Scarred Children : State Hospital and County Help Victims of Emotional, Bureaucratic Breakdowns

Scars cover the inside of Jennifer’s arms. They were put there during numerous attempts at suicide, once with a knife and sometimes with shards of glass. When there was nothing else available, she used the tabs of soda cans to make the cuts.

The 16-year-old endured years of abuse before she was taken away from her parents by the courts. She landed first in a series of foster homes and then in a private hospital she calls the “torture chamber.”

Now she is one of the 164 children between 7 and 18 locked in the psychiatric wards at Camarillo State Hospital. She is certain no one loves her, and she might be right.

For children like Jennifer, this is the last stop on a line that most often begins with abuse at home and a deteriorating system of foster care and mental health programs throughout California.

Many of the children at Camarillo should never have ended up there, the psychiatrists say. Only about a fourth of them have the types of chronic mental illness that qualify adults for admission in a state mental hospital.

For the most part, the experts say, they are here because of behavioral disorders and problems of depression easily understood against the background of the sexual and physical abuse most of them have experienced.

And, bitter mental health officials say, many have been placed in Camarillo simply because there is no other convenient place for society to put them.

Jack Cheney, an art therapist at the state hospital, has seen dozens of cases like Jennifer’s. They are children and teen-agers with tales of horror.

What they cannot say, they express through their art and poetry. Sketches of monsters and broken bodies. Dark clouds and lonely sunsets. Cheney often shows visitors a clay sculpture of a bashed-in skull created by a 10-year-old neglected boy who burned down buildings to express his rage.

About 90% of the children in the psychiatric wards at Camarillo State Hospital have been physically and sexually abused. Some are so hard to handle and so disruptive that it is difficult to find a place for them anywhere else.

About a quarter of these children desperately need to be hospitalized and probably will spend most of their lives in institutions, officials say. But many of these youths could have made it in the community if they had received adequate care from local health deparments before their illnesses progressed, officials say.

For Cheney and other staff members at Camarillo, many of these children are a vivid example of how the local mental health systems break down in the face of crisis.

“You see a whole gamut of horror stories when you look at these kids’ charts,” Cheney said. “All of this is preventable, yet people don’t realize it. And it is something that comes back to haunt us.”

Some of these children could have made it if they had been lucky enough to be placed in the right foster home and given follow-up counseling, Cheney said. Some were abused by their foster parents as well as their own parents. Others never received the care they needed until they were “blue from drowning” in their despair, he said.

The children at Camarillo suffer from various psychological problems--extreme aggression, suicidal tendencies, depression--”but that does not mean they’re crazy,” said Henry V. Soper, a senior psychologist at the hospital.

Yet for the rest of their lives, these youngsters will carry the stigma of spending time in Camarillo, he said.

“Some have spent time in county hospitals, but it’s different when they get to Camarillo,” Soper said. “They are well aware of what it means. It’s an embarrassment. Some feel like they have CSH branded on their foreheads. They say: ‘Everyone thinks I’m crazy.’ ”

Soper estimates that 25% of the children would be in Camarillo regardless of their home environment because of chronic mental illnesses. Another 25% may have ended up there anyway, depending on their conditions. But the remainder, he estimates, would “never have seen the inside of a state hospital” if they had received early treatment.

Camarillo and Napa State Hospital are the only state facilities in California that take children. About 80% of the children in Camarillo are from Los Angeles County, although the hospital admits children from throughout the state.

These youths look like any other at the local schools. They wear tennis shoes, T-shirts and jeans. They like to listen to their Walk-mans and cut their hair in the latest styles. During the summers, staff members say they sometimes have a hard time telling the difference between the teen-agers and the college interns who volunteer in the clinics.

Some children have literally grown up in Camarillo State Hospital. Others spend only a few months there. Whether they get out largely depends on their behavior, and sometimes whether there is any place to put them in the community.

Aurora Hendricks, a psychologist, supervises a unit of 27 teen-age boys at the facility. Over the years, she has bolted all the pictures and bookcases to the walls. The glass vases have been locked away. Staff members have learned the hard way that angry children like to throw anything they can get their hands on, she said.

The backgrounds of the children and teen-agers vary. One boy who had been badly abused was caught chasing neighborhood children with a butcher knife. Another youngster tried to burn down his foster parents’ house. A couple of children killed the family pets.

Hendricks said she hides her paper clips because some teen-agers will use them to slice their wrists. Others youths have swallowed tops of pens, flashlight batteries and glass.

Although most of the children come from dysfunctional families, they often long to go home. Many work extra hard on their behavior so they can earn weekend passes to see their families. Hendricks says it always breaks her heart when the parents do not show up to get the youngsters.

“It’s so disappointing for the kids,” Hendricks said.

The staff at Camarillo says the treatment at the hospital is the best care available.

