Special Report: Juvenile Detention Center
Registered nurses Beth Johnson and Joanne Alvarado’s paths never crossed when they worked at the Adair Youth Development Center. They met for the first time last month when they sat down with two members of the press to share their concerns about what they consider systemic abuse and mistreatment of juveniles in the local detention center.
They were joined by Registered Nurse Nina Burton, whose time at the facility overlapped both Johnson and Alvarado. She resigned her position as facility nurse supervisor after three years on staff. Her employment ended in October, a month prior to the Nov. 11 riot that left one staff member critically injured and the reported rape of a female juvenile.
Alvarado worked at the facility for a year, starting in September 2018. She returned in 2022 after being told “things were so much better it’s like a breath of fresh air,” but left again last August after only two months – three months prior to the riot – when she did not see significant improvements.
Johnson worked there through a hiring agency from November 2020 until March 2021, then returned that November until January 2022. All three women say they left their jobs because they were unable to resolve what they considered mistreatment of juveniles and the inability to do their jobs responsibly.
Since the riot, the women shared their stories with the Community Voice and WAVE 3 in Louisville. Before that, however, they tried reaching out to anyone who would listen within the Department of Juvenile Justice. Now, they are providing documents to the Community Voice that reflect some of the attempts that were made to address specific troubles at the facility.
They reviewed documents and redacted any information that would identify a specific juvenile. A number of documents reflect communications between medical staff, facility superintendent Tonya Burton, and DJJ medical director James Van Buren this past summer concerning a female who was housed at the Adair facility but was reportedly not charged with a crime. She apparently suffered from mental health issues and Nurse Burton and other health care professionals advocated for her care as her health continued to deteriorate.
The Voice reached out to Tonya Burton, Van Buren, the governor’s office and a spokesperson for DJJ. Morgan Hall, communications director for the Justice and Public Safety Cabinet, provided an official response for all parties and that response is included in the front page article: Beshear expected to take more steps for changes at youth development centers.https://adairvoice.com/beshear-expected-to-take-more-steps-for-changes-at-youth-detention-centers/
Emails Reflect Indecision, Lack of Protocol
Documents reflect a growing practice of housing juveniles who have mental health issues in a detention center instead of a psychiatric facility. These juveniles tend to be have no family members to advocate for them.
In one email, a psychiatrist points out that detention centers are now getting more youth with significant psychosis. He notes that child psychiatric hospitals more often than not refuse to accept youth who have any history of violent behavior. He is recommending a protocol for staff to be able to provide treatment for youth with significant psychotic disorders.
In the specific case discussed in documents provided to the Voice, weeks of email conversations reflect a lack of protocol or experience with dealing with major mental health cases. As the juvenile deteriorated mentally, administration was slow to take action and often considered her lack of interaction as failure to comply. At one point it’s documented she went 11 days without leaving her cell or taking a shower – reasons given include that she would not wear clothes and there was not adequate female staff to remove her from the cell.
According to a report by a psychiatrist, the female would stand and stare out of her cell for hours at night. Documents report odor problems as she urinated and defecated all over the cell, which was not cleaned because the cell remained closed at all times.
‘…the most terrible state I have ever seen…’
While documents reflect discussions about her mental health taking place for more than a six-week period, even into just a week into the documentation, a health service administrator reported that, “This is the most terrible state I have ever seen any of the youth be in. There are no words to really describe what I witnessed today.”
After nurses advocated for the juvenile, from email conversations it appears some measures were taken. At the same time, however, Nurse Burton reported the juvenile was in isolation to the point that even the “flap” on the door was supposed to remain closed at all times. During a one-month period, the youth’s cell was only opened twice, Burton said, which exacerbated her mental health issues.
At one point, the female was transported to a medical facility and received treatment then returned to the detention center. Superintendent Burton wrote in an email that the youth would be allowed to keep her door open as long as the facility had the needed staff, unless the youth was naked or showed aggression. Three minutes later, she reported that the door would be closed that night because of lack of staff.
From that point, nursing staff report further mental deterioration, and a nurse practitioner wrote, “She improved when she received mental health treatment just to be placed back in the same situation…If the child was with parents and found in this condition she would be removed from their custody and the parents would be jailed!!!!”
CABINET OFFICIALS RESPOND:
Nurses Report Backlash, Hostility
The case obviously caused a rift between staff. All three nurses said at different times during their work at the youth center they experienced backlash and hostility from other employees.
At one point, a psychiatrist, who was a consultant to DJJ, wrote that if he treated a fellow employee the same way for “trying to follow directives of a supervisor, I would be reported to my supervisor, an incident report would be filed and I would face disciplinary action. My question is are we considering asking the commissioner to step in an assist with this situation.”
Van Buren responded that they were making a positive impact. He said the juvenile was medically stable and UK had no grounds to keep her. He states that she is there because a psychiatric hospital was unable/unwilling to take her and the detention center was the only place she could be.
In addition, Van Buren wrote: “We have to also remember that just because we don’t see people in action, doesn’t mean they aren’t trying. I know that Commissioner Reed has been trying all angles for these kids. (Juvenile’s redacted name) unfortunately isn’t the only youth of this type of situation and she is trying all avenues possible to get them help. We are just very limited in what we are able to do.”
Alleged Assault by Youth Workers
A document also reflects an investigation into the alleged assault by two youth workers toward a juvenile, and the nurses confirm the case involves the same juvenile. Two youth workers were put on leave following the incident but at least one of them returned to work, according to Nurse Burton.
Alvarado reports in a document that she had tried to file a complaint about the incident but the case was closed without anyone attempting to interview her. She started reporting the incident internally to her superiors, but later reached out to the Internal Investigations Branch. It wasn’t until she contacted Sen. Max Wise’s office that someone from IIB visited the facility and reviewed the video footage of the incident and ultimately contacted Kentucky State Police.
One email from a nurse practitioner voices concern about finding the female in a locked cell almost two weeks after it was determined her door could remain open. After learning that Nurse Burton and Alvarado were resigning, the nurse practitioner complimented them for giving her “adequate information based on their top notch assessment skills.”
“I hope things change soon,” she added. “It will be hard to find a nurse to come into this setting and witness the things that go on here.”
The nurses said it didn’t change, and they left. They say the female juvenile was in the facility for at least three months. They are not aware of her current situation.
Times Have Changed
The nurses will not argue with Gov. Andy Beshear’s statement during a Nov. 17 press conference following the riot in Adair County that more juveniles are committing crimes and the population in juvenile facilities is different than it used to be. Adair County’s facility has recently received numerous juveniles from a former Jefferson County facility and staff report they are dealing with juveniles who face serious violent offenses. Johnson, Alvarado and Nurse Burton all say they liked the work they did at the juvenile facility, however.
“We all three loved the kids; we had problems because of the staff. The way some of the media wants to taint – it’s the kids, the kids are worse – yes, they probably are a little worse, but at the same time, it’s not the kids that caused us to quit,” Johnson said.
By Sharon Burton