Showing posts with label restraint. Show all posts
Showing posts with label restraint. Show all posts

Friday, April 28, 2017

Restraint and Death of Disabled Civilians in Texas

The New Statesman reports on deaths in restraint or otherwise in custody of mentally ill civilians in Texas. There's a new bill pending, the Sandra Bland Act. The paper reports on the bill, but also investigated deaths. Excerpts:
Klessig is one of at least 33 people with histories of mental illness who died after being restrained by police in Texas over the past decade, according to a first-of-its-kind investigation by the American-Statesman of in-custody deaths. Six of those people wielded weapons; the rest were unarmed, records with the Texas Attorney General indicate.
And
Some of the deaths in police custody also raise serious questions about the way police deal with people struggling with mental illness. In several instances, police appear to have acted contrary to what experts advise — a slower, less confrontational approach to mentally ill people that can prevent violent encounters and death.
And
State Rep. Garnet Coleman, the Houston Democrat who filed the Sandra Bland Act — named for a mentally ill Illinois woman pulled over in Waller County for a minor infraction and later found dead in her jail cell from an apparent suicide — said the additional training would help officers distinguish between “a person who is in crisis and one who is being aggressive … and resolve the situation in a peaceful manner.”
My take: Such bills will help, but relying on officers to distinguish between disabled and non-disabled civilians will leave many vulnerable. We need core, default, changes.

Here's the project webpage. I'll be following it!

Thursday, December 24, 2015

Restraint for Safety vs Restraint for Punishment (And Freddie DeBoer)

I wrote a piece for Pacific Standard that many people seem to have read (it was their most popular story on the site for 5 days or so. I gather that must mean something) on the systematic abuse of disabled children by teachers and other staff in schools and institutions across America. In the piece, I took three reports by three separate groups - Pro Public, the Center for Public Integrity, and the Disability Law Center of Massachusetts - and discussed the common pattern: restraint and seclusion being used to punish students for basic non-compliance.

For regular readers of this blog, you'll know this is the kind of thing I coordinate under the phrase the "cult of compliance" (search the tags for many more posts).

A few days ago, the well-known writer Freddie DeBoer responded on Twitter by asking me to read a piece he wrote that criticized the Pro Publica essay as "sensationalist and damaging." He calls it "Difficult Problems After the Death of Nuance." In the essay, DeBoer describes his experience as a caregiver in an public school with a segregated section for children with emotional disabilities, experiences that included restraint. With children who are likely to harm themselves or others, he asked, what are you supposed to do?

This is an entirely reasonable question. There are many situations in which restraint is a reasonable and appropriate response to specific behaviors. For example - if a child is about to run into the street, you should hold them. If a child, as DeBoer describes, is trying to throw a chair at your head or another student's head, you should stop them. These things happen.

But what the experts (for example Positive Behavior Interventions & Supports or Trauma Informed Practices) tell us is that such behavior have an instigating point, a cause, and that the correct response to such behaviors is to investigate those causes and try to work at the root issues, rather than try and solve the problem by treating the symptoms, the acting out in some way, with force. There is no amount of force that can make someone less disabled. All you end up doing is intensifying trauma.

Many IEPs (Individualized Education Plans) and similar documents contain provisions about the use of restraint. They are ideally crafted in collaboration with parents, other caregivers, as especially as possible the disabled person themselves. Restraint and seclusion may be necessary, but only as a holding action while you work on root issues.

In the cases I discuss, however, restraint and seclusion are being used to punish and to force compliance. Again and again, we see staff and teachers - who are surely under great pressure themselves, and drastically under-resourced - resort to fear, pain, and isolation to teach disabled students that if they act as themselves, in non-typical ways, they will suffer for it. People strapped to beds for throwing food, thrown into a closet with the lights off for not following orders, given electric shocks. That's the abuse. That's the practice we need to stop. That's the cult of compliance.

So overall, my response to DeBoer's entirely reasonable question is this: Restraint may be part of a safety plan, but it's not a teaching tool. It doesn't really change behaviors. Moreover, there are usually positive ways to change behaviors, but they take time, resources, and creativity. I think the restraint as safety vs restraint as punishment is a useful dialectic along which to assess a given situation.

Now a brief aside: I'm a little nervous about responding to Freddie DeBoer because my introduction to him was really through his back and forth with Angus Johnston (@studentactivism), who once wrote: "It’s become clear that Freddie is the kind of person who says “Give me an answer!” when he means “Admit that there are no answers!”

He has asked me for an answer, and I've given him one above, and my brief interaction on Twitter suggests he's open to the dialectic I propose. Again, I think he asks a useful question, and I'm pleased he sought me out.

The problem with his essay is this "death of nuance" framing. DeBoer believes that reactions to this type of outrage journalism, "Demonstrate the ways in which the world of sharing and likes and shallow understanding destroys nuance and creates a bogus conception of a black-and-white world."

