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Residential Treatment and Viewpoints of Mental Health Among Youth

Updated: Jun 8, 2019


About a month ago a video was released by Buzzfeed that revealed disturbing video of a young man seeming to be attacked by a staff member at a residential facility here in the city I live in Birmingham, AL. A residential facility from my experience is an institution for individuals who are experiencing mental, behavioral and/or emotional distress that prevents them from being able to remain in everyday society. The only definition I could find that made sense from a Google search came from The National Caregivers Library:

"Residential care facilities, which also are called board and care homes, personal care homes, sheltered housing, or domiciliary care homes, offer housing for individuals who need assistance with personal care or medical needs. This means that the facility is normally state licensed and meets minimum staffing requirements. The facility is staffed 24 hours a day.

To be eligible for residential care facilities, an individual usually must be fairly mentally alert; able to dress, feed, and take themselves to the toilet; able to eat meals in a central dining room; and need no more than moderate assistance with personal care or behavior supervision. Check with the specific facility for any policies concerning walkers or wheelchairs."

A more recognizable term would probably be group home which in my eyes is more into my field of work as a licensed social worker where I worked as a therapist for youth in care ages 13-20 in the temporary custody of Department of Human Resources (DHR) due to a variety of issues including, but not limited to abuse, neglect, delinquency and abandonment. Merriam-Webster defines a group home as:

"a place where people who need special care or attention live together in a group"

Either way there is not a very clear definition of what facilities are, many are hospitals like Hillcrest which accept a variety of different patients ranging from DHR youth to adults to sexual offenders to "last chance" individuals. The video goes on to account testimonies from former staff, current staff, former residents and family members regarding the poor treatment received from staff while in the facility. I have only been to Hilcrest once to train their staff one time and any other time I heard about it was from my clients I treated at the facility I worked at in which many of them had been if not once, multiple times. I heard varied stories, some loved it, others did not.

I can only speak from my experiences. The place I worked for was not a hospital setting but it staffed a 24 hour nurse, 24 hour staff, therapists that were on call 24/7, case managers and a psychiatrist. Residents were administered meds throughout the day and had to participate in weekly group and individual therapy. They attended school on campus unless otherwise approved which was rare.

I hated it! The only thing I enjoyed was my clients and even at times helping them through their frustrations and trauma made the job extra tough. The environment created was just so toxic and overwhelmingly full of unhappy individuals on a daily basis, both the staff and the kids placed there. And I would be amiss if I didn't mentioned the mistreatment of the youth by some of the staff, most likely from stress, long hours and poor management. I often realized this played such a major role in the manner in which the staff interacted with the residents, therefore causing a constant tension and an inability for the staff to do what they were hired to do, which should have been to help heal those seeking refuge and a home and to received treatment. I found this was rarely a priority and often what took precedence was managing behavior and ensuring beds were full, while important, distracting at the same time.

The Buzzfeed video very much exposes one thing for sure. Some staff hired to work at these establishments are not qualified and/or are burnt out and are reacting so poorly to those placed there that it is causing complete chaos. I have been reading some of the comments and while many are mentioning a need to fire staff and change the protocols, there are some comments focusing on that of the residents themselves, saying they are there for a reason and that people do not know the conditions the staff are required to work in. This is for another blog post because I truthfully believe their is an overall misunderstanding both in our society and within the system in regards to how to respond to behavior and how to respond to mental health. One thing that stood out to me when I worked at the facility was the lack of understanding by staff, upper management and sometimes even clinicians the effects trauma from being at the facility had on both the residents and the staff, therefore causing a very toxic environment.

I believe there are two solutions: Conversation and Relationship. I caught so much trouble in opening my mouth with suggestions on how to redirect our focus and think outside of the box in how we handled issues within the mental health community. Many times I was told I didn't understand the behavior when I was saying they weren't understanding the complexities of the differences between trauma and mental health. On the other hand, they were constantly calling on me when they were reaching barriers with residents because I had developed a trust and bond with many of the young people and they respected me. This is where Professional Development with EK comes from, a place deep within my soul knowing that the conversation needs to be held among professionals. The realities exposed by this video are so significant in the need to have a discussion about the breakdowns in the system of social services and helping professions. Thank you for joining the conversation.

Here is a link to a video that was shared by a local news anchor, that mentions the Buzzfeed videor: https://www.facebook.com/FredWVTM13/videos/1143012299166769/

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