Pennsylvania has become the fifth state to ban youth residential programs from using prone restraints, which can lead to accidental asphyxiation or sudden cardiac death.
Prone restraints are blamed for the deaths of at least 48 juveniles from 1998 through August 2006, according to the Coalition Against Institutionalized Child Abuse.
The ban - which affects all licensed child residential and day treatment centers, state youth development centers and youth forestry camps - was announced Aug. 14 by the state Department of Public Welfare and takes effect Feb. 14, according to department spokeswoman Stacey Witalec.
Debate has raged for years over the use of prone restraints, in which a person is immobilized face down, often with one person holding the juvenile by the arms, another holding the youth by the legs and a third straddling the youth.
Jennifer Gray, a former counselor at KidsPeace near Allentown who was assaulted by a 15-year-old girl, told The (Harrisburg,Pa.) Patriot-News that she opposes the new ban. "All this is going to do is cause more injuries to counselors and kids," Gray said. "The restraint is not the problem; it's the untrained people performing the restraint that are the problem."
But studies have shown that the very conditions that might lead to the use of prone restraints - such as a person's extremely excited state and large size - are also predictors of possible harm to the person being restrained.
The ban in Pennsylvania comes a year after the state shut down admissions to KidsPeace facilities statewide after it was discovered that seven children had suffered broken bones while being restrained at the group's main North Whitehall Township campus.
Last year, a 17-year-old resident at the private Bowling Brook Preparatory School in Maryland died after being held in a prone restraint, leading to the closure of the school after the state removed all youths who were there under state authority. (See "Restraints That Kill," May 2007). Deaths have been reported in numerous other states, including Texas state mental health and juvenile boot camp facilities.
The Pennsylvania ban was issued after an investigation of prone restraints was begun at the behest of Public Welfare Secretary Estelle B. Richman, whom Witalec described as "feeling strongly" that such restraints are too dangerous.
Pennsylvania also issued new guidelines for attempting to defuse situations before they get to a crisis level and require coercive intervention by staff.