By Andrew Keltner
It was back in August 2012 that employees of the Sequoyah Treatment Center in Albuquerque, New Mexico, wrote then administrator Anita Westbrook a “memorandum of concern” citing grievances considered ”improper, if not unlawful acts” being carried out at the center.
It has taken nearly three years for New Mexico’s only psychiatric center dedicated to violent male adolescents to gain governmental attention. After a hearing from New Mexico’s interim committee on Behavioral Health Services last fall in which a presentation on Sequoyah Treatment Center was given, New Mexico Senator Jerry Ortiz y Pino (Democrat, District 12) began to look into the treatments center’s operations, which the staff had said in their 2012 letter had deteriorated with changes in patient mental status, mood, change in the de-escalation techniques used for patients, and administrative problems. Senator Ortiz y Pino created State Bill 43 and State Memorial 115 as a result of his findings.
The letter written by direct care staff expressed dissatisfaction with a variety of occurrences at the center, all accumulating after ”recent and dramatic changes.” These changes are partly attributed to the sudden departure of then director Dr. Henry Gardner and the series of directors that would replace him.
The medical care complaints include the JKM Safe Crisis Management system being replaced by PRN medications, including intramuscular injections, overuse of restraints – in one instance to medicate a boy, and over medication – according to Emily Bullerf who worked at Sequoyah as a Mental Health Tech from 2004 to 2015. The JKM Safe Crisis Management system explains itself as a ”trauma-sensitive approach with emphasis on building positive relationships with individuals” and is used throughout both the United States and the United Kingdom. PRN medication refers to medication given as the medication is needed, or in Latin Pro Re Nata, PRN. The PRN medications were used to calm the patients by order of new doctors, in lieu of de-escalation techniques that had been in place for twenty years. There were other changes as well, such as the release of un-rehabilitated individuals, increased violence, decrease in patient numbers (in part due to neglecting admittance of possible residents, and sending patients out of state, an incredibly expensive procedure), and speculation that some children were sent to juvenile centers.
Changes in directors also proved to be a source of problems for the center. After the departure of Henry Gardner, a series of interim directors were hired. These directors were seen as underqualified, some with “no psychiatry experience,” said former Sequoyah worker Emily Bullerf. Not only did the lack of experience of the interim directors lead to lack of communication and procedure in caring for the patients, but also led to hostile relations with staff and administration.
Senate Bill 43, written as an emergency measure, would by power of the Adolescent Treatment Hospital Act, work to transfer administrative power of the Sequoyah Treatment Center to the board of regents of the University of New Mexico.
”My SB 43 was intended to turn the operation over to the UNM Med School’s Department of Psychiatry on a contract; this turned out not to be a workable solution because the Psychiatry Department was unwilling to take it on,” said Jerry Ortiz Y Pino in an interview via e-mail. ”However, they expressed a willingness to work with the Department of Health (current operators of STC) to do a thorough evaluation of its operations and to offer to place psychiatry residents there to help bring it back to full productivity.”
Bill 43, introduced in mid-December 2014 and passed mid-February, found a new direction after the University of New Mexico was not able to fully work with STC and eventually became Senate Memorial 115. A Senate Memorial is not a force of law, as a Bill would be, but is a strong suggestion of interest by the senate. UNM would support SM 115 and provide the investigation of the ”therapeutic model, residential services, staffing levels and qualifications, and after-care services be undertaken by a task force under the direction of the chairman of the university of New Mexico school of medicine’s department of psychiatry and behavioral sciences or the chairman’s designee.” University of New Mexico Psychiatric and Behavioral Sciences chairman Mauricio Tohen has been unable to answer questions, because “unfortunately the evaluation has not begun.” Senate Memorial 115 received its final senate vote on March 21.
The evaluation by the university’s task force will be presented with recommendations to the interim legislative health and human services committee no later than November 1, 2015. The recommendations will focus on methods to improve the treatment of residents and the facility itself, repair the financial status, and prepare a statewide system of after-care for residents once they are dismissed from the center. The task force will also propose possible legislative measures to be taken, if found to be necessary.
Andrew Keltner wrote this story for the Journalism for Social Change massive online open course.