San Jose center for troubled teens closing abruptly

By Karen de SáMercury NewsArticle Launched:
04/10/2008 01:31:09 AM PDT

Related document
Evaluation report on Starlight Adolescent Center

Part 1 (includes list of four Type A deficiencies; PDF)

Part 2 (includes details on broken arm incident; PDF)

The region's center for emotionally disturbed children is abruptly shutting its doors, following scathing reports of unsafe conditions and multiple violations of state law governing locked treatment facilities.

Although owners of the Starlight Adolescent Center in San Jose said its closing was not connected to recent complaints, records show the facility was cited by state officials in recent months for 14 violations that placed children in 'immediate risk' and 12 others that posed potential harm.

State records show one youth had his arm broken in January while being restrained; a bulimic teenager lost 15 pounds at the facility, and staff complained to state investigators of inadequate training.

In addition, in February, an outside agency charged the Starlight facility with 'unlawful and irresponsible' behavior for its use of physical restraint and seclusion to subdue the teenage mentally ill patients, including 518 violations of state law. 'Starlight must be sanctioned for its failure to protect vulnerable children,' said the second critical audit of the facility in two years by the Mental Health Advocacy Project, which the county funds to monitor the rights of mentally ill patients.

The decision to close the facility in June comes amid a growing concern among experts about the wisdom of keeping mentally ill youth in locked facilities on a long-term basis. The average stay at Starlight is one year.

Santa Clara County began sending youth to the 36-bed center in South San Jose seven years ago; children 12 to 18 years old are placed there by county foster care, mental health and juvenile probation officials. The facility also accepts youth from other counties, as well as some children brought there by distraught parents. No contract renewal.

Nancy Pena, director of the Santa Clara County Department of Mental Health, said Wednesday the county decided not to renew its contract with Starlight, beginning this June, and instead to rely on unlocked group homes and supervised family care. Because the county owns the building and local residents are a significant portion of the clients, this made it impossible for the facility to remain open, Pena said.

Both Pena and Mary Jane Gross, the founder and head of Stars Behavioral Health Group, the for-profit parent company that owns Starlight, flatly denied that recent reports contributed to the decision to permanently shutter the facility.

Gross said the agency is a victim of its own success. 'The reason is that we have been successful at graduating close to 300 youth over the past seven years and there is a reduced need for this high-level program,' Gross said. 'We have been able to transition many of these children into community settings.'

Her firm 'vehemently' denied the conclusions reached by investigators. On March 18, Stars Behavioral Health Group challenged the Mental Health Advocacy Project's reports as 'sensationalized and irresponsible,' and ultimately harmful to the children served by Starlight.
The agency noted that a 2006 Starlight program review by the Child Welfare League of America - while recommending improvement in safety procedures and a reduction of restraint and seclusion use - also listed many of the program's strengths, describing it as competently serving a very challenging group of young people.

Pattern of violence

But Mental Health Advocacy Project senior attorney Brenna Silberstein described a 'nearly daily pattern of violence' at Starlight. 'For us, this is really about the safety of the children,' she said.
Since January, state officials have had similar concerns, following the incident where a child's arm was broken by a Starlight staff member. In one 90-minute spot check, agents with the Community Care Licensing division noted a total of 14 California law violations, including poor supervision of children attempting to harm themselves, a lack of documentation for a girl so over-medicated she slept all day, and the failure to monitor the food intake of the bulimic child.
Staff members told state investigators they do not feel adequately trained to work with the population and meet their clients' needs, specifically regarding behavior management. The state also found Starlight failed to report, or under-reported incidents of restraint and seclusion, and has cited Starlight for the violations in addition to requiring multiple corrective action plans.
'We're always concerned with any kinds of deficiency or violation and we move to take immediate action,' said Shirley Washington, spokeswoman for the California Department of Social Services. 'These are disturbing reports, absolutely. And that's why we went in to take the appropriate action.'

Santa Clara County agency directors said Wednesday they are now pulling children out of the facility, moving them to group homes or back with families supported by social worker help. Currently, only 20 of the beds are filled.

Considered an alternative to a state hospital commitment, Starlight serves young people who have typically spent years moving through shelters, group homes, psychiatric hospitals and juvenile halls. In some cases, they have attacked parents, teachers and caregivers; others have turned the violence inward, attempting suicide or cutting their arms.

Starlight Adolescent Center, located on Silicon Valley Boulevard, is one of only four locked psychiatric facilities in the state.

Dr. David Arredondo, a nationally renowned child psychiatrist, said that locked facilities are 'unproven at best' for more than a brief stay.

'When too many adolescents with behavioral or emotional problems are crowded together in a locked facility they tend to escalate the level of tension,' requiring the use of restraints or powerful psychiatric drugs as a means to control behavior.

Original Article from ...

Charlie Wittman, Director, Advocates for Children and Families, The ACF, CCHR Board of Advisors, theacf@hotmail.com , PO Box 10, Los Gatos, CA 95031, Main ACF WWW site:: http://www.theacf.org CRIN: http://www.crin.org/organisations/viewOrg.asp?ID=1774 CCHR: www.cchr.org LUNAR #1405, http://www.lunar.org/ Aero-Pac # 699 http://www.aeropac.org NAR [L2] #85655, http://www.nar.org/ Tripoli [L2} #11202 www.tripoli.org************************************