State keeps mentally ill teen at jail

After nine hearings, no psychiatric care has been found for her

Staff WriterApril 6, 2008 

A mentally ill 14-year-old from Rowan County has been in juvenile jail for more than two months because no appropriate treatment can be found for her, one of her attorneys said.

The girl, identified in court papers as S.R., has been locked up since Jan. 28. District Court Judge William Kluttz wrote on March 27 that keeping her at the state detention center in Alexander County without mental health treatment is unacceptable, inexcusable and probably against the law. She is locked up because she might harm herself or other people, Kluttz wrote.

One of the girl's lawyers, Lewis Pitts, linked the scarcity of intensive treatment to the state's bungled mental health reform, which moved most services into the hands of private companies.

"That's a systematic flaw," he said.

Pitts asked for an administrative hearing to force the state to find such care, claiming the state Department of Health and Human Services was violating the girl's Medicaid rights. Kluttz has held at least nine hearings on the case since the girl was placed in the jail, Pitts said, but no one found another place for her.

A number of agencies were called into court to ask why no treatment had been set up for the girl. A case manager with a private company is looking for a place to send her. Any proposal for placement has to be approved by the local mental health office, Piedmont Behavioral Health, which oversees care in the five-county region about 100 miles west of the Triangle that includes Rowan. The Rowan social services department has legal custody of the girl.

But Pitts said it is the state's responsibility to find a place for her.

An administrative law judge, Donald W. Overby, agreed. He ordered the state to come up with a plan by Monday to move the girl to a place where she can get psychiatric treatment. She needs to live in a facility with locked doors and receive intensive treatment, his order said.

"As a matter of law, as a matter of fact, and as a matter of human rights and fundamental decency, it is an abysmal failure of us as human beings and as a society ... for this 14-year-old child to be illegally locked up in a juvenile detention center, and to have been locked up without treatment since January 18, 2008, because the North Carolina mental health system has been unable or unwilling to locate treatment at a PRTF [psychiatric residential treatment facility]," the order said.

Pitts wrote the order, and Overby said in an interview that he paused before signing it. He decided to sign, he said, because it says essentially what he said at a March 31 hearing on the case.

Overby said the private company in charge of finding treatment has worked to find a place that will take the girl. But he said the state and the local mental health offices are responsible for finding the girl proper treatment, even if it means she will have to leave the state.

He rejected the argument from the state's attorney that the state is not responsible for finding the placement, but has the duty only to pay for it.

Assistant attorney general Diane Pomper argued for the state. She could not be reached for comment.

Steve Tomlinson, spokesman for Piedmont Behavioral Health, said intensive residential treatment for mentally ill children is hard to find. The office sends juveniles to residential treatment centers outside the region if necessary, he said. or (919) 829-4821

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