Lawsuit over institutionalizing foster youth in psychiatric hospitals continues

hss-logoWhen foster youth are admitted to a psychiatric hospital in Alaska against their will, they can stay there for up to 30 days without judicial review. Two tribes are arguing that’s too long. The Office of Children’s Services says a judge shouldn’t have to sign off at all on keeping kids at North Star Hospital. The court battle has lasted over two years, and a judge will hear more oral arguments later this month.
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During his 18 years in foster care, Nathon Pressley bounced from foster homes to treatment centers, including multiple months-long stays at North Star Behavioral Health Hospital. He said he’s tried to block out most of his memories at North Star, but some things have stuck with him.

“The moment you get aggressive in any way, whether it’s physical, verbal, emotional in any way, they can just put their hands on you and say you are a threat to yourself or others,” he said. “Then you stay in a place called the quiet room, which is a secluded, locked door with padded ground, ceiling, and sides and two cameras is what it was before. And Plexiglas windows and you’re just sitting in there.”

Pressley, now 19, said he was told he was admitted to North Star because caseworkers and foster parents labeled him “defiant.”

“You refuse to take your meds for five minutes, ‘Oh you’re being defiant,'” he explained. “You don’t go to school on one day or you skip school–defiant. You don’t go to bed on time–defiant. You see what I mean?”

At different points he tried to follow all of the rules and just walk away when someone upset him, he said, but staff members saw that as disrespectful and he would be in trouble again. Pressley felt harassed.

“It gets to the point where either you decide all hope is lost, and you just go and do something to yourself. Or you just say, ‘F-U, I’m going to do my own thing,’ and stand up for yourself. It’s kind of just two choices, and I chose the second one.”

Official statistics from the Office of Children’s Services show about 100 foster youth are sent to North Star each year. Until last year, youth could be involuntarily admitted to the institution and stay there indefinitely – without a judicial review.

The Native Villages of Hooper Bay and Kongiganak are suing Christy Lawton as the head of the Office of Children’s Services and North Star to stop that practice. The case began more than two years ago. The tribes say that committing foster youth to North Star without oversight violates their rights.

“The tribes were sick and tired – to put it bluntly – that their teenagers were being put in a mental institution and being separated from their tribes and their culture when they didn’t have a mental illness, they just needed foster homes,” said Alaska Legal Services’ James Davis, who is arguing the case on behalf of the tribes.

OCS Director Christy Lawton denied that kids are placed at North Star because of a lack of foster homes. In a written statement she said, “Placement at a hospital cannot occur unless a medical professional decides that placement at the hospital is medically necessary. In all cases, OCS, as a matter of statutory and policy mandates, has to look toward the least restrictive environment for the placement of a child when the child cannot live in their own home.”

North Star did not reply to requests for comments.

Amanda Metivier, the executive director of Facing Foster Care – Alaska, said Pressley’s story is fairly common. Many of the 300 youth she works with have been sent to North Star, she said, and she also attributes it in part to a lack of foster homes.

“It’s pretty typical, especially for teens in foster care because if you’re in the system, you’re sort of under a microscope already,” she said. Even normal milestones like school dances are under scrutiny. “Everyone’s watching you. Anything you do that’s not convenient for them can be seen as trouble.”

Metivier said putting children into North Star without a judge’s oversight violates the foster child’s rights.

“I think that when we’re institutionalizing young people, there should definitely be major checks and balances in place first to make sure that’s absolutely somewhere they need to be. That they need behavioral health treatment, and it’s not just normal adolescent behavior.”

Davis, the tribes’ lawyer, argues institutionalizing young people when they don’t need it is damaging – and unconstitutional. His plaintiffs also argue the state is violating its own statutes, which require a judicial review within 72 hours for a person who is involuntarily committed to a mental health evaluation or treatment facility.

The Department of Law is arguing the statutes about involuntary commitment do not apply to North Star because it is not a statutorily-designated treatment or evaluation facility. It’s a psychiatric hospital.

Department spokesperson Cori Mills wrote in an email, “Children who are admitted to North Star Hospital are evaluated and treated as those terms are understood by medical professionals.”

In September 2015, Superior Court Judge Erin Marston issued an order in which he wrote, “Given the illustrative cases presented by Plaintiffs, it appears that based on history, foster children may be placed into psychiatric care for issues unrelated to mental health or without sufficient cause and have no guarantee that their placement will be timely reviewed by a neutral factfinder.”

The order requires there to be a court hearing within 30 days of a youth being admitted to North Star.

Davis said that’s still too long. “How long should a youth be locked up in a hospital before a judge looks at what’s going on and decides if it’s right or wrong? 30 days or 3 days, which is how the rules apply to all other Alaskans.”

On September 27, the case will continue. Marston will hear oral arguments to decide if 30 days is the right amount of time and if that’s determined by statutes or by the state Constitution.