Report rips mental health care at juvenile center

Here's a new twist. Instead of delivering shoddy treatment options, they decided to deliver nothing at all. But they still collected the money, becoming another example of mental health fraud. As seen in this report in the Palm Beach Post

A girl locked in Palm Beach County's juvenile detention center asked to see a therapist on the anniversary of her mother's death, but said she never heard back.

A boy at the center was recommended for substance abuse treatment, but nine months later, reviewers could find no evidence he ever got it.

And other teens did not get medication they were supposed to be taking for mental health problems because workers failed to follow up with their parents or doctors, according to a report from attorneys at the Legal Aid Society's Juvenile Advocacy Project.

Mental health treatment for teens at the center on 45th Street in West Palm Beach is sporadic and limited, the attorneys said, in part because a private company has not met the terms of its contract.

Palm Beach County Juvenile Court Judge Peter Blanc ordered the review in response to attorneys' concerns that teens were being locked up for months without meaningful treatment.

The 93-bed facility, managed by the Department of Juvenile Justice, holds juveniles charged with serious or repeat crimes until space opens for them in a longer-term residential programs.

This year some teens have been forced to wait several months in detention. The time they spend there does not count against their sentences, which can vary depending on behavior.

The state pays PsychSolutions, Inc. of Coral Gables up to $180,170 a year to provide a therapist and two mental health workers at the facility, and $28,665 for a part-time psychiatrist.

Teens can get 45 minutes of individual counseling once a week, the report said, but PsychSolutions does not provide the group counseling or drug treatment promised in its contract.

A PsychSolutions executive told reviewers that they wanted the company to focus on mental health instead of drug treatment. The company had not been able to set up group therapy because it was only able to hire two of the three workers specified in its contract. PsychSolutions has been looking for a third worker for eight months and hopes to have the position filled soon, according to the report.

That has forced the company to focus on those children who are in crisis, according to the report.

Others may have been overlooked.

One boy who had been in detention for two weeks cried during his interview with the Juvenile Advocacy Project, saying he was sad, had lost his appetite and was having trouble sleeping. He wanted counseling, according to the report, but was not receiving treatment.

In another case, attorneys were told that a boy with anxiety and a history of suicidal thoughts had to wait more than a week before seeing the PsychSolutions' psychiatrist, even though the doctor was coming to the facility sooner and the contract specifies he is on call for emergencies seven days a week, the report said.

The report's authors, Legal Aid attorneys William Booth and Michelle Hankey, said one of the main problems seemed to be breakdowns in communication.

In some cases, mental health experts suggested that state juvenile justice workers keep constant watch on suicidal teens, or check on them every five minutes. But records show detention officers actually made those checks just twice an hour.

In other cases, mental health evaluations after teens were arrested never got to the detention center files.

"It appears that there is no follow-through," Booth said.

Leaders at the Department of Juvenile Justice are reviewing the report, spokeswoman Cynthia Lorenzo said. A spokeswoman for PsychSolutions said the company would respond to the findings soon. Judge Blanc has scheduled another hearing on the issue, and said he would wait to hear from the state before making any decisions.

Booth and Hankey hope their report will resonate with those committed to helping children.

"No child in the detention center should ever again be without mental health and substance abuse services," they wrote.

Of course, we would be skeptical of the quality of the services if they were delivered at all.