Girl kept in jail because of a lack of mental care

A mentally ill 14-year-old girl has been in juvenile jail for more than two months because no appropriate treatment can be found for her.

The girl, identified in court papers as S.R., has been locked up since Jan. 28. District Court Judge William Kluttz wrote 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.

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 private company's hands.

"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 went to jail, PItts said, but no one found another place for her.

A number of agencies have some responsibility for finding treatment. A case manager with a private company is looking for a place to send her. The plan has to be approved by the local mental health office, Piedmont Behavioral Health, that oversees care in a 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.

The administrative law judge, Donald W. Overby agreed, and ordered the state to come up with a plan by Monday to move her somewhere she can live and get psychiatric treatment. The girl needs to live somewhere with locked doors and 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, and especially for the state of North Carolina, 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)..., to which she is entitled by Federal and State Medicaid law," said the order.

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

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

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

"That child is really being held illegally, for her own good, to try to find some place, and everybody is pointing the finger," he said. Assistant attorney general Diane Pomper argued for the state. She could not be reached Friday.

Steve Tomlinson, spokesman for Piedmont Behavioral Health, said intensive residential treatment for mentally ill children is hard to find. The office sends children to residential treatment centers outside the region if necessary, he said.