Starlight Adolescent Center

As the rumors of the community treatment center (CTF) closing became a reality, there have been two articles featured on the front page the San Jose Mercury News exposing some of the problems in Starlight.
http://www.mercurynews.com//ci_8874174?IADID=Search-www.mercurynews.com-www.mercurynews.com
http://www.mercurynews.com/ci_8909940?source=most_emailed
These articles highlight citations from MHAP (mental health advocacy project) including an incident when a staff member accidentally broke a client’s arm.

As a former employee of Starlight, I’d like to comment on the articles.

I worked at Starlight for a year in 2006-2007 as a mental health clinician and rehab therapist. My position at Starlight was my biggest challenge in my career to date, even after working in NYC’s inner city schools and with families struggling with a terminal illness.

While a lot of the information in these articles is true, I don’t believe the public understands just how acute most of the youth in Starlight are. They end up in Starlight after every placement option has been exhausted. This includes foster homes with intensive wraparound services, level 9, 11, 12 and 14 group homes that have increasing levels of staff supervision and structure. They all exhibit severe enough self-harm and/or aggressive behaviors that present a serious safety risk to themselves and others. Regularly the teens try to hang themselves, cut themselves, attack each other, attack staff and set fires. In addition, most everyday objects are contraband because these things are often used as a weapon or to cut on themselves including pens, CD’s, shampoo, jewelry, etc. I had to remember not to staple my papers together or use a paperclip because they are perfect devices for self-cutting. When I did beauty activities with the girls, I had to keep a strict count on every bottle of nail polish. One time, I accidentally left a hand-mirror on the unit and within five minutes, one of the girls smashed it and tried to use the shards to cut herself.

People are often naive to believe that if we are kind enough, respectful enough or tough enough, kids won’t show this type of behavior. While more skilled staff members were able to prevent an incident or de-escalate a client, the behaviors of the youth were difficult to control. It was always interesting to observe a new, more naïve staff member believe that they could “rescue” the kids. The youth usually picked up on the staff’s naiveté and would take advantage of him/her.

However, while the clients presented tremendous challenges, myself and other staff members were able to form strong therapeutic alliances with them. We enjoyed working with them, playing games with them, sharing stories and watching them grow. Despite their extreme behaviors, we had strong empathy for these kids who were suffering from a severe mental illness and/or endured severe trauma. Many of them did make progress and it was fulfilling to see. Also, in my role as a Mental Health Clinician, I had the privilege to work with and get to know many of the parents and families of the youth. (See my previous blog entry “The Day the Voices Stopped” for one example)

Unfortunately, the system beat my coworkers and me down. While we were working with one of the most difficult populations, we were also expected to do the job of 3 people. We were bombarded with mounds of paperwork, treatment team meetings, case management, crisis interventions and responsibility for 3 full days of therapy groups. Even with very good time-management skills, it was unusual to work less than 55 hours. (Keep in mind this is 55 hours of high intensity, not a corporate setting)
Often we were scheduled to be in 2 or 3 places at the same time. Inevitably I got burnt out and so did everyone around me. Countless people were hired for that position and left in under two weeks, wasting company time and training $. I lasted in that position only 6 months and then transferred to a per diem position. While I was better qualified as a clinician and enjoyed that work, I was tired of being set-up to fail so I felt I had had little choice.

And this is where I believe was the biggest problem of Starlight Adolescent Center and most of the child-welfare system. Workers are set-up to do the job of the impossible with unmanageable workloads. Staff who choose not to leave often go into “survival mode” to keep up with the demands placed on them both physically and emotionally. Because of the difficulty to retain staff, there was almost always a shortage of manpower, which would force even higher workloads on those who were left. Also, youth counselors, the front-line workers, were often forced to work overtime in this high-stress environment. While most staff entered their job with good intentions, it is near impossible to be present and handle the most difficult youth of the state of California under such conditions. How could the company claim they provided excellent service if this is how workers felt? There were exceptional staff at Starlight that were able to handle circumstances that most people couldn’t dream of. I felt frustrated when I observed them to be unacknowledged and then given more work until they were forced to leave.

Starlight is closing due to state budget cuts and is now under scrutiny from the media. However, it took on a challenge most organizations could never do. While Starlight had some major holes in its management, the cases and circumstances were all extremely challenging. I hope the youth still there will find a placement that will lead to healing and at the very least, safety. Caring for these youth is no simple task. Social workers and others work very hard swimming upstream in a system that makes it challenging to do more that put little band-aids on a large open sore.