A coronavirus outbreak has infected two foster youth and 13 staff so far at Star View Adolescent Health Center, a residential psychiatric and behavioral health treatment facility in Los Angeles County housing dozens of the county’s most vulnerable young people.
The Torrance-based facility — one of the few places available in the county to serve youth with severe mental health issues — is the latest institution to report a coronavirus outbreak.
Kent Dunlap, president and CEO of Star Behavioral Health Group, said that the two infected residents are currently experiencing mild symptoms. Neither the youth nor any infected staff members have required hospitalization. The outbreak started on April 3, Dunlap said, and the two teenagers, 18 and 16 years old, are being isolated in rooms separate from the rest of the youth.
High-needs youth in behavioral health facilities are a particularly challenging population for staff to care for amid the pandemic sweeping every sector of society.
It’s even harder being a foster youth in a restrictive group facility right now, said Jose Canizal, 24, an organizer with the National Foster Youth Institute.
“I wonder what these youth are feeling right now, cut off from family,” Canizal said. As a former foster youth placed in many different types of group homes and treatment facilities growing up, Canizal said his heart goes out to the young people inside Star View. “When you’re in an institution like that, it’s a hard, lonely feeling, like you’re not a human being, just a statistic.” Contracting COVID-19 just adds to the sense of isolation.
During his childhood, growing up in and out of institutions, “I always had some kind of hope that I held on to so I wouldn’t go crazy,” Canizal said. “But that’s probably hard right now.”
Even though the number of people infected at Star View is relatively small, L.A. County officials suggest that is a reason for concern as the virus continues its deadly spread. On Friday, the L.A. County Department of Public Health director, Barbara Ferrer, announced that the number of deaths from the coronavirus now stands at 495, about half of all state mortalities.
A huge chunk of those deaths — 36 percent — track back to people living and working in institutions. Ferrer said the county has launched investigations into 228 institutions with at least one confirmed case of coronavirus, including nursing homes, assisted living facilities, shelters, supportive living facilities, treatment centers and correctional facilities.
“We are extraordinarily worried about the outbreaks that continue to happen across the many different institutional settings,” Ferrer said at Friday’s news conference.
A number of safety measures to prevent further transmission of the highly contagious virus are in place at Star View, according to Dunlap. Staff are wearing surgical masks at all times and are screened for fever and other symptoms before entering the facility for each shift, Dunlap said.
Dunlap said nurses, youth counselors and primary therapists are among the infected staff members now isolating at home.
None of the residents, regardless of possible exposure, are able to leave the locked facility. All outings and home visits have been canceled. In person family visitation has also been halted and is instead taking place via teleconferencing. Dunlap said they’re practicing social distancing within the facility “when we can,” given the needs of the population.
Located in Torrance, a midsize town south of Los Angeles, Star View Adolescent Center is one of only two secure residential facilities in California, also known as community treatment facilities. Originally designed as an alternative to out-of-state placements and the state’s psychiatric hospitals, the facility provides mental health treatment to children ages 12 to 18 who are deemed seriously emotionally disturbed.
At the locked facility, the staff is authorized to use restraints and seclusion, though state law mandates that such measures must be overseen by a psychiatrist and a registered nurse. Youth stay at Star View for long stretches, about nine months for many youth, Dunlap said.
Most children at Star View are involved with the child welfare and juvenile justice systems in California and have a history of abuse and trauma. The most common diagnoses include bipolar disorders, serious depression and post-traumatic stress disorder, along with substance misuse.
With the coronavirus claiming many victims with underlying health conditions, there is reason to believe foster children could be at special risk. A Pediatrics study found that half of all foster youth have special health care needs, such as asthma.
But youth at Star View are especially vulnerable. Most of them come from the child welfare and juvenile justice systems, with diagnoses like bipolar disorders, serious depression and post-traumatic stress disorder, along with significant substance abuse issues.
“A lot of the reason young people end up in facilities like that is that they are a risk to themselves,” said Wende Julien, CEO of L.A. County’s Court Appointed Special Advocates program. “That is a gigantic concern for their care right now: making sure they are safe from harming themselves. That’s our biggest concern for kids that are in level 14 and other lockdown facilities.”
Sharon Balmer Cartagena, directing attorney for the Children’s Rights Project for the pro-bono law firm Public Counsel, said in a facility like Star View, patients need tremendous support to manage the terror and uncertainty the global pandemic has caused among even the healthiest people. In populations with severe mental health challenges, the routine of social distancing could cause even greater challenges to their well-being.
“These are young people who may be very easily triggered, who may be much more reactive to being isolated or experiencing a favorite staff person who won’t come within six feet of them — they’re much more likely to experience that as rejection,” Balmer Cartagena said. It is critical, she said, “that they feel connected and understand why certain measures are being put into place — that they feel comforted.”