December 14, 2017
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Mental health centers are calling the cops on their own juvenile patients

By Jake Bleiberg, BDN Staff
Updated:

Maura Kelly was screaming, and no one could get her to stop.

Not her mother. And not staff at the mental illness treatment center where she lives much of the time.

As the 16-year-old screamed into the winter night, she slammed a metal door against the outer wall of Sweetser’s Rockport residential facility.

After a short time, the staff called 911. And according to the teenager’s mother, Eileen Kelly, a Rockport officer soon arrived with a question: “Do you want to go to jail?”

A new study by Disability Rights Maine has found that organizations paid by taxpayers to help juveniles with mental health crises frequently call the cops on the young people in their care, sometimes passing responsibility for mentally ill teenagers over to the state’s law enforcement and corrections officials.

Not every call leads to a juvenile being arrested, but more than four out of every 10 inmates in Maine’s youth corrections facility spent time in a mental health center before being locked up. Once confined to the overburdened youth prison, juveniles are largely in the care of guards who are not trained mental health professionals.

The Jan. 20 call involving Maura Kelly was one of hundreds the staffers at Maine’s residential treatment facilities called the police about a young person with severe mental illness during a 13-month period, according to Disability Rights Maine.

The group used public records requests to gather calls to 21 Maine law enforcement agencies from the residential service providers, which are run by eight private organizations but mostly paid for through MaineCare. After removing calls unrelated to juveniles, Disability Rights Maine found that there were 815 police calls from Jan. 1, 2016, to Jan. 31, 2017.

These youth treatment facilities are required to report most police calls to the Maine Department of Health and Human Services. And the group also requested and reviewed DHHS’ records related to police calls. It found that the department didn’t have a corresponding incident report for more than half the police calls.

Disability Rights Maine found the frequency of calls to the police varied widely from organization to organization. One mental health provider’s staff called the police more than six times per treatment bed over those 13 months while others called less than once per bed.

The advocacy group concluded that mental health workers call the police when young people are putting themselves or others at risk, but also for an array of other behavior — from running away, breaking things and threatening staff to “acting up” and being “out of control” — apparently related to the mental illnesses that landed them in treatment in the first place.

In a written statement, a DHHS spokeswoman questioned the findings of Disability Rights Maine’s report and rejected the the idea that shortcomings in mental health treatment system result in mentally ill youth being sent to prison.

“There are figures within the DRM report that cannot be taken at face value,” spokeswoman Samantha Edwards said. “This department does not accept that youth are at [Maine’s juvenile prison] simply because they cannot receive mental health treatment. Youth are [there] because they committed a crime.”

In small towns with residential treatment centers, however, police sometimes are called to the facility many times per shift. The Saco police chief recalled once responding to Sweetser’s campus there six times in 48 hours.

And on many of these calls there is no productive role for police, according to some law enforcement and criminal justice officials. To them, it’s a symptom of the state of Maine’s having gradually deferred much of the job of dealing with mentally ill people to cops, courts and prisons.

The heads of some residential treatment facilities said police calls rarely end in arrests, noted the strain of staff shortages and low wages in their facilities and said that part of the problem is that Maine lacks a mental health treatment center with the security of a corrections facility. And they defended their staff’s calls to police as in-the-moment requests for aid in handling some of the most challenging young people in the state.

“When we have a situation and we need support we contact local police,” Jim Martin, Sweetser’s vice president of programs, said. ”It doesn’t mean that that call is triggering some larger event in terms of the child being moved to corrections.”

Department of Corrections officials, however, have been alarmed by the influx of mentally ill young people into the facility that serves as a temporary detention center and prison for Maine youth.

As of last July, nearly 85 percent of the teenagers committed to the Long Creek Youth Development Center had three or more diagnosed mental conditions. Forty-two percent had spent time in a residential treatment program, and 30 percent had been sent to the prison directly from one. Corrections officials say this pattern has continued.

‘A self-fulfilling prophecy of failure’

When the Rockport police office asked her daughter if she wanted to go to jail, Eileen Kelly was furious. She was also confused.

