The orderly, antiseptic atmosphere of the Henry Horner Children’s Center, one of the nation’s largest state-run youth asylums, is just a veneer. The history of the Northwest Side facility is soiled-and its future a subject of exasperated debate.
As the centerpiece of the fractured system designed to care for Illinois’ burgeoning population of mentally disabled children, the locked 120-bed facility was created to offer monthlong bursts of therapy to the state’s most disturbed and destitute children, including some awaiting trial for brutal crimes. Its mission is to treat these children quickly and then disperse them into therapeutic schools and outpatient programs.
Its six snowflake-shaped “cottages,” scattered on a rolling, 154-acre campus, were designed two decades ago as an antidote to the stark stone towers where state agencies had previously warehoused mentally disabled kids.
But today, coping with waves of staff cuts and a burgeoning population of violent children, Horner functions as little more than a mind-jarring holding pen where children live in chronic neglect and the threat of violence to patients and staff lurks like a low-level fever.
No one defends Horner, even those in charge of it. State officials have said they would like nothing more than to totally renovate Horner or shut it down and put the kids in smaller, more congenial facilities.
But there’s no money to do that. And with the rising cost of medical care and cutbacks in insurance coverage, more and more middle-class parents are turning to state facilities like it, experts say.
As bad as it is, parents struggle to get their kids in Horner because they simply have no other choice.
The seemingly placid campus is a testament to the challenges of handling a growing population of children who often defy even the most highly trained experts.
The “cottages,” for example, where two to four children are locked in rooms at night to sleep, have proved a convenient setting for sexual abuse and other torments, records and interviews show.
Kids awaiting trial for vicious crimes are herded together with passive children who are in state care only because their parents tapped out their medical insurance in paying for other psychiatric programs.
In February, Horner workers asked a gang member to negotiate a truce between fighting teenage patients who have gang ties.
Some youths are kept in Horner’s wards for months after they are ready for release because their case managers cannot find after-care programs for them in the overburdened state system.
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Others are discharged long before they are ready, in an apparent attempt to keep the population down.
Whatever their painful histories, children often leave Horner more battered and debilitated than when they came.
An attorney for the facility recently appeared in Juvenile Court trying to obtain the release of a 17-year-old boy named Demetrius, who has been charged with sexually molesting an 8-year-old girl. While in the juvenile detention center, Demetrius had confessed to setting 10 house fires and tried to kill himself by smashing an exit sign and eating the glass, court records show. He was then admitted to Horner.
Demetrius is “generally better than many of the other children” at Horner, the attorney argued, and some other arm of state government should provide for him. After public defenders fought the release attempt, the boy was moved to a Downstate psychiatric facility.
Seven years ago, a federal class-action lawsuit brought by the American Civil Liberties Union said the food at Horner was unsanitary, the rooms were infested with rats and insects, and children were provided no meaningful therapy.
That suit is still unresolved.
In October 1991, the Mental Health Association in Illinois, a watchdog group, conducted unannounced inspections and found blood and feces on the walls and furniture. Interviews with patients and staff suggested a “culture” of violence and sexual abuse. The association’s findings led to the firing of the facility’s superintendent and the resignation of the state’s Mental Health Department director.
Since then, the feces and blood have been scrubbed from the walls and floors. In August, the department purchased 32 framed prints from a Wisconsin art company, at a cost of $3,036, and $14,326 worth of brightly colored plastic stacking chairs.
The cinder-block walls were given fresh coats of glossy tan paint. In the adolescent girls’ unit, construction-paper tulips were taped in rows across the walls, forming a bright, fragile garden.
Social worker Susan Blumenfeld, who worked at Horner from August 1990 to August 1992, noticed the changes right away:
Before the media spotlight, “it would take 3 months to get a lightbulb changed. After, it was like Santa Claus came along with all this stuff to make it look better. All of a sudden, there were carpets in the day room and new pictures all over.”
But, she said, “I didn’t see much difference in the work being done there. I just saw a lot of administrative hemming and hawing and running around. No one seemed to put much emphasis on the kids. It just doesn’t seem like it’s ever going to change for them.”
Blumenfeld quit to take a job with a north suburban special education cooperative.
