The state-run Sequoyah Adolescent Treatment Facility is supposed to help mentally ill, violent youths heal, but some staffers say it’s doing just the opposite.
Earlier this year, management at one of New Mexico’s key mental health facilities set a laudable goal: to reduce the frequency with which employees use physical restraints on the center’s violent, mentally ill teenage boys.
Now, though, several employees are raising serious concerns about how Albuquerque’s Sequoyah Adolescent Treatment Center is achieving that goal, alleging “improper, if not unlawful acts.”
For years, the state-run treatment center has offered a unique opportunity for troubled teenage boys with violent tendencies to turn their lives around. Yet since the facility set its new goals, employees have stepped forward, and outside agencies have come in to monitor a situation that critics say is rapidly deteriorating.
In late August, nearly half of Sequoyah’s 122 employees signed a letter to Administrator Anita Westbrook detailing a distressed workplace and demands for better conditions. The letter describes patients getting into fights with increasing frequency—normally a rare occurrence at Sequoyah—and even details one patient’s attempted suicide.
“There were substantial bruises on his neck caused by his attempt to strangle himself,” the letter reads. “He stated the reason he wanted to die was because he feels terrible since his medicine changed…his pleas for help continue to be ignored by the doctors responsible for his care.”
The letter also alleges that Sequoyah, which is run by the New Mexico Department of Health, has released violent teens to the public before they’re ready—a potential threat not only to the teenagers being released, but also to the general public. It also claims staffers have improperly used drugs to pacify teens in order to avoid using physical restraints.
The same week the letter went out, the state Children, Youth and Families Department’s Licensing and Certification Authority conducted a report on Sequoyah. It identified several deficiencies and prescribed corrective action. A few weeks ago, the nonprofit Disability Rights New Mexico also began looking into the situation.
“We’ve got a couple of broad concerns,” DRNM Legal Director Nancy Koenigsberg tells SFR. “The biggest ones are whether or not their restraint practices fall under the federal or state requirements [and whether] kids are being discharged properly and safely.”
DRNM is attempting to finish the report by Thanksgiving.
But DOH spokesman Kenny Vigil disputes such claims.
“We strongly deny that we are discharging people ‘too early,’” Vigil writes in an email to SFR, adding that the use of physical restraints and “seclusions” at Sequoyah dropped 67 percent over the summer—proof, he suggests, that the changes are working.
Yet Sequoyah employees, who asked to remain anonymous because they fear retaliation (at least one employee involved in drafting the letter is in the process of being dismissed, according to Communications Workers of America Local 7076 President Donald Alire) argue that the improvements look good only on the surface.
“On paper, yes, it looks like they’re decreasing the number of seclusions and restraints,” one employee tells SFR. “But that’s not the case.”
The letter alleges that the drop in emergency restraints is due mainly to the improper discharge of three of Sequoyah’s most violent teens. It also alleges that intramuscular injections used on Sequoyah residents aren’t being properly recorded as chemical restraints.
In July and August, “the facility discharged three residents, two of whom turned 18 and were considered adults, with long lengths of stay: 30 months, 19 months and 26 months,” Vigil writes.
He adds that, when residents reach the maximum benefit of treatment—a point at which they can safely be treated in a setting like foster care or outpatient services—“it is imperative we discharge according to plan as soon as possible.”
Yet one of the directives from CYFD bars Sequoyah from discharging its clients, except during medical emergencies, “until further notice.” CYFD also identified “medication errors” and ordered an audit of every patient’s medication records.
On Sept. 14, Sequoyah drafted a work plan that addresses many of CYFD’s corrective actions. Vigil writes that staff has since been added to “aggressively monitor the use of seclusion and restraint and any potential allegation of abuse and neglect.”
Sequoyah management did meet with union officials about the letter—to, as Vigil writes, “partner with them in resolving any outstanding issues.” Yet Alire says nothing came out of the meeting and that neither information from CYFD nor any external reports on the situation were provided to them.
Still, he’s hopeful that the ongoing external investigations will force a change.
“The reason for the petition is that people wanted to see change,” Alire says. “I can’t see it not happening because we have agencies overlooking the operations. I don’t know if that will keep everybody happy, but at least there’s a direction now that [it’s] going.”
Recently, Sequoyah held an appreciation day as “a joint effort to show unity,” Vigil writes.
On NMDOHCrisis.com, a website run by employees to detail the dysfunction of their agency, an anonymous commenter wrote: “Today is ‘Staff Appreciation Day’ at Sequoyah. I would feel more appreciated if Anita Westbrook had responded to our formal letter of concern. It’s been two months now.”
Read the employees' letter to Anita Westbrook and CYFD's report below:
I am a psych tech at Sequoyah Adolescent Treatment Center. I have been here for a few years and make between $9 and $12 an hour. The longer I have been here, the more likely I am to make less money. Newer people are being hired at a higher rate. Like most state employees, I haven’t had a raise in years.
I probably have children and I may or may not have someone to help raise them. I have to work a second job/collect food stamps/work extra shifts or even do all three to support my family. I have looked for other jobs, but it is hard to find a job. Besides, I like working at Sequoyah, or at least, I did. I have worked at other treatment centers or in corrections, and I would never work anywhere else. People have worked here for many years. Two psych techs actually retired and worked their entire careers at Sequoyah. Let me tell you why.
Before July 2012, Sequoyah was an amazing place. It was not perfect, and there had been changes with a new director, but overall it was still running really well. I work with some of the most difficult kids in New Mexico. I have worked with rapists, murders, and kids who had really hurt people. I am not afraid of them. They are human, just like me. Most of these kids have been horribly abused or neglected, which does not excuse their violent behavior, but it does help explain it. I know that if I treat them with dignity and respect, most times I get the same in return. And I feel like what I do is important and has meaning. I could tell you stories about kids that everyone else had given up on, and after they came to Sequoyah, they ended up doing ok. Not every kid does good after they leave, but there are enough to make it clear that what I do matters.
