Looking at Alternatives to Keep Kids in Residential Treatment Programs Closer to Home

Earlier this year, the Philadelphia Inquirer ran an article about the tragic death of a Philadelphia boy who died in a Tennessee treatment facility, similar to Devereux behavioral treatment centers in Arizona, Colorado, Florida, Georgia, Pennsylvania and Texas.

According to the article, in June of 2005, a Philadelphia childcare investigator heard about allegations of abuse and three months later, the city learned of a 14-year-old New York resident who had died of a heart attack in the Tennessee facility after a confrontation with a staff member.

The article went on to report that 17-year-old Omega Leach of Philadelphia died in June of 2007 after he was pushed, face down, on the floor, obstructing his breathing. At the time, 44 Philadelphia children and adolescents, more than 50 percent of the facility’s population, were in the same Tennessee center.

This young man’s death offers the opportunity to address options for organizations, like Devereux and others, to treat these children closer to home.

Below is a letter to the editor, published the week after the original report. I share the
letter here in the hopes that as a society, we can discuss reforms that will allow future incidents, like the one in Tennessee, to be avoided. With a new Philadelphia city administration only a few weeks away, we must begin having that conversation.

Dear Editor:
Your thoughtful article about the death of a Philadelphia teenager in a Tennessee psychiatric residential treatment facility highlighted the difficulty in monitoring distant treatment. One critical issue was not explored – why did every comparable facility in the Commonwealth refuse to admit this teenager? Does Tennessee have better or more specialized programs? No – Pennsylvania is home to outstanding psychiatric programs such as KidsPeace, Wordsworth Academy, and Devereux. Philadelphia children are served in Tennessee primarily because Pennsylvania’s licensing rules aggressively limit a facility’s ability to lock doors, to employ restraints, and to seclude an angry child. This laudable philosophy has the unintended consequence of making it impossible, with normal staffing, to safely treat some disturbed adolescents in Pennsylvania. Pennsylvania children are sent to more “secure” facilities in states with less stringent regulations that undercut the philosophy of Pennsylvania’s regulations.A facility can be made “staff secure” by increasing the number and training of staff as noted by the Allegheny County official quoted in the article. Allegheny County places its severely challenged children closer to home by paying for the extra staffing. Philadelphia has been reluctant to take this approach given budgetary pressures. Perhaps your article wi11 catalyze the difficult but necessary discussions to find a means to keep all of our children safe here in Pennsylvania.

Sincerely,
Robert Q. Kreider
President & CEO
The Devereux Foundation

 

Preparing our Children for Resiliency

The 2007 hurricane season is upon us and the first major storm, Hurricane Dean, has pummeled Jamaica and is currently bearing down on eastern Mexico. Mother Nature’s fury can have devastating effects on those people who survive the storm with their lives, but lose so much in the aftermath.

It was almost two years ago to the day that Hurricane Katrina was quickly approaching the shore of the United States. Her aftermath left the city of New Orleans decimated and the lives of its survivors shattered. Two years later, the area surrounding New Orleans has not improved much and those affected are still dealing with the residual effects of the storm. Based on FEMA estimates, 25,000-30,000 children, displaced by Hurricane Katrina are still living in the temporary trailers.

The American Psychological Association held a conference last week and in preparation, USA Today ran articles on the mental health struggles the victims still face in the August 16, 2007 issue. For adults, post traumatic stress disorder has increased five percent in the past year. The number of people contemplating suicide has increased from three percent a year ago to between six and eight percent now. Many adults are struggling with the stresses of rebuilding delays, loss of community and financial pressures.

For children, doctors report seeing an increase in panic attacks that come with rainy weeks. The wait to see a therapist at the Children’s Hospital in New Orleans is about a year, compared to a six month wait time pre-Katrina. There are reports of children’s increasing violent behavior, often a symptom of depression in children. One pediatrician estimates that 50 percent of his patients have mental health problems as opposed to five percent only two years ago.

While resources to support the mental health needs of people living in Louisiana, post-Katrina are desperately needed, this ordeal also reminds us that adults need to work with young children, beginning at infancy, to help them build their internal resilience. For more than a decade, the Devereux Early Childhood Initiative (DECI) has been working throughout the country assessing children’s resiliency factors and helping teachers, parents and care givers to learn how they can help children develop better internal resiliency factors. A person’s resiliency is a key factor to helping them better cope with the challenges throughout their lives.

We don’t know where our nation’s next big catastrophe will be, but we do know that we need to invest in helping all children to become resilient so that they can weather whatever storm their life’s circumstances will bring.

