Say his name. Cornelius Fredericks.
Cornelius was 16 years old. He was described as “funny, happy and outgoing” by a friend, and his aunt and other family members loved him very much. He reportedly wanted to be a counselor when he grew up. We wish we could share his favorite subject in school, what he liked to do in his spare time, and his other hopes and dreams; but Cornelius’ life was cut short when he was killed as the result of a restraint performed by the adults who were supposed to help him and keep him safe.
In the wake of Cornelius’ death, Lakeside Academy, the facility in Michigan where Cornelius was a resident, was quickly shut down. Criminal charges were brought against three staff members involved in the restraint, and a civil lawsuit was filed. As a result of widespread state and national advocacy, Michigan Gov. Gretchen Whitmer (D) cut all ties with Lakeside Academy’s parent corporation, Sequel Youth and Family Services, and the state is implementing new restrictions on restraints in licensed residential programs.
Like everyone else who has learned about this young man’s life and tragic death, we are incensed at this unnecessary loss. But our collective outrage is not enough. A culture of abuse is absolutely unacceptable anywhere, but especially in what should be a therapeutic, healing place for children.
The murder of George Floyd sparked a national conversation and lit a fire under the movement to eradicate racial violence and inequity. It would be an absolute injustice to Cornelius if his death doesn’t also ignite a sustained national campaign to ensure that children and families are only served by professionals who can safely, compassionately and effectively meet their needs.
That means not only shutting down a single residential program, but also examining the principles and practices of every program across the country. Residential intervention, defined broadly as therapeutic residential care, comes in all shapes and sizes and serves children and families with a wide range of needs, from psychiatric treatment to recovery from trauma. Children are referred for help by school systems, child welfare systems, juvenile justice systems, mental health systems, and families themselves when home and community-based interventions are unsuccessful. The variety of purpose is, unfortunately, matched by a wide variety in quality.
High-quality residential interventions have the ability to change lives for the better and are a critical part of the continuum of behavioral health services. They have well-trained and supported staff who provide individualized, trauma-informed, youth-guided, family-driven care in environments that are safe, welcoming and encourage healthy relationships. Members of the Association of Children’s Residential Centers include only a fraction of the residential programs out there, but all of our members have ascribed to these principles and practices that reflect a commitment to quality. Innovations and best practices are recommended and endorsed by those who matter most: youth and families with lived experience in residential care.
Providers who are incompetent or prioritize profits over people cannot be tolerated and have no business caring for already vulnerable children. The most recent example is systemic, horrific conditions in Sequel-operated programs in Alabama. In addition to the problems at its Michigan location, problems at Sequel’s Alabama programs were revealed in a letter and accompanying report by the Alabama Disabilities Advocacy Program.
But Sequel is not the only for-profit, multi-state provider with concerning practices highlighted in recent news. Universal Health Services, which owns and manages nearly 200 psychiatric facilities, including multiple facilities for children, just agreed to a $122 million settlement with the Department of Justice to resolve numerous allegations of violation of the False Claims Act. Among the allegations were accusations of inadequate staffing, training and/or supervision of staff and improper use of physical and chemical restraints and seclusion.
This is not the time for handwringing or commissions that take several years to conclude what we already know. Residential interventions that are ineffective must radically reform; residential interventions that have a consistent track-record of abuse and dysfunction must close; and state systems should invest in, and learn from, programs with expertise and proven success. Restraint reduction and elimination is part of what every program should urgently strive for, and the conversation about quality can’t stop there.
Leaders in the field of children’s behavioral health and residential care have a responsibility to speak out loudly and clearly. This includes acknowledging our part in dysfunctional systems, rife with racial and cultural bias, and drawing lines of distinction so youth and families and communities know what clinical excellence looks like and what the expectations should be.
Cornelius wasn’t the first child to die from a restraint in a school or a residential program, but he should be the last.
Dana Dorn is president of the Association of Children’s Residential Centers Board of Directors and the director of a residential treatment program serving girls in Milwaukee. Kari Sisson is the executive director of the Association of Children’s Residential Centers.