Skip navigation

Cripa Logansport Facility in Investigation Findings 9-9-05

Download original document:
Brief thumbnail
This text is machine-read, and may contain errors. Check the original document to verify accuracy.
September 9, 2005

The Honorable Mitch Daniels
Governor, State of Indiana
Office of the Governor
State House, Room 206
Indianapolis, IN 46204-2797
Re: 	 Investigation of the Logansport Juvenile

Intake/Diagnostic Facility, Indiana 

Dear Governor Daniels:
I am writing to report the findings of the Civil Rights
Division’s investigation of conditions at the Logansport Juvenile
Intake/Diagnostic Facility (“Logansport”), located in Logansport,
Indiana. On February 10, 2004, we notified you of our intent to
conduct investigations of Logansport and two other juvenile
correctional facilities, the South Bend Juvenile Correctional
Facility (“South Bend”) and the Plainfield Juvenile Correctional
Facility (“Plainfield”), pursuant to the Civil Rights of
Institutionalized Persons Act, 42 U.S.C. § 1997 (“CRIPA”), and
the pattern or practice provision of the Violent Crime Control
and Law Enforcement Act of 1994, 42 U.S.C. § 14141
(“Section 14141").1 At that time, we informed you that our
investigation of Logansport would focus on the provision of
mental health care. As we noted, both CRIPA and Section 14141
give the Department of Justice authority to seek a remedy for a
pattern or practice of conduct that violates the constitutional
or federal statutory rights of children in juvenile justice
institutions.
On May 10-11, 2004, we conducted an on-site inspection of
Logansport, accompanied by an expert consultant in mental health
care. We interviewed mental health providers and other staff,
youth residents, and facility administrators. Before, during,
and after our visit, we reviewed an extensive number of
documents, including policies and procedures, mental health
records, youth detention records, unit logs, and orientation
1

Our findings regarding South Bend and Plainfield are
provided separately, but are referenced in this letter.

- 2 
materials. Consistent with our commitment to provide technical
assistance and conduct a transparent investigation, at the
conclusion of our tour, we conducted an exit conference with
facility staff and Indiana Department of Correction (“IDOC”)
officials, during which our expert consultant conveyed his
initial impressions and concerns.
At the outset, we commend the staff of Logansport for their
helpful, courteous, and professional conduct throughout the
course of this investigation. We also wish to express our
appreciation for the cooperation of IDOC officials and staff.
Consistent with our statutory obligation under CRIPA, we now
write to advise you of the results of our investigation, the
facts supporting them, and the minimum remedial steps that are
necessary to address the deficiencies we have identified. As
described below, and in the findings letters also issued today in
regard to South Bend and Plainfield, we conclude that youths
confined within these facilities suffer harm or the risk of harm
from constitutional deficiencies in the system’s mental health
services.
I.

BACKGROUND

Logansport is an 84-bed maximum security facility which
serves as the IDOC’s intake facility for all males between the
ages of 12 and 18 who are committed to IDOC’s Juvenile Services
Division. The facility is comprised of one self-contained
building with an average daily population of 59 youths.
Generally, juveniles received at Logansport undergo a 13-day
intake process. According to Logansport officials, during this
intake period each youth undergoes a physical examination;
dental, vision and hearing screenings; an intellectual and
educational assessment; a risk and needs assessment; a substance
use assessment; a crimino-psychosocial history; and, if deemed
necessary, is referred to a psychiatrist and/or psychologist. At
the conclusion of the 13-day intake process, juveniles are
classified and transferred to one of seven IDOC-operated juvenile
treatment facilities, including South Bend or Plainfield, or to
one of four privately-operated facilities.
II.

FINDINGS

As a general matter, States must provide confined juveniles
with reasonably safe conditions of confinement. Youngberg v.
Romeo, 457 U.S. 307 (1982); Nelson v. Heyne, 491 F.2d 352
(7th Cir. 1974). Such constitutionally mandated conditions
include the right to adequate mental health care. Youngberg,

