Professional Documents
Culture Documents
Around the world, many populations and subsects encounter less than ideal health care
and treatment. These victims often become patients and are subjected to many injustices and
health disparities. The millions of children and adolescents who suffer from mental health in the
United States is tremendous and many times leads to hospitalization for treatment, and safely
from oneself as well as others. Often when children are admitted into an acute psychiatric
facility, it is because they struggle with managing their emotions or behaviors. Some hurt
themselves, others and destroy property, triggered by traumatic exposures such as neglect, sexual
mental and emotional abuse, death, loss of loved ones, and poverty. Adolescent exposure to
violence has been associated with symptoms of psychological trauma including depression,
anger, anxiety, dissociation, and posttraumatic stress “Anixt et. al, 2012). Anger has a rippling
effect on future behavioral concerns of fighting which puts the child at risk for repeated injury,
Sadly, the rate of children who have endured trauma is increasing. Children and
adolescents have a high rate of trauma exposure as evidenced by national estimates of 702,000
victims of child abuse and neglect in and of one in 20 youth meeting criteria for a posttraumatic
stress disorder (Dopp, Hanson, Saunders, Dismuke, & Moreland (2017). Also, the annual
economic burden of childhood trauma in expenses pertaining to mental health care, lost
productivity, and participation in social services is over 120 billion. These findings are disturbing
because so many children are innocent victims of things beyond their control and furthermore
put these youth at risk for mistreatment. While being hospitalized in a psychiatric hospital, there
are times when one may require restraints, seclusions, medications or physical removal from the
environment. This becomes challenging for the staff and leaves much room for mistreatment and
patient abuse. Although these angered youth are culprits of many wrongdoings, they are likewise
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patients in need of psychological care and treatment. Seclusion was once considered therapeutic,
now it’s understood to cause profound distress (Isobel et al., 2013). Seclusion is utilized in so
many disciplines including simple ones as extended children time-outs to the greatly enforced
separate confinement systems used in the prison system. It is vital that caregivers and staff
members are trained and educated on the delicate of ensuring these mentally bruised children
The setting in which the children’s psychological health is cared for must be one that the
youngsters can restore, grow and learn to work through their distress. It needs to be positive and
constructive, yet beneficial. As Dobb et al., (2017), “because residential staff members are, in
essence, the youth’s immediate caregivers during residential treatment, the functioning of the
team as a surrogate family system can have a profound effect on the youth’s functioning. If a
team does not have a good system for communication among members or if team members do
not consistently uphold residence expectations, the milieu environment is distressed” (p. 95). The
challenges ahead include working with groups of children with a variety of diagnosis, triggers,
and other issues but protecting a balanced atmosphere gives individuals within their care a safe
place to express themselves and learn how to work through their hardships.
There have been many models aimed at helping reduce restraints and seclusion when
treating traumatized youth, but one of the most renowned and public interventions is Trauma-
Informed Care (TIC). According to Isobel et al., (2013), “TIC is a much broader and universally
applicable approach to care that requires a wide understanding of complex forms of trauma;
recognition of the prevalence of trauma; understanding how trauma impacts upon the life and
reduce iatrogenic harm” (p. 589). The importance of TIC training is paramount and teaches the
staff to be more understanding of their patients’ actions and responses, producing an effective
Presenting the complications and adversities of using restraints and involuntary seclusion
Isobel et al., (2013), “numerous federal, state, and local initiatives focus on building capacity to
deliver trauma-informed care (TIC) across many systems serving maltreated children. Most share
the assumptions that TIC involves awareness of the prevalence of trauma and its impact on
health and mental health; recognizes signs and symptoms of trauma in children, families, and
Representing the essence of TIC and its direct benefits of caring for children who have mental
illnesses is essential in succeeding and treating them. Other efforts noted were those regarding
substance abuse which often coexists with mental illnesses. “Since the early 1970’s, mental
health advocates have been working in conjunction with federal legislation to secure the passage
of mental health parity legislation (United States Department of Health and Human
Services [HHS])” (Mason, Gardner, Outlaw, & O’Grady, 2016, p. 225). Senators Paul Wellstone
and House Member Pete Domenici led the effort to achieve Mental Health. The issues with the
MHPA was that it did not include substance abuse which research shows that mental health and
substance often go hand and hand. “Researchers have determined that when only one of the co-
occurring disorders (mental health or substance abuse disorder) is treated, both disorders usually
get worse” (Mason et al., 2016, p. 225). The issue with the MHPA led to a more extensive bill;
The Wellstone and Domenici Mental Health Parity and Addiction Equity Act of
2008 (MHPAEPA), which included the substance abuse component of mental health. Such
policies exist, but with the rise in mental health concerns demands the need for more.