The mother was confused, because she hadn’t known that Sweetser staff had called the police. But suddenly there was an officer, right there in front of them, telling her daughter that it was his third visit to the facility that week and suggesting a trip to Long Creek.

Eileen Kelly was furious because she felt that nothing Maura had done warranted police attention.

Maura was shrieking and slamming the door, Kelly recalled, but she wasn’t hitting people or breaking things. And fits of rage have been part of her daughter’s behavior for years, Kelly said.

When Maura was growing up, her mother, a career social worker, would take her to story time, swimming lessons and Girl Scouts meetings. At age 6, Maura also started to be taken to psychologists and psychiatrists.

Maura was hospitalized for the first time at age 8 and has since cycled through more than 20 medications and a fistful of provisional diagnoses, ranging from anxiety to bipolar disorder.

Puberty and hormones made Maura angrier and more aggressive. And she moved up the rungs of Maine’s mental health services from in-home care to eventually arrive in residential treatment and the Rockport facility.

So when Sweetser staff called the police on Jan. 20, Kelly said she felt they were using law enforcement to deal with the behavior Maura was there to be treated for.

Sweetser and the Rockport police declined to comment on the incident, citing juvenile confidentiality regulations.

A short police report from that night states that a Sweetser supervisor “wants [Maura] removed and not to return.” It describes the call as being for an “out of control juvenile female” but doesn’t cite out-of-control behavior other than yelling.

In the police report, the officer classified the incident as a “juvenile problem.” This broad category, which includes everything from pulling a fire alarm and “acting up” to threatening “assaultive behaviors,” accounts for about 39 percent of calls to the police in the Disability Rights Maine report.

Another 38 percent are for missing or run-away youth. Mental health or medical issues account for 10 percent. Combined, calls related to assault, “investigation/information,” probation, sex offense, drugs, theft, “law enforcement visits” and “other” amount to about 13 percent.

Sgt. Jonathan Shapiro, who represents the state police in the Maine’s Juvenile Justice Advisory Group, said frequent calls from residential treatment facilities drain the resources of his York County troop with incidents that police “really don’t have a good role in.” And the 28-year-police veteran believes the calls to law enforcement contribute to severely mentally ill young people moving to Long Creek, where staff are not trained to treat them.

“That whole scenario is inappropriate in almost all cases,” Shapiro said, adding that there are times when police involvement is warranted. “That whole scenario is a self-fulfilling prophecy of failure.”

Edwards, the DHHS spokeswoman, pointed out that it’s unclear which — or whether — calls to law enforcement by residential treatment providers directly resulted in those young people being detained at Long Creek. The Disability Rights Maine report does not directly connect the two, she said.

She added that the Department of Corrections’ own data shows that the most common causes of commitment to Long Creek are charges of theft, assault, criminal mischief and burglary.

Mentally ill young people are frequently detained at Long Creek temporarily until they can be placed in a residential treatment facility that will take them, according to Assistant District Attorney Christine Thibeault. Because they are privately run, these facilities can turn people away.

“A large majority of the kids we’ve seen have a history of residential placements or they are awaiting residential placements,” Thibeault, who handles juvenile cases in Cumberland County, said.

Saco police Chief Raynald Demers said his department has had to ask for assistance from other police departments because of the frequency with which his officers are called to the Sweetser residential facility there. He recalled having been called for “minor assaults” but was told by a judge or a prosecutor not to pursue charges because that behavior is part of why a child was in treatment.

Demers also said that police involvement can be constructive and that some of the mentally ill youth at Sweetser’s Saco facility require a more secure setting.

Martin, Sweetser’s vice president of programs, said part of that challenge is that staff can — and sparingly do — use physical restraints, but they cannot use locked doors or gates to contain teenagers in the way Long Creek does.

In Belfast, police Chief Michael McFadden said that calls from that community’s Sweetser facility may tax his department but are “invariably for a legitimate reason.”

“It’s for safety concerns or criminal situations occurring,” said McFadden, recalling an incident in which a teenager broke a window and began threatening staff with a piece of glass.

