Monday, September 10, 2007

Grim statistic on Post Traumatic Stress among TYC complainants

From the "transparency" section of TYC's report to the Legislature last month, we learn that initially 320 incarcerated youth who called the agency's abuse hotline this spring requested counseling, and 300 of those received an assessment for Post-Traumatic Stress Disorder (PTSD).

Of those 300, an eye-popping 249 were diagnosed with PTSD, or 83%, though the report insists the trauma "may not have been related" to anything that happened at TYC. Despite that caveat, and accepting that a lot of TYC kids come from abusive backgrounds, that many PTSD diagnoses very well could be related to the youths' stay in TYC - that's a high ratio in anybody's book.

For a long time I believed PTSD was something reserved for "shell-shocked" soldiers who lost friends on the battlefield or people who lived through horrible disasters. But in recent years I've had cause to learn from events in my personal life that, from a clinical diagnostic perspective, there are many kinds of traumas that trigger PTSD symptoms, especially physical abuse or unresolved psychic trauma during childhood.

Only 135 of the 300 continued to receive counseling, and those services ended, says the report, at the end of the summer. That's not good enough, and TYC and UTMB's healthcare folks need to step up with more and better counseling services for TYC youth. And I don't just mean prescribing drugs or telepsychiatry.

Without a lot of one on one help, certainly more than a couple of months' worth of episodic sessions, there's a good chance that whatever caused these kids' PTSD, whether while they were in the state's custody or not, will haunt them into adulthood, affecting their life and behavior negatively for years to come.

The report seems to treat the incident from this spring as a one time crisis to manage, not a problem that merits long-term change in how kids are treated, certainly not regarding their behavioral health. Despite the high percentage of complainants diagnosed, no plan was mentioned in the report to assess the rest of TYC's population for PTSD, nor to provide additional future counseling.

Before they shut down the counseling program, I think they need to see how many kids besides just the complainants need similar treatment, and re-assess the initial 300 to see if they could still benefit from additional mental health services. If so, we owe it to them.


Anonymous said...

Scott it might interest you I entered counseling after leaving TYC and the diagnosis was also PTSD related to my employment at TYC. TYC is such a toxic place to work! The way I view life will never be the same after my experiences at TYC. The agency is in total chaos which means it can only be a worse place to work than only a few months ago. A human being cannot be treated as they do at TYC and not be damaged. TYC is a very bad place to work and now you know why people left Hamilton to work at the hog farm. The hogs were much nicer to be around than TYC administration. The hogs even smelled better!

I think TYC was a bad place for staff and children to be. Maybe the place should be closed.

I wonder if there are other TYC employees who have been diagnosed with PTSD. Maybe we can form a support group to help each other.

Anonymous said...

Every kid receives a DSM diagnosis when they come in, so it should be pretty easy to see how many recently diagnosed with PTSD had that diagnosis at intake.

Anonymous said...

83% seems awfully high. While the majority of TYC youth have had traumatic experiences, I really doubt that many kids meet the full criteria for PTSD. That said, of course TYC youth need more treatment. It all comes down to money (once again). It costs to bring trained mental health professionals in. The psychologists that do work there now can't keep up. They are too few and TYC can't keep them because they don't offer competitive salaries. If we can't get our returning troops the mental health care they clearly need, why would we think Texans would be willing to cough up the money to treat those who most perceive as little criminals who deserve to be locked up?

Gritsforbreakfast said...

83% was only the percentage of TYC kids who a) complained to the hotline this spring, and b) received at least one counseling visit as a result. That's not the figure for every kid in TYC.

Apparently, though, somewhere that figure is available for all TYC students from the original DSM diagnosis upon intake.

Gritsforbreakfast said...

Oh, btw, this is a good question: "If we can't get our returning troops the mental health care they clearly need, why would we think Texans would be willing to cough up the money to treat those who most perceive as little criminals who deserve to be locked up?"

I think the only reasonable answer is "To prevent crime." Often, though, it doesn't really seem like that's the goal when you look at the state's priorities.

Anonymous said...

State Auditors Report: re-do it and lets see if things got better. The pols don't want to for fearing the results, and that's the bottom line. It would spank SB103 as the ass-failure it is.

November comes and November goes, but this time, let's make a show. Register To Vote.

Anonymous said...

What 3:18 says won't make sense to anyone who hasn't worked at TYC.
Many think they know but they really don't know.

The facilities have actually deteriorated since the investigation.

Watch out, because something is about to happen. I don't know what facility will be involved but there is fantasy and chaos at all of them.

Its just a matter of time.


Anonymous said...

I think we need conseveratorship - but with the right people. This has become such a "take care of your friend" network that it's divided the existing employees with that rag-a-tag bunch. I'm just amazed at how inept or rather non-caring our ledge did to TYC. It's sounds like you got picked off guys (whit, chuey, madden).

Anonymous said...

The rank and file at TYC are not without fault.

For one thing they are a bunch of lily livered cowards it that they won't speak up.

Yes, I mean teachers and JCO's

Anonymous said...

