Seneca supervisors, citing privacy concerns, declined to describe the teenagers or the situations that caused them to be at the center, but said the most common diagnosis is post-traumatic stress disorder.
?These are the kids that have the highest level of behavioral health needs of any youth in the system,? said Jo Robinson, the director of behavioral services at the San Francisco Department of Public Health. ?But I feel pretty strongly that we?ll find the appropriate level of care for each child.?
Since 1996, the Community Treatment Facility has been the city?s only secure residential program for teenagers from backgrounds of abuse and neglect. Ken Berrick, Seneca?s founder and chief executive, said his clients can be ?very aggressive toward adults and other kids.?
?They?ve been in multiple placements, 10 or 12 by the time they?re 13 years old,? Mr. Berrick said. ?From their perspective they come to us from multiple failures, and from my perspective the failure of programs to meet their needs.?
It costs up to $15,000 a month to house and treat each client in the program. The city reached an agreement with Seneca in February to close the facility and redirect remaining financing toward other programs that serve at-risk youth.
Mr. Berrick said the closing is symptomatic of the tough choices counties must make because of California?s realignment of mental health services. The move, he said, has effectively capped spending on high-risk, low-income youth who depend on MediCAL to support their treatment.
It also reflects a trend over the last decade of closing Bay Area group homes in favor of working with youths in their communities, and Seneca has shifted much of its focus in that direction.
?If I had to choose between community-based services and the C.T.F., I would choose the community, but it?s like ?Sophie?s Choice,? ? Mr. Berrick said.
Seneca once ran several residential programs in the Bay Area, but by next month the agency will be down to one. The remaining site is not a locked facility, and concerns persist over how to ensure that high-risk youths are kept safe in less restrictive settings.
?I hope that community-based services gain enough strength, but there are probably kids who are going to need more than that,? said Alicia Hooton, a program director of the Seneca Center.
Daren Dickson, who oversees Seneca?s crisis and residential services, said that over the past five years there has been a sharp increase in the number of young people who are psychotic and schizophrenic.
?I?m worried about the closure, for sure,? he said. ?The juvenile justice system is going to be seeing more of these kids.?
Since the closing was announced, several teenagers have moved to other programs or back to their communities. At least one will be going to a secure program in another state.
?It?s hard for kids, the anxiety of not knowing where they?re going and seeing staff start to leave,? Ms. Hooton said.
The process has also been emotionally wrenching for the 68 staff members, who have formed close relationships with their clients.
As they walked through one of the units Wednesday, Ms. Hooton and Mr. Dickson passed a room where a teenage girl was packing her belongings and fretting over whether she would have enough school supplies at her next placement. On another unit, they peered into a room that had already been vacated.
?Two weeks ago this was packed with beds and dressers and artwork,? Ms. Hooton said.
The room conjured up another memory for Mr. Dickson. ?I remember seven or eight years ago in this room a kid set the carpet on fire,? he said.
tbundy@baycitizen.org
Article source: http://www.nytimes.com/2012/04/20/us/mental-health-center-for-youth-in-san-francisco-is-closing.html
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