‘Room for improvement’

Along with police experiences, the volume and type of calls to law enforcement varies among Maine’s more than 20 residential treatment facilities and eight providers.

The largest treatment provider by number of residential beds, Sweetser accounted for more than 500 of the calls to police tallied in the Disability Rights Maine report. The majority of those came from its Saco and Belfast campuses.

Sweetser also had the second highest rate of calls to the police with an average of more than five calls per treatment bed over 13 months, according to the report. The next largest provider, Spurwink, averaged one call per bed over the same period and placed 67 total.

The average for all eight organizations was just under two police calls per bed. The organizations range in size from Sweetser’s 93 youth treatment beds to six beds apiece for the Opportunity Alliance and The Northern Lighthouse.

Asked why Sweetser called police at a rate more than twice that of most of its peers, Martin said, “I’m not sure that information represents the full context of residential and treatment services that we’re providing to families that come to Sweetser.”

“There is always room for improvement across any system and in any practice,” he added. Sweetser is involved in ongoing working groups with law enforcement, corrections and DHHS officials, among others, looking at how to better serve the children in their care.

Kidspeace had the lowest rate of police calls per bed, with five in 13 months from its 44-bed Ellsworth facility, according to Disability Rights Maine. The Opportunity Alliance had the highest rate, with 38 calls from its Scarborough center.

Opportunity Alliance’s call rate is somewhat skewed by 10 calls for a single young person prone to running away, said President and CEO Michael Tarpinian. But his organization plans to re-examine when it calls law enforcement, based on Disability Rights Maine’s report.

“I can guarantee you that those 38 calls will be dug into to determine whether or not some alternative direction could have been taken,” Tarpinian said.

‘Dangerous events’

Department of Health and Human Services regulations require that residential service providers inform the department within a business day when law enforcement is called on one of the young people they care for.

These reports are considered important for keeping track of what has happened to a mentally ill young person, since traumatic experiences can affect their behavior and treatment. But Disability Rights Maine found they largely don’t get made.

The advocacy group, which is empowered by federal law and contracts with the state of Maine to monitor and advocate for mentally ill people and access their confidential treatment files, compared the 815 calls residential service providers placed to police over 13 months with the incident reports filed with DHHS over the same period. Disability Rights Maine did not share the police call data nor the confidential DHHS records with the Bangor Daily News.

The group found that there weren’t corresponding DHHS incident reports for 59 percent of the police calls.

In addition to the 483 police calls that didn’t have a report, Disability Rights Maine could not find a law enforcement record associated with 183 existing department reports. If all of these stray reports were to match up with police calls, it would bring the rate of unreported events down to 37 percent.

“Whether the rate is 59 percent or 37 percent or somewhere in between, the failure of residential providers to accurately report to DHHS their use of law enforcement is problematic,” the Disability Rights Maine report states.

Residential providers that the Bangor Daily News interviewed for this story said they fully complied with DHHS regulations and declined to comment on Disability Rights Maine’s finding of unreported calls because it is not broken down by provider. The advocacy group said the disaggregated data are not presently available.

Edwards, the DHHS spokeswoman, said there are a number of reasons why a call to law enforcement may not have been reported to her department. For instance, if youth in a mental health facility are in a “school setting” they would be under the supervision of the Department of Education and not all police calls would be reported to DHHS, she said.

She also said that some police calls only need to be reported if the behavior that prompted them “causes possible danger” or “if danger exists or is perceived to exist.”

The DHHS’ publically posted guidelines state that “law enforcement involvement” is a reportable incident and that “actual harm or injury need not occur.”

The Jan. 20 police call for Maura Kelly’s yelling was one of the incidents for which Disability Rights Maine could not find a DHHS report.

And it did not end with the 16-year-old going to Long Creek. Eventually, Maura quieted down and the police officer apologized for his initial response, according to Eileen Kelly.

The officer told Kelly “she needs to take her daughter and not to return,” the police report states. Maura is still at the Rockport facility, but her mother is working with Sweetser and her daughter’s case manager to get her moved to a different care center.

“The last thing I need is for police to haul off my daughter,” Kelly said.

 


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