 

Fiscal Year 2007 Ends on a Positive Note

Devereux has closed the books on fiscal year 2007, which ended on June 30, and it was an extraordinary year for Devereux.  A safer environment for our consumers and employees, a more stable workforce, wider support from our communities and financial success led to making this an excellent year.  Some of our specific organization-wide achievements included: 

• The number of donors supporting Devereux at $1,000 or above during the year was above 750, exceeding the target by almost 10%.
• Normalized operating earnings continued a positive four-year trend to the highest level in many years.
• Risk management expenses were 20% below the annual target.
• Employee turnover was below the annual target.

Strong financial results for fiscal year 2007 were primarily driven by outstanding Center operating results, more than $3,000,000 better than what was budgeted. Residential census grew significantly in the fourth quarter and this trend provides strong operating momentum going into fiscal year 2008.   

Almost $6 million in non-operating gain was provided by the sale of Pennsylvania real estate. Together with the strong operating results, this real estate gain enabled us to post what we believe is the highest excess of revenues over expenses in Devereux’s history.

Some other notable factors that led to our success include investment earnings that were slightly ahead of plan, but because of another strong performance by Devereux’s investment portfolio, unrealized gains increased by more than $8.8  million for the year. Also, a major bequest enabled Devereux to meet its 2007 fund raising goal. In addition, a major four-year commitment was received from the Marcus Foundation to support the expansion of Devereux’s Center for Effective Schools into the Atlanta School System.

The employment of the best and brightest is a good way to insure Devereux’s future and fiscal year 2007 was a very successful recruiting year for key Devereux positions. We filled four vacant center clinical director positions and two senior corporate clinical positions. Our national marketing capacity was enhanced by recruiting two senior professionals, one from inside Devereux and one from a major competitor, as well as several new center marketing directors. We were also able to attract a leading recruiting consultant to join Devereux, and most recently we added a very experienced finance and business development professional to lead the effort to market our intellectual properties.

During fiscal year 2007, we also developed and adopted a new mission statement and a statement of core values: 

Our Mission

Devereux changes lives and nurtures human potential.  We inspire hope, ensure well-being, and promote meaningful life choices.  Our mission is achievedthrough a wide range of services and supportsfor individuals and their families. 

Core Values 

We support a respectful and integrated team approach.We foster personal and professional growth of our staff.We develop innovative and effective solutions.We partner with families and communities.  

Together with the Strategic Plan developed in fiscal year 2006 and the Philosophy of Care developed in fiscal year 2005, we have a clearer sense of direction for Devereux’s long-term success, a direction that is supported by an ever widening range of stakeholders.

With key staff additions, our strong operating momentum, the sharply increased strength of our balance sheet and our clearly outlined strategic direction, we are very well positioned for the future. As we prepare to celebrate Devereux’s 95^th anniversary, we will reflect on our commitment to fulfill Miss Devereux’s dreams for her clients. We must continually strive to be the Provider of Choice, the Employer of Choice, and the Charity of Choice.                                                               

 

School-Based Services

Devereux is extremely proud of its 95 year history of providing outstanding residential services to individuals with special needs. Tens of thousands of individuals have received life-changing care in our residential programs across the country.

Despite this extraordinary history, over the last fifteen years Devereux has increasingly focused on developing additional community-based services because care in the least restrictive, clinically appropriate setting is most respectful of the autonomy and dignity of the individual served. Our experience has also indicated that community care, when done well, can be more cost-effective in many situations. It can serve as prevention or early intervention on the front end, and as a step-down from residential care on the back end. Today, for each one of the twenty-four hundred consumers Devereux treats residentially each year, six to ten individuals are served in an array of community settings, including foster care, outpatient, supported living, wraparound, and in-school services.

As we look ahead, the provision of in-school services is one of our most promising areas for impact and growth. Although the funding will be complex and challenging, the benefits to individual students and society will be enormous. Many of our public schools, especially in urban areas, are clearly struggling – if not failing – in their mission to graduate informed and thoughtful citizens with the skills to succeed in 21st century jobs. Virtually all of our most difficult social problems – including poverty and violence – are directly impacted by this educational failure.

The Federal legislation, No Child Left Behind, promotes and emphasizes academic accountability, an important element of this problem. Unfortunately, it consumes significant local resources without, in any way, addressing the most important problem. The vast majority of today’s teachers do not have either the behavioral or developmental training, or the appropriate support resources, to address the social and emotional health of their students. If the social and emotional needs of students are not adequately addressed, not only will those students not be successful, but their disruptive behaviors will make it difficult for other students in the class to be successful.

