Physical restraint use on Allendale youths concerns experts

Physical restraint is considered the final option to resolve emotional and behavioral problems involving juveniles at Allendale Association in Lake Villa, officials there say.

Strictly forbidden is the more aggressive neck restraint authorities say caused the death of 16-year-old Shaquan Allen of Chicago in March at the residential treatment center.

However, a Daily Herald review of three years of police reports involving Allendale shows dozens of instances when children were physically restrained by staff members in what's termed "restrictive intervention."

Some resulted in injuries, including a teenage girl who suffered a severe arm or shoulder injury, and other youths receiving bruises or rug burns.

A report released in July by the University of Illinois at Chicago Department of Psychiatry showed restraint is "quite common" at Allendale - it was used several hundred times in 2015 and 2016. The report, commissioned by the state Department of Children and Family Services after Allen's death, said youths reported feeling threatened and unsafe.

It also states that the Allendale staff uses restraints despite frequently being able to de-escalate aggressive behavior through other means.

Allendale President Mary Shahbazian said physical restraint is intended as "a last resort when other de-escalation techniques have failed," and neck restraints are never an approved option. She said the treatment facility is a safe place for youths, and the only reason for physical restraint to be used is to maintain safety.

But experts said the use of restraints reflected in Lake Villa police reports and documented by UIC is cause for concern.

"The number of restraints seems shockingly high for one residential facility," said Alexandra Cox, an assistant professor of sociology at the State University of New York at New Paltz and an expert in child restraint. "It also comes at a time when there is a national conversation taking place to reduce the number of physical restraints on children in these facilities."

DCFS officials pointed to the UIC report and Allen's death as the reason the state stopped sending wards to Allendale for nearly six months. That restriction was lifted Thursday.

DCFS Director George H. Sheldon said while significant steps have been made at Allendale in the last six months, his department's involvement has not ended.

Police, UIC reports

According to its website, Allendale Association was founded in 1897 as a private, nonprofit social service agency for children and adolescents with moderate to profound emotional and behavioral disabilities.

Its cornerstone is the 148-bed residential treatment program on the 100-acre Lake Villa campus on Grand Avenue. It also has a 20-bed facility in Benet Lake, Wisconsin, and two community group homes in Waukegan.

Individual units serve 8 to 14 children or young adults grouped by age, diagnostic profile, and social and emotional functioning level. The programs serve people of both sexes ages 7 to 21.

Allendale is not a detention facility. Most youths have been placed there because of problems at home, not for criminal reasons, DCFS Deputy Chief Neil Skene said. DCFS currently has 56 youths in the Allendale program, including 35 at the Lake Villa campus.

"These are kids raised in rough homes or who have behavioral issues. They don't come in and instantly change and become perfect," he said, adding that "dust-up" issues with staff members have happened.

Reports show Lake Villa police have responded to 576 calls at Allendale from Jan 1, 2013, to Sept. 7, 2016. Those calls range from assisting another agency and rounding up runaways to the more serious batteries, arsons and sexual assaults.

The Daily Herald reviewed about 150 of the most serious reports. Thirty-four said Allendale clients were physically restrained by the staff, and some of them were injured.

One of the most serious cases involved a 15-year-old girl who suffered a broken arm or shoulder separation in July 2014.

According to the 15-page police report, the girl was walking in the hallway when she began to hit herself, prompting staff members to restrain her. Employees told police she lost her balance and they heard a loud pop from her arm, according to the report.

Staff members initially said the girl fell while trying to kick an employee, the report shows. However, a DCFS worker investigating the case expressed concern because "she was not getting consistent answers or reportage from Allendale," the report reads.

During a follow-up interview, the teen told police an employee bent her arm behind her back until it popped. She said she did not tell the whole story because she felt threatened by peers, as the employee was a favorite of the residents'.

The accusations were determined to be unfounded, and the case was closed. But the case was reopened in January 2015 after a DCFS review found the staff member was negligent in the restraint and protocols were not followed.

The staff member was never charged, but the case went to civil court. The file was ordered sealed by a Lake County judge because it involved a juvenile. Police reports show the employee continued to work at Allendale in 2016.

Other restraint-related injuries revealed in the reports included:

• A 12-year-old girl suffering a serious rug burn during a restraint April 6, when she was on the floor for 25 minutes.

• An 18-year-old woman suffering neck bruises in March 2013 because a scarf choked her while being restrained, the reports read.