- 3 
457 U.S. at 323, n.30; Nelson, 491 F.2d at 360. See also A.M. v.
Luzerne Cty. Juvenile Detention Ctr, 372 F.3d 572, 585 n.3
(3rd Cir. 2004). Neither the Supreme Court2 nor the Seventh
Circuit3 has determined definitively whether the Eighth Amendment
or the Fourteenth Amendment provides the governing constitutional
standard for conditions in juvenile facilities. For purposes of
this letter, we need not resolve which standard governs because
we find that the mental health care at Logansport is so egregious
that it violates even the more stringent Eighth Amendment
standard.
Logansport’s mental health services focus primarily on
initial screening and assessment to identify emergent mental
health issues and psychopharmacological treatment needs.4
Because of the short duration of stay at Logansport, treatment,
monitoring, and follow-up assessment for mental health issues
identified at Logansport must occur at the youths’ treatment
facility. Based on our review of mental health care at
Logansport, and our review of follow-up care at South Bend and
Plainfield, we find that certain aspects of the care provided at
Logansport are constitutionally inadequate. Specifically, we
find that Logansport fails to provide adequate
psychopharmacological services. Additionally, while Logansport’s
mental health screening and assessment services meet minimum
constitutional standards of care, we note here the need for
systemwide coordination of services to ensure that required
additional screening and assessment occurs at the youths’
treatment facility.
A.

Psychopharmacological Services

2

See Ingraham v. Wright, 430 U.S. 651, 669 n.37 (1977)
(Although holding that the Eighth Amendment is inapplicable to
the paddling of schoolchildren, the Court declines to consider
whether the Eighth Amendment applies to conditions in juvenile
institutions).
3

In Nelson, the Seventh Circuit held that the State
violated the Eighth Amendment rights of confined juveniles by
administering abusive corporal punishment and forced
tranquilizing medication, but violated their Fourteenth Amendment
rights by failing to provide them with minimally acceptable
rehabilitative treatment. 491 F.2d at 357; 360.
4

Psychopharmacological treatment refers to the use of
psychotropic medications to control symptoms of mental illness.

- 4 
When a youth is admitted to Logansport and reports that he
is currently receiving psychopharmacological treatment, he is
typically permitted to finish whatever medication he has with him
at the time of intake. If the youth reports that he is currently
receiving psychopharmacological treatment but does not have any
medication with him, then the intake nurse will refer him to the
psychiatrist, who will meet with the youth within seven days. In
either scenario, however, unless the youth is overtly exhibiting
the symptoms the medication purports to treat, medication is
automatically discontinued once the youth’s personal supply has
been exhausted.5 Logansport’s psychiatrist reports that the
purpose of this discontinuation practice is to institute a “washout” period. A wash-out period is a medication-free time during
which, in theory, the mental health professional will monitor the
youth’s behavior and assess whether any psychopharmacological
treatment is appropriate.
A wash-out period, if implemented appropriately, can be a
useful diagnostic tool for ensuring the appropriate use of
psychotropic medications. However, in order to meet generally
accepted professional standards of care,6 a youth who undergoes a
wash-out period must be carefully monitored and assessed by a
qualified mental health clinician before, during, and after
discontinuation of the medication in order to determine whether a
return to medication is warranted. Without adequate monitoring
and assessment throughout this time, youths are exposed to a
number of potential harms. Most obviously, youths whose mental
health needs are not adequately identified and treated may suffer
mental distress and anguish, as well as an increased risk of
suicidality. Additionally, the youths are less likely to be able
to successfully complete the rehabilitation program, a
requirement for release from the treatment facility. Moreover,
youths with unmet mental health needs are more likely to
5

In interviews during our visit, Logansport’s
psychiatrist stated that it was his understanding that the
discontinuation of psychotropic medications once a youth exhausts
his personal supply is mandated by IDOC policy. IDOC’s medical
director, however, stated that no such policy exists. Thus, the
origin of this practice remains unclear.
6

In assessing the constitutional adequacy of mental
health care practices at Logansport, we must consider whether
professional decisions substantially depart from accepted
professional judgment. See Youngberg, 457 U.S. at 323; Estate of
Cole v. Fromm, 94 F.3d 254, 262-63 (7th Cir. 1996) (deriving the
standard for assessing the adequacy of mental health care
provided to pretrial detainee from Youngberg).

- 5 
demonstrate unacceptable behaviors that elicit punitive responses
from staff.
We find that Logansport’s wash-out practice, as implemented
across the treatment facilities we investigated (Plainfield and
South Bend), is constitutionally inadequate. Specifically,
youths whose medications are discontinued at Logansport are not
adequately monitored and assessed after the medication is
discontinued to determine whether there is a need to resume the
psychopharmacological treatment. Because residents are
transferred out of Logansport shortly following the
discontinuation of medication7, the bulk of the requisite
monitoring and assessment would occur at the treatment facilities
to which the youths are transferred. In our concurrent
investigations of South Bend and Plainfield, we find that such
monitoring and assessment generally fail to occur. See South
Bend Findings Letter at 11 and Plainfield Findings Letter at 14.
B.