Over the last ten years, Devereux has developed two sets of educational programs: one directed at early childhood education and one directed at primary and middle schools. The Early Childhood program is built around a strength-based assessment tool (The Devereux Early Childhood Assessment), which has been administered to well over a million three to five-year olds across the country. This assessment tool is supported by teacher and parent training, and curricular materials to build on the strengths identified and to address indicated needs for social and emotional support.

The primary and middle school program, School-Wide Positive Behavioral Supports, provides developmental and behavioral mentoring for teachers and other school staff to understand how to use behavioral approaches for all students in order to maintain a positive environment in the school, provide targeted interventions for the students most likely to be disruptive, and help in identifying students who will need mental health resources from outside the classroom to be successful.

When teachers are provided with information about why many of the children are exhibiting challenging behaviors, and the real meaning behind the behaviors, they are frequently receptive and eager to receive new tools, training, and approaches to try to engage the children. This results in positive culture change throughout the schools.

Both of these programs have secured significant governmental and private foundation grant funding over the last ten years and have produced very exciting results. Devereux is now committed to promoting a large scale implementation of these programs. Toward that effort, this week Martha Lindsay became Devereux’s Vice President for Product Development. Martha has a very impressive resume as Chief Financial Officer of a major for-profit organization, Chief Operating Officer of a successful start-up, and a long history of successful product development. Martha will quarterback our efforts to further develop and market both these exciting products, as well as other intellectual properties in earlier stages of development.

I am pleased to announce that the Marcus Foundation, under the leadership of Bernie Marcus, a founder of Home Depot, has provided a significant, four-year grant to implement School-Wide Positive Behavioral supports in twelve to fifteen Atlanta public schools. This is a wonderful first step in our effort to expand the use of these important programs.

 

Appropriate Insurance Coverage for Mental Illness

According to the National Alliance on Mental Illness (NAMI), the best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.

Public policy in this country is not always based on a long-term investment strategy, data, or research. Crises of the moment, temporary public outcry, or strong lobbying efforts by special interest groups – these are the forces that often shape policy, and in many cases, may trigger unanticipated and unintended negative consequences.

At this moment in time, Congress has an opportunity to take action on an important issue, which not only makes sound economic sense, but it is also the right and compassionate thing to do. Bills have been introduced in both the House and the Senate that would require group health plans, which have fifty or more enrollees and which offer mental health coverage, to provide that coverage according to the same terms as the coverage for other medical conditions. This policy is referred to as mental health parity.

One of Devereux’s Trustees, Dr. Marilyn Benoit, Past President of the American Academy of Child & Adolescent Psychiatry, suggests that we should use the term “brain disorders,” rather than mental illness. Mental health issues are the result of complex brain based biological processes and should be treated similarly to other organ based disorders such as those related to the heart, lung, pancreas, or kidney. If thought about in this manner, the parity issue should be easily resolved.

There is compelling evidence that when mental health needs remain unaddressed, total medical expenses increase. For instance, workers experiencing depression use significantly more sick leave as a result of their depression. Individuals with chronic diseases such as diabetes or heart disease will experience medical expenses almost twice the average for those diseases if they also suffer from depression. Initial studies at state and federal levels, where parity legislation has been implemented, indicate that the initial costs of additional mental health coverage are offset by reductions in other medical expenses, without considering the increased productivity of individuals receiving appropriate care and the decreased use of sick leave.

If we do not institute a policy of mental health parity, we will pay the costs in multiple social systems such as emergency rooms, child welfare systems, or juvenile and criminal justice systems. These are the systems that meet the needs of children and families when critical mental health needs remain unaddressed. We, in turn, all pay the price – none more so than the individuals suffering without help. Surely we wish to help those in need. It just makes good economic sense. Now is the time to speak up, to speak up for compassion and for justice.

For more information or to make your voice heard to your legislator, please click here.

 

Reflecting on the Tragedy in Virginia

While everyday routines are beginning to return to normal, many people are still reeling from and contemplating the tragedy at Virginia Tech. People are shocked and saddened to know that violence of such horrific proportions could impact a college town in rural Virginia and leave an entire country mourning the loss.

I expect that each of us has taken time to think about how the events at Virginia Tech have affected us on a personal level. As a parent, I am reminded that children, at a very early age, reach a point where a parent can no longer shelter them from the potential threats of our modern world.

