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After judge’s ruling, state school for boys must now take mental health care seriously

Children who enter the school are caught in a vicious cycle of violence perpetuated by the institutional shortcomings of a school that places very little emphasis on treating mental health disorders.

Originally posted to the Des Moines Register on April 6, 2020

Nathan Kirstein and Harry Frischer, Iowa View contributors

There was a good deal of press about U.S. District Judge Stephanie Rose’s ruling in C.P.X. v. Garcia, a case we brought against Iowa’s Boys State Training School in Eldora. Her order is a resounding victory for children, putting an end to the unspeakable mistreatment and abuse of young boys in that facility.

Much of the media buzz around the case has centered on the school’s use of the gruesome mechanical restraint called the “wrap,” which the court found to constitute “torture,” and rightly so. However, the root cause of mistreatment at the State Training School for Boys is much more systemic. Children who enter the school are caught in a vicious cycle of violence perpetuated by the institutional shortcomings of a school that places a dangerous amount of emphasis on physically punishing mentally ill youth and very little on treating their mental health disorders. We cannot forget that, most importantly, the Court ruled that the school fails to provide mentally ill youth with the mental health care they desperately need, and ordered state officials to fix the problem.

In too many cases, the staff chose to use physical punishment when mental health treatment could have addressed the problem in the first place, with horrific consequences. One boy diagnosed with multiple mental health disorders stabbed himself in the penis while in solitary confinement at the school. Photographs of his bloody underpants were introduced into evidence at trial.

The court said it best: “Failure to treat mental illness increases the risks of deterioration of mental health, self-harm or suicide, more restrictive (and thus more harmful) placements, and criminal or delinquent recidivism. These risks play themselves out at the School. Students who self-harm, do so repeatedly.”

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According to Rose, despite the number of State Training School mental health staff members, the school’s mental health program is woefully inadequate. With the court’s order, the school has the chance to take mental health care seriously and truly rehabilitate the boys in its care rather than exacerbating the mental health conditions that young people often exhibit when they first enter a juvenile justice facility. Staff must be more integrated in providing care in order to make a real impact on their patient’s mental health outcomes.

As we wrote in these pages in 2018, humane treatment is the key to transforming a broken system, keeping staff safe, and changing outcomes for kids. Research tells us that a lack of proper treatment — and especially abusive treatment — exacerbates existing trauma and causes young people to lash out. A more compassionate approach — centered on addressing the roots of violent behavior and meeting each child’s real needs through mental health intervention — can lead to healing.

The court’s order will make the school substantially safer, and help mentally ill students avoid the type of behavior that brought them to the school in the first place.