Recently, however, mental health officials throughout the state have been seeking ways to provide more county care for the youths.

Officials say it costs the state $128,341 a year to keep one youth at Camarillo State Hospital, money some believe could be saved in the long run if counties developed better programs. As a result, mental health officials say it is time to re-evaluate the local systems that send these children to the state institutions.

In 1987, the state allocated Ventura County Mental Health Services $1.5 million and a promise of $1.5 million more each year to beef up services for youngsters and develop a statewide model for children’s mental health services.

Ventura began by identifying mentally disturbed children who were separated or at risk of being separated from their family. The officials developed a special school to address the need of these youngsters and formed a crisis team to work closely with families, foster parents and distraught youngsters.

A special school staffed with psychologists was started for youths who had been thrown out of school because of behavioral problems.

Mario Hernandez, the chief of children and youth services, said the county approached children’s mental health services the way a life-insurance salesman approaches a client.

“We’ll be there any time of the day, any day of the week,” Hernandez said.

And the method has paid off for foster parents who were at their wits’ end because of a distraught child.

In many instances, the county provided foster parents with enough support to work with seemingly unbearable youngsters.

For example, one foster parent threatened to give up a young boy who had been badly abused by his natural parents. The boy was beating up other children in the family and tearing up the house.

Ventura County mental health officials immediately increased in-house sessions with the family. Slowly, they were able to work through the problems. “It’s so important to help the parents be co-therapist with us,” said Ventura County Psychologist Rene Beauchesne.

The boy has been with the family for two years. The key, Ventura officials say, is keeping children in stable home environments.

“The last thing we do is send a child to the state hospital,” said Randall Feltman, the director of Ventura County Mental Health.

When the county started the program, there were 16 Ventura County children in the Camarillo hospital. Now there are four.

Ventura County’s program has been so successful that counties throughout the state are using it as the model for their mental health care. Recently, San Mateo, San Francisco, Santa Cruz and Riverside counties began developing programs based on Ventura’s program.

But before the impact of these programs will be felt at Camarillo, Los Angeles County must also reform its system, something officials say they lack the money to do.

The county asked the Legislature for $1.5 million this year just to identify the children and teen-agers who could benefit under a program like Ventura’s, but the funding was denied. Officials estimate it would cost $20 million to start a similar program, although that money could be recouped in the long run by cutting the number of children at Camarillo.

Edward T. Ray, a senior psychologist and admissions coordinator for teen-agers at Camarillo State Hospital, shakes his head when he talks about Los Angeles County.

“I don’t understand their system,” he said.

Ray estimates that one in five children Los Angeles County asks the hospital to admit should be treated in local facilities.

In a few instances, Ray says he has admitted borderline youths because he was afraid they would go without care.

Recently, Ray said he accepted a 17-year-old boy who was in danger of being discharged from a county hospital because he is about to turn 18.

“The boy’s father said he would go to jail before he took him back,” Ray said. “I asked my boss to make a special exception.”

The youth will soon be placed in the adult unit at the hospital.

Los Angeles County mental health officials said their services for youths are taxed to the limit, especially after recent state budget cuts.

John Hatakeyama, deputy director of the Children Youth Services Bureau of the county’s Mental Health Department, said: “Whatever we’re doing, it is not enough.”

“It’s a disastrous situation,” he said. “I only laugh about it not to cry. We have virtually dismantled our mental health system.”

He said the county vaguely knows which children need help. About 17,000 are in the county system, and many of them are near the breaking point.

Luxuries such as working with abused children in foster homes are almost unheard of in the mental health system, he said. Prevention seems always to get left behind in the budget crunch, Hatakeyama said.

Chris Amenson, director of Pacific Clinics, which contracts to provide services for Los Angeles County, said the clinic can treat only a small portion of the people who seek help.

“We treat them when they are already blue from drowning,” said Amenson, who is also a consultant to the Alliance for the Mentally Ill in Los Angeles. “The bottom line is there is not enough to take care of the kids who have a chance of surviving.”

Some Camarillo officials fear that once the children are returned to their communities, they will get lost in the system again. Last year, two youngsters committed suicide after being released.

“What do the kids have to go back to?” one official asked. “They’re unwanted, unloved and the lives of their family have gone on without them.”

“There’s no safety net for these kids,” said Don Lomas, director of children and adolescents for Pacific Clinics. “They graduate from Camarillo, but they’re not ready to deal with the community. They don’t have the family resources and they get lost.”

Assemblywoman Cathie Wright (R-Simi Valley), who obtained the funding to start the Ventura children’s program, said she will try again next year to get money appropriated to assist Los Angeles County.

“It is important that the child and the family problems be treated as a whole in comfortable surroundings,” Wright said.

In the meantime, staff members at Camarillo say they will continue their work until officials come up with something better.

“Children, after all, are our most important resource,” Cheney said.