“I couldn’t work there anymore,” she said of Horner. “The majority of the people there are happy with the way things are because they are getting paid and they are being taken care of by the state and they want time to pass.”
At 7 p.m. on a Tuesday evening in September, facilities director Marva Arnold walked through the hallways of Horner’s dormitories. She had to introduce herself to the staff.
“Hi, I’m your director,” she said, offering her hand.
At the time, Arnold had been overseeing the facility for 4 months and had managed it as part of an interim team for 6 months before that.
In one activities room, a solitary boy lay face down on a couch with his head burrowed into the cushion. The lights were off, but the television blared.
An older woman sat just outside the doorway, craning her neck to watch the program. She had bleary eyes and gray hair that dripped around her face. She smiled benignly as the new director offered her hand.
The middle-aged women who greeted Arnold have perhaps the most demanding and exhausting jobs in the facility: After the psychologists and social workers leave at 5 p.m., they are in charge of some of the state’s most disturbed and violent children. They supervise the units, lead recreational activities and mete out impromptu therapy and discipline.
Even in the afternoons when trained specialists are available, the women are described by parents and state officials as the children’s primary caretakers. (During the day, the children attend the Durso School, 4201 N. Oak Park Ave., run by the Chicago Board of Education, although funding cuts are reducing its programs.)
The caretakers, called mental health technicians, need no formal education. They are paid $8.25 an hour.
Some have been doing this job more than 30 years, and a quarter of them for more than 20, department records show.
Arnold didn’t ask their names.
In one activities room, a technician sat at a table by herself, completing a puzzle, while children drifted in and out unattended.
“Hi, I’m your new director!” Arnold said cheerily.
The technician started to stand, her face suddenly flushed, then sat back down with a contrite smile.
The technicians come “with no child or adolescent experience,” said a 1991 Horner report written in part by Arnold. They “seem to lack knowledge of developmental issues of children and basic behavioral principles.”
“Staff morale is understandably low,” according to a January 1992 report. “They feel beleaguered, hopeless and helpless.”
A May 1992 report said that Illinois state psychiatric hospitals have among the worst staff-to-patient ratios in the country.
“Staff on many units report being afraid for their own safety and feel unable to prevent violence among patients,” the report said.
In another activities room, a group of boys hovered around a desk. On an oversized sketch pad, one of them drew a grimacing man who held a gun in one hand and flashed his middle finger with the other. In the margins were gang insignia.
Chronic neglect “is the overwhelming reality for patients,” said Ronald Davidson of the mental health association.
“A patient not having his needs met, his medications never being at the proper level because his physician sees him once a week and his psychologist once a month, that is daily life in Horner,” Davidson said.
As Arnold walked toward the outer door of another unit, a group of teenagers swarmed after her, crowding toward the glass and chattering excitedly.
They were not trying to run away, Arnold assured her guest, just trying to show that they can.
But, the director conceded, “if one decides to dart off, there’s not many of us fit enough to catch them.”
In an average week, four kids escape, records show.
Those who flee often do so after complaining they have been attacked or tormented by other juvenile patients or pressured by them to have sex, records show.
Some get out by jamming wads of toilet paper into doorlocks so the bolts won’t catch. Others puff cigarette smoke into the fire alarms, then scramble out the doors as they unlock electronically.
A boy and a girl slipped away from a limbo line during exercise class.
“The activity staff were told to be more aware as to how they structure the use of the area for an activity such as the limbo to minimize any potential confusion situations,” a department report on the incident noted.
But most of the kids simply outrun the elderly female mental health technicians.
They scramble across the grassy campus, past the squat, red brick dormitories, over the black iron fence at Irving Park Road and into the city streets.
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There were 124 runaway cases reported during a 6-month period in 1991, the most recent period for which complete records were available. In not one of those cases did department investigative reports attempt to shed any light on why the child ran or what he or she endured in the streets.
Instead, the capture was typically marked with a single sentence: “Child returned in good physical condition.”
About half the children stayed on the streets for a night and a day, and most of those were caught by police.
Some were gone for weeks.
During the same 6-month period, a total of only 5 children escaped from the state’s six other children’s psychiatric facilities.
“Many of the kids run because there is no safety there,” Davidson said. “They are being propositioned and pressured to have sex. They’re running a hospital that’s out of control, and as a result, kids are running.”