10:01 I guess that's why you're on here as Anonymous, too.

Anonymous said...

As an associate psychologist with TYC, I was consistently frustrated because I had youths in my office who fully met the criteria for PTSD but that diagnosis from the Marlin Orientation and Assessment Unit never showed up in their charts.

Statistics from other states indicate one should expect about 65% of the youths in juvenile lock-up to meet the criteria for PTSD. I randomly selected 50 charts to see if any of the youths had been diagnosed with PTSD. According to the research, I should have found about 32 youths with PTSD. I found NOT ONE.

Many of the criteria for PTSD match the criteria for Conduct Disorder. Apparently a decision was made somewhere up the food chain to dismiss the PTSD symptoms and rely on Conduct Disorder -- possibly because this provides evidence that TYC is dealing with "the worst of the worse."

There is absolutely no will to provide treatment for this issue and I believe this is because the treatment protocol for PTSD is challenging and exhausting for the psychologist.

That said, however, a lock-down setting could be viewed as the perfect opportunity to provide treatment for PTSD. The youths cannot go anywhere, which guarantees they will attend each scheduled session even if they're in Security. In outpatient treatment, youths often don't come regularly which makes it nearly impossible to meet treatment plan goals.

Furthermore, it is interesting that when counselors outside the agency were asked to come into TYC and assess the youth, they did not find the same diagnoses TYC psychologists at Marlin found. Some say that is because those psychologists were naive and inexperienced with this kind of youth. After having an opportunity to chat with several of them, however, I found they had much experience working with traumatized children in the foster care system and were actually better prepared to see PTSD AND Conduct Disorder than many of TYC's best psychologists and psychiatrists.

Sorry for such a long post, but this was one of the principal issues that led to my resignation from TYC at John Shero. I saw children who were in pain stuck in a system that provided no opportunity to relieve that pain -- even though I had the training, skills and desire to do so.

TYC is the saddest experience of my career and while I am thankful to have escaped such a toxic environment, my heart breaks for the children who've been failed by the entire system.

Many of these children have been reaching out for help the best way they know how for most of their lives. That help has been elusive and unavailable for most.

Anonymous said...

Yes, those of us who resigned from John Shero all agree that our last years there were highly toxic.

I agree with my former coworker that many diagnoses were discounted for appearances sake. In the education end of TYC we had nearly 60% of our student body receiving Special Services, and of those 60% were E.D., This article and My coworker's post make me wonder how many more "slipped through the cracks" in the highly bureaucratic TYC system.

Cowboy said...

If you think the youth have it bad try working there! You have two choices you can kiss butt or you better learn how to brown nose fast.

Ron, yes we know you are single but get a life you do not have to work there weekends w/o pay or compensation. What happened to you that makes you not being able to look at people when they talk to you? You don't actually believe Robin M. is going to take care of you do you?

Sylvia, you're not going anywhere after 29 years there so you can stop kissing butt. Your sister, Cynthia E and Loretta S thank you for your hard work but did they really take care of you? HELL NO. You can continue making cakes for them the rest of your life and you can tell everyone you do it because you like to WE ALL KNOW the real story.

I too would say - TYC is such a toxic place to work! The way I view life will never be the same after my experiences at TYC. I was there for 3 years and that was more than enough. I finally listened to my doctor who told me to leave asap. I needed the experience but it was not work the hell I was put through.

Anonymous said...

Mental health treatment diagnoses are allowed to be highly flexible and fluid while the youth receives treatment in TYC. The agreement of diagnoses between mental health professionals has always been remarkably low in any setting.

In other words, If a psychologist finds a youth who they thinks primary mental health diagnosis was misdiagnosed, and not treating this misdiagnosed disorder is influencing the youths ability to progress in TYC, then the psychologist could have easily changed the priority for treatment and provided services or advocate to provide services for these youth.

Also, the majority of youth who meet criteria for PTSD are also likely to have another comorbid major mental health diagnosis which may be percieved as the primary diagnoses.

I am skeptical of the high number of youth who were found to meet criteria for PTSD, as found by outside counselors. These counselors were called in to provide treatment in the midst of allegations of abuse and neglect. Sounds like people were finding what they were looking for or some self-fulfilling diagnoses to me...

It is also important to remember that not all youth who have experienced abuse or trauma, just like not all soldiers who have experienced traumatic events, suffer from clinical levels of PTSD symptoms.

I am not saying the assessment process is perfect, and am I certainly not saying that mental health treatment resources in TYC are adequate.

Anonymous said...

Cowboy, what's your problem? Finance has always had a low turnover rate because of good morale and good leadership.

Anonymous said...

My son was in TYC. Two years after he got out, I took him to private counseling and the doctor told us he was so..... traumatized by the experience. The doctor told us he witnessed such violence as no child should ever have to witness. The doctor was shocked with what my son told him in confidence and it took him two years to be able to process any of it.

Anonymous said...

PTSD is a joking matter to the folks at Brownwood Texas' Talk Radio KXYL 96.9FM. What a shame and what an indictment of the "small town" condition !