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Government News
Photos of Shackled Youngster Prompt State to Ban Practice
Psychiatric News
Volume 41 Number 12 page 2-2

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 mental illness.

"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 Health.

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 bill.

"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 quick implementation.

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