The silent scandal

After being mostly ignored in these parts, the case of Angellika Arndt is getting the attention of the national news media after a General Accounting Office report showed, according to a report by National Public Radio, “children have died or been injured when they have been tied, taped, handcuffed or pinned down by adults or locked in secluded rooms, often to be left for hours at a time.”

Yeah, no kidding.

In late May 2006, Angellika Arndt was placed in a “control hold” at a “counseling center” up in Rice Lake after several infractions, such as gargling her milk, an initial state investigation showed. She died. I know the case was “mostly ignored” in the media because I was one of the people who ignored it.

Here’s the full report from the GAO. But here’s the shameful bottom line:

Examples of these cases include a 7 year old purportedly dying after being held face down for hours by school staff, 5 year olds allegedly being tied to chairs with bungee cords and duct tape by their teacher and suffering broken arms and bloody noses, and a 13 year old reportedly hanging himself in a seclusion room after prolonged confinement. Although GAO continues to receive new allegations from parents and advocacy groups, GAO could not find a single Web site, federal agency, or other entity that collects information on the use of these methods or the extent of their alleged abuse.

GAO also examined the details of 10 restraint and seclusion cases in which there was a criminal conviction, a finding of civil or administrative liability, or a large financial settlement. The cases share the following common themes: they involved children with disabilities who were restrained and secluded, often in cases where they were not physically aggressive and their parents did not give consent; restraints that block air to the lungs can be deadly; teachers and staff in the cases were often not trained on the use of seclusions and restraints; and teachers and staff from at least 5 of the 10 cases continue to be employed as educators.

Almost all of the incidents involved children with disabilities.

Currently, eight states specifically prohibit the use of prone restraints or restraints that impede a child’s ability to breathe. Minnesota is not one of those states, according to the report.

Currently, seventeen states require that staff receive training before being permitted to restrain children. Minnesota is not one of those states, according to the report.

In 2008, the Special Education Task Force submitted its report to the Legislature on the issue, including recommended language on a proposed state regulations on the use of restraint.

  • Minn Whaler

    There was a bill proposed to MN legislature this year regarding the use of restraints in schools and day treatment centers. Lost track of it when the budget took all my attention.

  • Chad

    This is an important story, Bob.

    As a mental health professional, I can say that not all “therapists” ascribe to the whole restraint rationale. Granted, there ARE times when kids in treatment programs need to be physically restrained– because of the therapists’ obligations to ensure the safety of other kids. But obviously gargling milk isn’t a safety concern.

    A major systemic problem here (in MN) is that, in the mental health world, daytreatment jobs are largely for the newest therapists. The people doing the holds usually have the least experience and psychological training. Unfortunately in these programs, the most seasoned and educated therapists (psychologists, clinical social workers, etc) mostly serve a supervisory function and have only limited contact with the kids– not really by choice. Largely because of the reimbursement system’s purely capitalist intentions, the only finanically feasible model of daytreatment demands a high number of under-trained workers. Why is that?

    The definition of mental health “professional” here can be debated. There is a great degree of variance in the level of training in therapists. Some come from shoddy pay-for-degree programs and have minimal training in how to cope with their own emotional reactions to clients (anger). Others are perfectly professional and wouldn’t have had this outcome. Newbie therapists working with the most difficult cases without adequate supervision is not the answer. Not all therapists allow for this type of accident.

    Tragically, having worked in these programs before, I can say that her daytreatment center was probably the center of Angelika’s life. Most of these kids leave school to live in complete hell.

    But the public will watch their Dancing with the Stars and return to Biggest Loser. I mean– that was THAT kid over THERE. Isn’t it a shame that happened in HER world? She doesn’t live next door to us, right? Wrong.

    The real tragedy here is that people don’t see that Angelika dies in OUR community. Her death affects us all– whether we pay attention or not.

  • Chad

    Another important point here is that “therapist” [unfortunately] can mean many things: bachelor’s in psych (or history for that matter), master’s degree and no license, MD psychiatrist, Psychologist, etc. The term “therapist” isn’t regulated by the state, and an electrician could advertise themselves as a therapist if they wanted to.

    Terms like Psychologist, Family Therapist, Clinical Social Worker are all regulated by the state, and it’s illegal to call one’s self that unless they’re licensed, etc– these are considered “Mental Health Professionals” in the law. Terms like “mental health practitioner” or “mental health worker” can mean almost anything, though.

    Typically in these programs, the licensed professionals do the supervision and some therapy, but the unlicensed workers are more responsible for the minute-to-minute contact with the kid– again, moslty because of the financial constraints insurance companies dictate– not by choice. What insurance company is going to pay a Psychologist with ten years of training to watch a kid gargle milk during lunch? Some state programs/grants allow for more flexibility, but those are disappearing too.

    And not every daytreatment center is bad either. Some truly are shady money-mills, but some make serious financial compromises to provide top-notch care.