As the President and CEO of Devereux, I have reflected on the potential missed opportunities to have reached the 23 year-old student perpetrator, who was so severely disturbed, but not receiving the mental health attention he desperately needed. Perhaps we may have been able to avert this tragic outcome. Quality mental health services can have an enormous, positive impact on individuals who are living with mental illness, and allow them to lead meaningful and productive lives.

Our society has struggled to find the balance between protecting those suffering from mental illness and society at large from harm, while safeguarding the civil liberties of all individuals. While I do not have an easy answer, I do believe we need to be more proactive in ensuring early identification, rapid access and continuing mental health care for people who are coping with serious mental illness. In post-tragedy interviews, many students and faculty spoke of their concerns and even fears of this student, referencing his erratic, withdrawn and anti-social behavior.

As a society, we need to fight the stigma that is so often associated with mental illness. In fact, violent acts by persons with mental illness are rare. However, we clearly need to find better ways to support those who need help to take advantage of the resources available in our communities.

We can hope, that from this tragedy at Virginia Tech, will come a greater awareness of the importance of mental health services to our communities and a more effective balance of individual and community rights.

 

Recognizing the Spirit of Philadelphia’s Working Women

Click to enlarge Susan Smith, executive director of Devereux’s Kanner Center; Renay Oberholtzer, nurse manager of Devereux’s Kanner Center; and Bob Kreider, president & CEO

Recently, I had an opportunity to attend the 15th Annual Paradigm Award Luncheon, sponsored by the Greater Philadelphia Chamber of Commerce. This award recognizes the outstanding female business woman from the Philadelphia area, honoring her personal and professional achievements. This year’s award recipient was Terry D’Alessandro, Market CEO for the Mid-Atlantic East Market of Sovereign Bank.

Devereux has been proud to be a sponsor of the Paradigm Luncheon for the past two years. Helena T. Devereux, a Philadelphia school teacher, epitomized this same spirit of leadership, vision, and tenacity when she started our organization in 1912. Ninety-five years later we remain a venerable Philadelphia institution.

While the luncheon itself offers a wonderful tribute to the accomplishments of the Paradigm Award recipient, there is also a focus on helping working women advance their careers. Each year the Philadelphia Chamber also awards scholarships to working women who are pursuing their bachelor’s degrees. During this year’s luncheon, we heard remarks from past recipients about how the scholarship changed their life.

One of this year’s recipients was Renay Oberholtzer, nurse manager at the Devereux Kanner Center. I was delighted to be among the crowd of 650 business people cheering for Renay as she and other women were recognized. Renay was awarded the maximum amount, a $5000 scholarship.

Honoring the achievements of a business leader like Terry and recognizing the dedication of folks like Renay seemed like a perfect reflection of the Devereux spirit and our founder Helena T. Devereux.

Devereux continues to be led by several strong women leaders. I salute the success of Devereux’s women leaders – past and present – and offer my heartfelt congratulations to Renay.

 

95 Years Young

This time of year, many people’s thoughts turn to thoughts of spring. I am thinking much further ahead; I am thinking about November 16th.

November 16th is a very important day for Devereux. That is the day that we will celebrate, in grand style, the 95th anniversary of Devereux. As the largest non-profit provider of behavioral healthcare services to people with developmental, emotional and behavioral disorders, I think we can all be proud of how we have carried forward the vision of Helena Devereux for 95 years. In addition, we will be celebrating the 50th anniversary of the Institute for Clinical Training and Research (ICTR), a division of Devereux, that has made tremendous gains in school assessments; early childhood resilience programs; helping inner city schools to create a culture that is more conducive to learning; and training tomorrow’s mental healthcare professionals.

In order to help us celebrate these Devereux milestones, we will be inviting the Philadelphia business community and Devereux stakeholders to join us at the Independence Seaport Museum at Penn’s Landing for what should be a special night of celebration as we consider the many lives which have been positively changed as a result of our 95 years of service.

We will be sending out invitations to this Gala later in the year, but mark your calendars now for the fun and festivities on Friday, November 16th. We look forward to seeing you there.

 

Our New Mission Statement and Core Values

This year, Devereux celebrates its 95th anniversary and the 50th anniversary of the Institute for Clinical Training and Research (ICTR), a division of The Devereux Foundation. Both organizations were conceived by a true visionary, Helena T. Devereux.

