A long road to a safe place: Children in state-licensed residential programs still face risk of injury
-
Danny is seen here four days after an incident last year in which he was physically restrained at Auberle, a juvenile facility in McKeesport. He was 12 at the time of the incident, in which his eye was injured.
Share with others:
Something as simple as a dispute about a piece of cake or as ugly as a trash can planted on a spitting child's head can lead to confrontation, injury and trauma for children in state-licensed facilities.
In moments of danger, workers in residential programs are permitted to physically restrain the youth in their care. Laying hands on a child almost always involves a struggle, though, and it is not uncommon for children -- and staff -- to get hurt. Sometimes, they walk away with bruises. Other times, they leave in ambulances, nursing concussions or fractured bones.
In 2006, the Pennsylvania Department of Public Welfare began a campaign to reduce such incidents in the private residential facilities that care for abused and neglected children, juvenile delinquents and other youth with profound needs.
"Nobody goes out and wants to hurt kids. I believe that in my heart," said DPW policy director Angela Logan. "I believe it was a perfect time for the providers and the state to get together -- and the family members -- to learn from one another."
In many of Pennsylvania's 767 residential programs, staff restrain children less often now. The total number of youth injuries reported to the state declined 7 percent between 2008 and 2010, though the number of youth in residential care also dropped significantly over that period.
But 361 incident reports obtained by the Post-Gazette show that children in residential facilities continue to face danger at the hands of staff members and peers, as well as their own. According to these reports, there were at least 264 injuries to children living in Western Pennsylvania programs between January 2005 and December 2010, including 17 bone fractures, four broken bones and 18 lacerations deep enough to need stitches. Most of these injuries were related to restraints. Recent reports show that some staff members still restrain youth for offenses like "aggressive posturing," despite repeated state bulletins reminding providers that restraint is "an emergency measure of last resort."
"We haven't moved as much forward with it [as I'd like]," said Marcia Sturdivant, head of Allegheny County's Office of Children, Youth and Families. "They have some challenging work. And it's not the worst, but it can certainly get better."
Dr. Sturdivant gasped as a reporter read some of the incident reports to her. "Oh my goodness," she said, reacting to documentation of a supervisor who "removed child from his personal space" during a verbal dispute. The girl's back hit a file cabinet; a laceration to her head was stapled shut.
"You don't remove kids from abusive situations to be re-abused," Dr. Sturdivant said. "It makes the people who work very hard to do the right thing; it makes the work that much more difficult for them."
A Post-Gazette review of the reports, as well as interviews with officials, parents, youth and staff, suggests that years of good-faith efforts to make institutionalized children safer have collided with practical barriers, entrenched staff cultures and, increasingly, a bleak financial reality for these publicly funded entities.
Complicating the matter, the DPW requires providers to report just a small subset of restraints and youth injuries, and did not compile the injury data until the Post-Gazette requested it, making it hard to evaluate state initiatives.
"I think we've done a lot better over the last six or seven years," said Allegheny County Common Pleas Judge Kim Berkeley Clark, who sits on juvenile court. "But we still have a ways to go."
First Published June 26, 2011 12:00 am