Kathy Cloutier, State Senator of Corrections & Public Safety, Health, Children, and
Social Services supported initiatives to help teenagers transitioning into adulthood who have
formerly been in the custody of the Department of Services for Children, Youth, and their
Families (DSCYF), ensuring they are provided mental and/ or behavioral health services. Per
“House Bill 40: An Act to Amend Title 13 of the Delaware Code Relating to Mental and
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Behavioral Health Transition Plans”, teenagers advancing into adulthood be afforded mental and
behavioral health services. Children in the custody of DSCYF have suffered trauma while in
their home setting leading to these same children seeking psychological help. As these children
continue to mature and become adults the problems seem to stay around and supporting
them will help their mental security. In addition to spiritual safety, this induces mentally-well
citizens of our everyday society, and the aftermath of that poses massive effects.
There are several stakeholders who all share the common interest of supporting mental
health and those who suffer from them, all recognizing the need for proper treatment, care, and
affiliates in every state and offices in more than 1,000 local communities in the United States.
They pride their selves in going to extremes to ensure all people affected by mental illness
receive the services they need and warrant in a timely fashion “With their more than 320
wellness for the health and well-being of the nation in the time of crisis” (National Center on
Domestic Violence, Trauma & Mental Health, 2017). Their message is one that believes good
mental health is fundamental to the health and well-being of every person of the nation. MHA
wants all people to recognize how to protect and improve mental health. Stakeholders are
A plan for action is needed to combat the increasing problematic flaws of treatment in
psychiatric facilities. There is a specific and organized way a Bill is introduced and passed.
“Only members of the US Congress (or a state legislator) can introduce bills (Mason et al.,
2016). According to Mason et al., (2016) once a bill is presented to Congress there is a two-year
deadline to get the bill passed into law, or it will default. Members of Congress put
As I am initiating a plan to action, I plan to first conduct a study over time on the effects of
restraint and solitary confinement of pediatric mental health patients. With this study, I will be
able to show a trend in physical, mental, and emotional changes after implementation of such.
After conducting the research and analyzing, I will then reach out to State Representative
Cloutier and propose a need for action regarding the use of restraints in psychiatric facilities, the
detrimental effects of solitude, and the need for state-mandated TIC training for caretakers at
these facilities. I plan to gather the support of the local chapter of one or both stakeholders
mentioned above and campaign for change. In this process, I hope to show a vivid picture of how
negatively restraints and solitude effects the mind which is essential in treating patients who are
already inflicted with a mental disease. Ultimately, I have goals of making children who are
facilities more promising and conducive to healing. Over the next 90 days, I will reach out to
Meadowood and Rockford Psychiatric and initiate the proceeding to conduct the study. I also
plan to research training programs to suggest as models to present to Senator Cloutier. The
process of getting laws and policies in effect is a long one that requires diligence and
determination.
environment integrated with trained mental health professionals will help rehabilitate children
who need hospitalization due to mental illnesses. Guidelines on restraints and seclusions about
these children should be authorized and revised before they become victims of farther injury,
References
Ainxt, J.S., Copeland-Linder, N., Haynie, D., & Cheng, T. L. (2012). Burden of Unmet
Dopp, A. R., Hanson, R.F., Saunders, B. E., Dismuke, C. E., & Moreland, A.D. (2017)
doe:10.1037/ser0000131.
Isobel, M. A., Brown, A., McCauley, K., Navalta, C. (2013). Trauma Systems Therapy
28(7). 29-139. doi:10.1007/s10896-013-9542-9
Mason, D. J., Gardner, D. B., Outlaw, F. H., O’Grady, E. T. (2016). Policy and Politics:
mental-health-organizations/