“It functions as a form of population control,” said ACLU attorney Ben Wolf.
Four children disappeared from Horner and were not found, and their cases were simply closed by “administrative discharge.”
Horner records portray children who are tremendously difficult to deal with: They explode in sudden rages, attack staff, and sometimes make up wild lies about the way they are treated.
But sometimes the children’s accounts of abuse by their peers or even staff are credible.
In July 1991, an 11-year-old boy named Robert said he was beaten by another patient while strapped to a bed in restraints. His was a typical case.
Robert, who has an IQ in the 40s, was put in restraints after disrupting his class at school. He had threatened to kill himself with a plastic knife, saying, “I’m different. But I don’t want to be different from other kids,” reports show.
As he became more agitated, his words grew incoherent, and he tried to pull apart a door. Facility staff strapped him to a cot with leather restraints and held him there for 7 hours.
The boy who allegedly came up and beat him, a 16-year-old named Alex, is described in department records as “highly aggressive towards vulnerable children.”
When an investigator asked what Alex had done to him, Robert mumbled two sentences, department reports show: “He go boom right in my chest. It hurt my heart.”
A third boy said he watched from the hallway as Alex went into the restraint room. The boy said he heard Robert yell for help and then a punching sound; then Alex ran out laughing.
Department policy says a staff member must remain with children at all times when they are in restraints. The technician who was supposed to monitor Robert said he left him alone, but only once-then the technician changed his story and said he left Robert alone twice, once to get some rubber gloves and once to get Robert a snack from the kitchen.
But the technician insisted that he locked the door both times. With that, department investigators concluded that the evidence “did not support” Robert’s complaint that he was abused by another patient or neglected by staff. The case was closed.
Records show that department investigators typically did not interview the children, staff or witnesses until weeks and sometimes months after the alleged incidents. By that time, those involved typically recalled only sketchy details of the events. Sometimes their accounts contradicted each other.
And so, with no concrete evidence to corroborate the patient’s account, the allegations were ruled unfounded in every case during the 6-month period examined by the Tribune.
Because much of the abuse at Horner happens at night behind the closed doors of children’s bedrooms or in unmonitored activities rooms, Davidson once had an architect draw a blueprint showing that by knocking down a few walls it was possible to create single-bed rooms for the children and have line-of-sight from the nurses stations to the activities rooms.
Davidson said he is optimistic that state officials will get money for the renovation.
But in general, state officials say they would like to close or downsize state-run asylums for children like Horner, calling them dangerously understaffed and inappropriate for many youths, and move the children to group homes and community-care centers.
But at a February state Senate hearing, parents and professionals protested the plan, saying they feared that the insititutions will be dismantled before any network of community agencies is in place.
“Where I come from, folks are scared,” said Makanda resident Rita Burke, who has a child at the Choate Mental Health and Developmental Center in Anna.
“We are not foolish people resisting the urgency and enlightenment of the future. We are cautious and concerned people who want to be assured that Choate and other facilities like it will be here tomorrow.”
A year ago, C.J. Dombrowski was appointed to head the Mental Health Department’s Office of the Inspector General. Dombrowski began work convinced that she would root out abuse and neglect of child psychiatric facility residents.
“If you imagine the most naive person in the world taking this job, that is me,” she said. “I actually believed that everybody wanted the same thing I wanted: that you could go in and say you did this and discipline someone for it. I believed that if an employee abused a recipient, they were history.
“But I’m finding that all is not that simple.”
Dombrowski got herself a beeper so that facility directors could alert her immediately when an abuse allegation was made.
But 6 months into the job, she conceded “I haven’t gotten any calls.”
On March 3, Dombrowski submitted a report to Gov. Jim Edgar in which she says that abuse and neglect of patients is widespread at the state’s mental health facilities and employees escaped punishment because of a “code of silence.”
Dombrowski also conceded that her inspectors took too long to investigate complaints and failed to gather enough evidence to substantiate complaints.
When she took the job of policing the state’s psychiatric institutions, Dombrowski’s friends told her that cleaning up the facilities would not be an easy job.
“I am a believer now,” she said. “I’m converted.”
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Next: The mainstreaming debate.