These residents act out. There are probably at least two or three restraints a week- sometimes more, sometimes less. There are countless times that I and the other staff worked through a situation and did not have to do a restraint. I hate doing restraints. I don’t know anyone who likes them. At Sequoyah, if there are people who “like” restraining kids or use restraints when they don’t need to, they do not last. It is not ok for any of us to use a restraint except as a last resort for safety and we all know that.
Like I said, I am not afraid of the kids. I am not stupid- I know every day that I come to work, I could get hurt. Staff get hurt, but it is usually minor, and we just know it is part of the job. It is a risk we take. I am not friends with everyone I work with, and I don’t even like some of them, but I did know they had my back. If I called on the radio for help, there would be someone there to help me very fast. Sequoyah has the best staff ratio I have ever heard of- we have at least 1 staff for every 3 kids. The state requires only 6:1. The managers work very hard to make sure every shift is staffed not only with enough people, but a balance between males and females and staff who have been here a while working with newer staff. Who is working is as important as how many staff there are.
I have been trained, and trained, and retrained on how to work with the boys. I know how to de-escalate them, and I know how to handle it if de-escalation fails. I was sure that if I was burnt out or being targeted by the resident, I had team mates who would take over. I didn’t have to say to restrain a kid by myself because we always worked as a team. And there was always a milieu supervisor on duty to deal with the really hard situations. Also, I knew that I could call my manager or the milieu director at any time, night or day, if I needed help.
Starting in July, things started falling apart here. The rules changed, but no one really told us. I had to do restraints that I did not think were necessary because some new doctor told me to. I had to watch a kid beat himself bloody and was not allowed to stop him because some other new doctor told me I could not. I asked my supervisors, and they asked their supervisors, and the only answer I got was “Do what the doctor says”. I started hearing that people were getting in trouble and worrying about their jobs.
I signed the petition because I believed what it said. I hoped that Anita would think about what was going on if she knew that so many of us saw the same problems. I have been worried ever since I signed it. I have seen people walked out of the building and they haven’t come back. I have heard that at least one person is being fired. My supervisors are scared and confused, and we no longer know what to do when problems come up. One day we are trusted to say if a resident is dangerous, and the next day we are told that we are not qualified to say that. We were told we have to call a nurse to decide, but it takes a long time for a nurse to come, and I am scared about what might happen while we are waiting. The nurses are so busy with their own stuff to do, it isn’t fair that they have to come do what has always been our job to do.
I heard that some of the managers got in trouble for not restraining a kid one day, and then got in trouble the next day because they did a restraint. Staff who do restrain kids are called into a meeting and have to explain what happened to the doctor and to the director. No one wants to be the one to restrain a kid because they don’t want to get in trouble. The responses to back-up calls take longer and less people respond because they don’t want to be in a restraint. I haven’t seen it yet, but I fear for the day we let a kid get hurt because everyone was afraid to do a restraint. It is a mess. I no longer feel safe when I come to work. It feels like at any moment everything could get out of control. Also, there are just not enough staff. Many of us are working overtime, but there are lots of shifts that are not staffed as carefully as before, and I just don’t feel like I have enough people around me to back me up.
And now they have taken away our spit nets. We are not told if residents have a disease such as AIDS or Hepatitis. We are taught universal precautions, and to treat everyone like they have a disease. Many of the kids spit and bite. Spit net are used to help us make sure we don’t get a disease. We have a policy that says when to use them, and we only use them when we have to. I feel even more scared now. If I have an exposure, I will have to spend my own time going to an urgent care or ER (staff don’t get paid for their time when they go to the doctor for a work related injury), I will have to get my blood drawn twice (once now and once in 6 months), and I will be worried the whole time that I may have gotten a disease and that I might expose my children. Why did this happen? Is administration punishing us or trying to run us off?
No staff appreciation day, no matter how well planned or what they feed us, can make up for what they have done to the morale of the staff. Someone once said we are “one big dysfunctional family”. We are not a family anymore. We are not even a team. Sequoyah is falling apart. I wish someone would see that, and help us, so that we can help the kids. Thank you for all you are doing and keep fighting for us and the kids.
God Bless,
-One of the Many Dedicated Psych Techs at Sequoyah
Something is rotten at Sequoyah and it's name is Babak Mirin!
He's turned Sequoyah upside down to satisfy his agenda which has little to do with child psychiatry. He has been threatening and demeaning to staff and has split us as a team. People are hired without due process, and others are demoted without cause. It's a new policy every week based on his inexperience with the population and those policies are not in writing. When Mirin came in, our psychiatrist with over 35 years of experience of child and adolescents was walked out the door without cause. The executive director has given Mirin carte blanche to do whatever he wants without accountablity. The most annoying thing is that whatever goes wrong is blamed on the milieu staff that work harder than he does. It's a very sad situation.
I left SATC in May of 2011 after five full and happy years. The writing was on the walls of what was to come. Our administration was no longer for staff--but aganist us. Anita wanted "more write-ups" and "proof" that staff were doing their job. As a supervisor, I was asked to give at least two write ups a year. This idea (from Anita's mouth) was to "keep it fresh in staff's mind, they are replaceable and can be written up at any time." I quit soon after I was asked to do this. The children were no longer first. It was making sure restraints were down, at any and all costs. It is a horrific situation. SATC used to be fun, caring and a place I thought I would retire from. This is no longer the case, which is truly sad...