and a member of the committee, said restraints should be used only as a last resort, to protect the safety of residents or staff.
“If you’re using restraints for compliance, you haven’t done a good enough job training your staff,” she said. She also questioned the lack of an on-site clinician “24/7” at Pueblo, given DCF’s assurances of providing adequate treatment.
Kleeblatt and Rosenbeck said staff members at Pueblo and CJTS receive ample and ongoing training to use restraint only as a “last resort.”
Pueblo and CJTS have been at the center of a controversy over DCF’s treatment of a transgendered youth, known as Jane Doe, who has been in isolation at CJTS since a July fight at Pueblo. On Thursday, lawyers for the girl, including Connolly, reported that they were going back to court to push DCF to move her into an appropriate program.