Mental Health Screening and Assessment

We also find that although Logansport adequately identifies
juveniles who are overtly suicidal, its screening and assessment
practices are not comprehensive or sensitive enough to identify a
number of other serious mental health issues. In particular,
Logansport’s screening and assessment services fail to identify
juveniles with internalized symptoms of mental illness such as
juveniles with depression who are not actively suicidal, those
with post-traumatic stress disorder, and some youths with
psychoses.
In light of the short duration of stay at Logansport, the
facility’s practice of screening for only the most emergent
mental health needs is minimally adequate. However, once the
7

We also find the characterization of IDOC’s medication
discontinuation policy as a diagnostic wash-out period to be
problematic. The fact that youths entering Logansport are
permitted to finish whatever quantity of medication they may
happen to bring in with them before the prescription is
discontinued suggests that the subsequent discontinuation is not
driven by medical considerations. Indeed, if the driving force
for discontinuing a medication is truly a lack of need for that
medication, then it should be discontinued regardless of whether
the juvenile brought in a supply of his own. And, in fact, when
we asked Logansport’s psychiatrist what the rationale is for
permitting residents to finish medications they have with them,
he stated that it was to avoid the medication going to waste.

- 6 
youth is transferred to his treatment facility, more
comprehensive screening and assessment services are required.
Unfortunately, as we discuss in our findings letter issued in
regard to Plainfield, we find that these treatment facilities
fail to provide such services. See Plainfield Findings Letter at
12-13. We note this issue here because systemwide coordination
is needed to ensure that comprehensive screening and assessment
is conducted.
III.

REMEDIAL MEASURES

In order to rectify the identified deficiencies and protect
the constitutional rights of juveniles confined at Logansport,
IDOC should implement, at a minimum, the following remedial
measures:
1.	

2.	

Provide adequate psychopharmacological treatment to youths.
If a wash-out period is implemented for youths who enter
Logansport on psychotropic medication, IDOC should:
a.	

Conduct an adequate baseline assessment of the youths
and ensure adequate documentation of the baseline;

b.	

Provide adequate monitoring during the wash-out period;

c.	

Provide timely follow-up assessments to determine
whether a return to treatment with medication is
warranted; and

d.	

Ensure that psychopharmacological treatment is promptly
resumed when necessary.

Provide adequate screening and assessment services to
identify youths with serious mental health needs. At a
minimum, all youths should receive a comprehensive mental
health screening and assessment, either during their stay at
Logansport or immediately after admittance to their
treatment facility.
*

*

*

As stated above, we appreciate the cooperation we have
received from IDOC officials and facility staff throughout this
investigation. We hope to be able to continue working with the
State in an amicable and cooperative fashion to resolve the
deficiencies found in IDOC’s provision of mental health services.
Provided that our cooperative relationship continues, we will
forward our expert consultant’s report under separate cover.

- 7 
Although this report is the consultant’s work – and does not
necessarily reflect the official conclusions of the Department of
Justice – the observations, analyses, and recommendations
contained in the report provide further elaboration of the issues
discussed in this letter and offer practical assistance in
addressing them.
In the unexpected event that we are unable to reach a
resolution regarding our concerns, the Attorney General is
empowered to institute a lawsuit pursuant to CRIPA to correct the
deficiencies of the kind identified in this letter 49 days after
appropriate officials have been notified of them. 42 U.S.C.
§ 1997b(a)(1).
We would prefer, however, to resolve this matter by working
cooperatively with you. We have every confidence that we will be
able to do so in this case. The lawyers assigned to this matter
will be contacting your attorneys to discuss this matter in
further detail. If you have any questions regarding this letter,
please contact Shanetta Y. Cutlar, Chief of the Civil Rights
Division’s Special Litigation Section, at (202) 514-0195.
Sincerely,

/s/ Bradley J. Schlozman

Bradley J. Schlozman
Acting Assistant Attorney General
cc:	 The Honorable Steve Carter
Office of the Indiana Attorney General
J. David Donahue, Commissioner
Indiana Department of Correction

Dawn Buss, Superintendent

South Bend Juvenile Correctional Facility

Curtis Correll, Superintendent

Plainfield Juvenile Correctional Facility

Kellie Whitcomb, Superintendent

Logansport Juvenile Intake/Diagnostic Facility

The Honorable Joseph S. Van Bokkelen

United States Attorney

Northern District of Indiana


- 8 The Honorable Susan W. Brooks
United States Attorney
Southern District of Indiana
John H. Hager
Assistant Secretary
Office of Special Education and Rehabilitative Services
United States Department of Education
Troy Justeson
Acting Director
Office of Special Education Programs
United States Department of Education