Even before women had the right to vote, Miss Devereux fought for the educational needs of the forgotten children: those students, often seated in the back of the classroom, who could not reach their potential without extra help. She began her mission to help those special children and developed an individualized, positive educational approach, which she used successfully during her tenure as a school teacher in Philadelphia. However, she believed that these children would advance even more if their academic experiences were integrated with a structured, caring living environment. So, Miss Devereux took students into her rented summer home and spent three months working on their academic, vocational and social skills. Using that summer’s success as a stepping stone, she expanded her dream again and established the Devereux Schools in 1912, later to become The Devereux Foundation.

Over the next 45 years, Miss Devereux saw her vision evolve into a premier organization, dedicated to meeting the needs of individuals with special needs and designing their education and treatment through a multi-disciplinary approach. In one of her final milestones, Miss Devereux wanted to ensure that the work she started would continue beyond her lifetime. Shortly before her resignation as President of The Devereux Foundation in 1957, Helena Devereux established the Institute for Training and Research, later renamed the Institute for Clinical Training and Research. ICTR embodies and perpetuates her commitment to furthering the understanding of individuals with special needs and training professionals to meet those needs.

Now the responsibilities of furthering the mission set forth by Miss Devereux fall on the shoulders of the stakeholders of today’s Devereux. It is the responsibility of employees, board members, clients, families and others to continue blazing the trail of what has become the nation’s largest non-profit provider of services to children, adolescents and adults with behavioral, mental health and developmental disabilities. Along with the widespread recognition of ICTR and our financial strength, we are a thriving institution and will remain strong with the continued commitment of our supporters. I hope you will join me in this important, life-changing effort.

To help guide us in this charge, I am very pleased to announce Devereux’s newly revised Mission Statement and statement of our Core Values.

Our Mission
Devereux changes lives and nurtures human potential.
We inspire hope, ensure well-being, and promote
meaningful life choices. Our mission is achieved
through a wide range of services and supports
for individuals and their families.

Core Values
We support a respectful and integrated team approach.
We foster personal and professional growth of our staff.
We develop innovative and effective solutions.
We partner with families and communities.

In future blogs, I will share with you our Philosophy of Care and the exciting plans we are developing to celebrate the 95th anniversary of Devereux and the 50th anniversary of ICTR. Stayed tuned for the details!

And finally, a Happy Birthday to Miss Devereux, who would have turned 123 on Friday, February 2nd. While the rest of the country celebrates Ground Hog Day, we celebrate the birthday of our founder.

 

Combating Autism Act

In the final days of 2006, President Bush signed into law the Combating Autism Act, brought to the House by Congressman Joe Barton (R-Texas) and sponsored in the Senate by outgoing Senator Rick Santorum (R-Pennsylvania) and Christopher Dodd (D-Connecticut). It is important to note that House Members Mary Bono (R-California) and Diana DeGette (D-Colorado) originally introduced a companion bill in the House last year.

The new Combating Autism Act funds almost $1 billion over the next five years, to combat autism in four critical areas: research; screening; early detection; and early intervention. The new legislation will increase federal spending on Autism Spectrum Disorders by at least 50 percent.

Building on provisions contained in the Children’s Health Act of 2000, the bill requires the National Institutes of Health (NIH) to expand and intensify autism-related research, including possible environmental causes of autism. Research dollars will be allocated to the National Institute of Environmental Health Sciences, the National Institute of Mental Health and a number of other institutes at NIH. The bill also provides for statewide autism screening, diagnosis and intervention programs to be developed and to monitor the efficacy of statewide programs and systems. This will ensure that all children are screened for autism before their second birthday, and that children at risk for autism receive appropriate services as early as possible.

Today it is estimated that 1 in 166 children will be diagnosed with autism. In his remarks before the House, Congressman Barton spoke of the crucial need for this funding. “Today, little is understood about the causes and mechanisms of autism. Many studies have been conducted into researching possible genetic and environmental causes of autism, and scientists are learning more about this disorder and how its effects can be lessened or eliminated. But without question, more work needs to be done to pinpoint the true causes of autism and to come up with a cure.”

We are encouraged by the resources going to the understanding of autism and the fact that this is an excellent investment to reduce the future incidence of autism. We must however, not forget the current challenges facing today’s families, desperate for the resources to help their loved ones receive the most up-to-date educational and behavioral therapies. Devereux sees this incredible need every day as it serves hundreds of families and individuals with Autism Spectrum Disorders across the country.

Devereux is a national, leading provider of services to children, adolescents and adults with Autism Spectrum Disorder. Our history includes our founder, Helena Devereux, working closely with Dr. Leo Kanner, who first identified autism in children.
Devereux is proud of its legacy of assisting individuals with autism and their families. We look forward to continuing that mission.