He is furthermore:
Reminded of a few sad realities: that American liberalism culture is now synonymous with a juvenile Manicheanism that imagines some perfect world we could achieve if people just weren’t so selfish and evil; that getting showily, publicly angry about problems is more popular than actually attempting to solve them; that there is no issue of such emotional and moral complexity that many people can’t reduce it to a black-and-white caricature; and that we have created a media which has made its financial best interest inextricable from destroying depth, nuance, and complexity. I genuinely don’t know if people believe in difficult choices and intractable problems anymore.
I hope DeBoer doesn't really believe this. I suspect it's rhetorical rather than, as he says, "genuine." It's a way for him to continue his long-running diatribes against PC culture and kids these days, which is fine. I'm not going to get into it, except for these two points:

First, it's ahistorical. Getting outraged about outrageous things is normal. The press has always published outraged journalism intended to evoke sympathy, rage, donations, voting, direct action, and, most of all, more sales of media products. Before there were media products to sell, the sharing of outrage traveled through different kinds of information culture, but travel they did. Speed, scale, and means have changed. Local outrages can become national or international in ways never before likely (consider police abuses). Outrage can feed on itself in new ways too, because we can communicate our upset more effectively and quickly. But getting outraged about outrageous things is an appropriate and rational response.

Second, DeBoer here draws his meta conclusion about the "death of nuance" based on lack of knowledge of both disability and disability-related pedagogy. His lived experiences matter, but he confesses that these were confusing times for him in his life. When he writes, "Mental illness is powerful and terrible and that’s the world we live in," he places himself in a casually ableist epistemology that informs everything else he writes (I fear he rejects the concept of ableism, but that's a bigger conversation).

What's powerful and terrible is when people with psychiatric disabilities are denied the resources they need, and when stigma and fear make it harder for people with such conditions to come out as disabled, to ask for help, and so self-treat and self-medicate.

What's powerful and terrible are the intersections of mental-illness-stigma with racism and poverty. Marginalizing forces multiply dangerously. It's not a coincidence that the people in these institutions of the sort DeBoer describes tend to be poor and non-white. The nuanced liberal response to such conditions is not to decry outrage, but to identify root cultural, social, economic, and political causes and get to work.

With that said, I'm going to get back to work.

Thursday, December 10, 2015

Minneapolis Hires Superintendent Who Oversaw Systematic Abuse of Disabled Children

Explosive new report of abuse from the Massachusetts Disability Law Center. UPDATE: You can see the whole report here.

1. The Cult of Compliance (from Boston Globe):
The investigation uncovered a school culture in which aggressive discipline of students had become ingrained, Eichner said. Many students suffered injuries, including scratches and bruises, and one student was given a hospital exam for a bump on the head...
One 67-pound student was restrained 50 times, including about a dozen times when the pupil was held prone on the floor, according to Eichner and the report. The child complained to a parent of being unable to breathe, and that some of the restraints had been painful, the center said.
“Prone restraints can lead to serious injuries or even death,” Eichner said. Some restraints lasted for longer than 20 minutes, the investigation found.
Children were thrown to the floor for not moving, pulled out of chairs for refusing to get up, tackled to the ground, and restrained for refusing to change into a uniform, investigators were told.
2. Accountability

It's unclear to me what's happened to the people who did these terrible things. The Superintendent has been fired. More on him in a second.

Update: The people at the DLC tell me that the principal was fired and some staff were reassigned. That's about it.

3. Intersectionality - Race and Disability
Eichner, of the Disability Law Center, said a combination of factors appears to have led to the abuse.
“Holyoke is an underserved district, obviously,” he said. “We think there wasn’t enough resources and not enough training, and this population is predominantly students of color. You combine that with students with emotional issues, and without adequate resources and training it becomes a power fight between the teachers and students.”
4. Welcome to Minneapolis!
The allegations surfaced during the tenure of former Holyoke superintendent Sergio Paez, who lost his job after Massachusetts education officials voted in April to place the district under state control.
On Monday, the Minneapolis school board voted to appoint Paez as that city’s next school superintendent. Members of the board did not respond to requests from the Globe to comment on whether the allegations would affect his hiring.
You can contact the Minneapolis School Board here.

UPDATE: Sergio Paez has denied all allegations. The School Board is investigating. Get involved!

More details from the full report (updated 3:30 CST 12/10)

5. A child locked in a closet!!
The most egregious seclusion reported was that on at least three occasions, a teacher put children in a locked closet and turned out the lights.When we interviewed the teacher in question about these incidents, she denied it, stating that another student had locked the door. However, her version is not supported by the record. When discussing this practice with the administration, we were told that the teacher is still employed at the school, but her job responsibilities have changed and she no longer has any direct contact with students.
Note - the teacher wasn't fired.

6. School to Prison Pipeline starts here
One teacher stated that "[a] lack of training and tools to address behaviors is hurting students." In Ms. Hirsch's letter she describes this negative culture and provides an example of public shaming of a student when a teacher asked the whole class to write down another students "bad behavior." We also heard that the school will routinely call the police to resolve issues when children are in crisis and in need of mental health supports. One teacher stated that he wanted to call the local mental health crisis
team but the administration called the police instead. This pattern perpetuates the cycle of children transitioning from a schoolhouse to jailhouse instead of receiving appropriate disability related services.