Bad Medicine

In a smattering of red brick buildings at the bottom of a hill on Eighth Avenue South, a few blocks away from the bustle of Wedgewood Avenue, sits Hermitage Hall—a Nashville treatment program for male sex offenders ages 9 to 17. With nearly 100 sexually abusive boys housed within the seemingly quiet buildings, Hermitage Hall is one of the largest service providers of its kind in the country.

The facility’s brochure outlines this simple mission: “At Hermitage Hall, finding hope for children is what we do every day.” But current and former staffers refer to the facility as a “child jail” where staffers often rough up the kids or drug them into submission—even isolate them in a single room for weeks at a time—all in the name of treatment.

At best, current Hermitage Hall employee Jane Davis—not her real name—describes conditions there as “pretty nasty.” At worst, she calls them a “nightmare.” Davis ducks her head as she describes the facility, which she says does little to treat and reform boys, some of whom are low-functioning and mentally disabled—and many of whom have been abused themselves. Davis decided to share her story after the Scene detailed the deaths of two teens and the abuse of countless others at the Chad Youth Enhancement Center, a residential treatment facility for troubled youth just outside of Clarksville (“Handle With Care,” Nov. 8).

Both facilities are licensed by the state’s Department of Mental Health and Developmental Disabilities (DMHDD) and owned by Universal Health Services Inc., a King of Prussia, Pa., for-profit corporation that owns more than 100 behavioral health facilities across the country. And like Chad, Hermitage Hall uses Handle With Care, a controversial method of physical restraint that teaches staffers to hold residents, theoretically to keep out-of-control children from hurting themselves or others.

In September, the facility’s counselors were having trouble getting a boy in the Eagles group, the facility’s youngest unit, to take a seat. According to staff reports filed with the state, the boy finally sat after numerous directives. But it didn’t stop counselor Byron Keith Brown from grabbing the boy by the back of his shirt and tightening his grip until the boy said he was choking. That complaint prompted Brown to slam the boy against a wall—a confrontation that didn’t end until staff called a “code blue” to break up the fight. A DMHDD investigation found that the unnecessary force constituted abuse. Hermitage officials fired Brown.

But Hermitage employees say it’s not unusual for counselors to get rough with residents. At the hands of “uneducated, unprofessional” counselors, Davis says restraints have almost become a sport to Hermitage counselors, who congregate at night and say things like, “Yeah, I got this kid. I got him good.”

Checo Perryman, a former counselor at the facility who now runs his own business that teaches an alternative method to Handle With Care, says it was so common for Hermitage boys to smack their chins on the floor during restraints that the facility’s staff named the bloody scabs on the boys’ busted chins. They called it the “Hermitage Hall tattoo.”

“What happened behind those walls was very scary and very sad,” he says. But not all restraints end in injury. For some residents, restraint leads to a drug-induced haze that eventually lulls them to sleep—or, as some in the mental health world refer to it, chemical restraint, quite simply because the drugs can be used to restrict residents deemed out of control.

Among incident reports in the DMHDD files, there is tale after tale of restraints that end in some sort of injection. Some of the medications are listed by name—Abilify or Zyprexa, drugs that are used to treat schizophrenia and severe mood disorders. In most of the records, staffers refer to injections with a simple, generic term: PRN, short for a Latin phrase meaning to give drugs as needed.

Davis says that, for Hermitage Hall residents, those unidentified PRN shots usually mean a syringe full of Thorazine—one of the most powerful antipsychotic drugs, which critics liken to a chemical straitjacket.

But DMHDD licensing officials see it differently: They simply say it’s completely legal. Such injections can send children into a sleepy haze that can span hours or days, but Tracey Robinson-Coffee, DMHDD director of licensure, says there is no rule that requires facilities like Hermitage to report the number of times it administers such injections. Robinson-Coffee says her department is only concerned with whether the shots are ordered by a doctor and administered by a nurse, not “the way the medication is actually administered.”

Even though Hermitage Hall doesn’t always include the name of the drugs administered under the PRN umbrella, Robinson-Coffee says the injections aren’t cause for concern. She says her department could check any of the estimated 100 patient records at Hermitage where “all that stuff is documented.”