A recently approved Vermont law will end the mandatory use of restraints on
residents transported by the state for mental health care.
The law addressed a previously little-known issue that burst onto the
state's agenda with the publication of photographs of an 11-year-old boy
transported for mental health care in leg irons and handcuffs.
Mental health advocates cited the photos of the young autistic boy—
taken by his father and published by newspapers across the state— with
spurring the state to change its policies on the transport of those with
"It raised all kinds of questions, including why we were transporting
children in a way that would induce trauma when there was no hard evidence
that these types of precautions were needed," said Larry Lewack,
executive director of NAMI-Vermont, about the events that unfolded when Shane
Brown was directed to treatment at the state's psychiatric hospital.
Approved by the Vermont legislature and signed by the governor, the measure
(H 306) bars state officials who oversee the transport of minors, adults, and
pregnant women for mandated care from using restraints unless individual
circumstances warrant their use.
In cases where they are used, senior state officials must describe in
writing why they are required for that patient.
Shane Brown was one of 45 children in mental health crises who were
shackled in police vehicles in 2005, according to the Vermont Association for
Mental Health. The association identified about 750 children in the custody of
the Department of Children and Families who also were restrained when
transported. An analysis by the association determined that more than half of
those youngsters had no history of violence or attempts to flee and were not
acting in a manner to justify the use of shackles.
"Our bill was never intended to ban the use of restraints but to
limit it and to make sure when it is used, it is clinically called for,"
said Ken Libertoff, executive director of the Vermont Association for Mental
Vermont Human Services Secretary Michael Smith condemned the routine use of
shackles on children and administratively changed the decades-old policy, but
mental health advocates pushed for the new law to ensure the policy could not
be administratively reinstated.
The state has already begun to use less-coercive transportation methods for
children through private transportation organizations when restraints are not
necessary to protect the patient or the public.
Since summer 2005, the state has already cut in half the use of restraints
in such cases, according to Libertoff.
The restraint practice stemmed from wide-spread use by sheriff's
departments throughout the state to provide "secure transport"
under contract with the state. The practice was common because the cost to
localities to transport children to involuntary treatment in this manner was
covered by the state.
Secure transport meant passengers were restrained by handcuffs and leg
irons and traveled in the backseat of a sheriff's vehicle.
Before enacting the legislation, advocates held discussions with
representatives of sheriff's departments to amend the policy, but the
representatives rejected such changes based on concerns for the safety of
their officers, according state Rep. Michael Fisher (D), who supported the
"Some discussions were held with the sheriff's offices to make sure
they knew the advantages of less-restrictive devices," Fisher said.
The bill followed a 2004 law that required the state to offer
less-restrictive transportation to mentally ill patients of all ages, but"
that law wasn't being followed," Fisher said.
The latest measure, which began as an effort to limit the use of shackles
on children and was later expanded to include adults and pregnant women, also
includes strict reporting deadlines to the legislature to ensure the law's