• An 11-year-old boy had two teeth knocked out in 2013 when a teacher pushed his head into a desk after he refused to answer a math problem. The teacher was charged with aggravated battery, but because the report involved a juvenile, the teacher's name was redacted. The result of the criminal charges is unknown.

In most cases, staff members reported being attacked by clients before physical restraint was used. For example, a staff member told police she was slapped and her hair was pulled by the teen wearing the scarf before the teen was restrained.

The UIC report includes interviews with 24 students who said they felt threatened by staff members and had witnessed the use of chokeholds and other restraints.

The report claims restraint was used at Allendale 546 times during the first three quarters of fiscal year 2015. That number fell to 459 during the same period in 2016. While the 16 percent reduction from 2015 to 2016 represents a positive change, the UIC report said, a more comprehensive process is needed to achieve better results.

Allendale clients filed 118 complaints against staff members in 2015, most involving the use of restraints, the report states. Youths questioned by the UIC investigators said they were reluctant to sign complaints out of fear of retaliation, the report said.

However, Shahbazian said the numbers cited in the UIC report, without additional details, do not paint a clear picture.

She said a plan was initiated in May 2014 to reduce the use of restraints through staff debriefings. For example, the more than 500 instances of restraint use cited in the UIC report in 2015 represents fewer than three restraints per youth in the facility, she said.

In addition, she said the movement of clients between various levels of programs affects the interpretation of figures in the UIC report. Incoming youths tend to have more "restrictive interventions," but those in the program for longer are involved in fewer restraints, she said. "This can result in a feeling that restraints never reduce - when actually individual youth make progress, move on, and a new youth enters the program to begin treatment," Shahbazian said.

The restraint issue surfaced after the March 30 death of Shaquan Allen. Authorities said employee James Davis, then 37, of Round Lake used a chokehold on Allen. Officials said Davis and Justin Serak, then 27, of Grafton, Wisconsin, restrained Allen while trying to get him to his room after a behavioral issue. Serak grabbed Allen's legs and Davis his upper body, applying a chokehold, officials said.

Lake Villa police and rescue crews responded to Allendale at 9:58 p.m., and Allen was taken to Advocate Condell Medical Center in Libertyville. He was pronounced dead at 11:10 p.m. Officials later said 15 minutes passed between when Allen became unconscious and staff members called 911.

Davis and Serak initially told police Allen slipped on water, Lake County prosecutors have said.

Davis faces two counts of involuntary manslaughter and two counts of obstruction of justice for placing Allen in the chokehold and lying to police. He's being held in Lake County jail in lieu of $500,000 bail. Serak was charged with obstruction of justice, but he is free from jail after posting the required 10 percent of his $50,000 bail. Both have pleaded not guilty to the charges.

Lake Villa police denied a Daily Herald request for the police report on Allen's death because of the ongoing investigation and various court cases. Allen's family has filed a lawsuit against Allendale.

Corrective actions

In the wake of Allen's death and the release of the UIC report, officials say corrective actions have been put in place and there are ongoing discussions between Allendale, DCFS and Lake Villa police regarding the need for other improvements.

DCFS issued Allendale a corrective action plan based on UIC's findings. That plan called for, among other things, a comprehensive de-escalation policy with emphasis on reducing the use of physical restraint, refresher training for the staff, implementing a tracking system to monitor staffing levels, initiating youth and staff debriefings after restraints, including youths in their behavior management committee, and initiating a plan to install surveillance cameras.

Allendale officials said they completed staff training, revised debriefings with staff members and youths involved in restraints, and invited youths to participate in the behavior committee. They have also met with board members about a capital improvement campaign to install cameras in residences, classrooms and key outdoor areas at the Lake Villa campus. The estimated cost is about $600,000, officials said.

Lake Villa Police Chief Craig Somerville has also asked for installation of a fence around the facility to protect Allendale youths and nearby residents.

Somerville added there have been changes with the way criminal activity is documented at the facility, and monthly meetings between law enforcement officials and representatives from Allendale and DCFS have been productive.

DCFS' Sheldon agreed video surveillance is needed but said outdoor video cameras may be preferable to a fence. A fence could make Allendale clients feel they are incarcerated, he said. "All of us have to recognize these youth are not adjudicated by a court and placed in a locked-up facility," he said, adding officials want to ensure youths are protected.

Sheldon said the corrective actions taken by Allendale led to the state's decision last week to lift the hold on DCFS wards sent to the Lake Villa facility. The intake hold is still in place at two residential cottages, he said. "If people think this is the end of our involvement, it's not. We will continue ongoing monitoring to make sure nothing slips," Sheldon said.