from the archives: physical restraint as the least bad option

This piece originally appeared on my blog in July of 2014.

I have seen now some dozen people share this ProPublica map, about the use of restraining holds on school children, on various social networks and websites. It makes me sad, because this issue is sad. But the kind of reactions that are being provoked also make me sad, because they demonstrate the ways in which the world of sharing and likes and shallow understanding destroys nuance and creates a bogus conception of a black-and-white world.

It happens that I have some experience in this regard. For about a year and a half, I worked in a public school that had a special, segregated section for kids with severe emotional disturbance. Some of the students were significantly mainstreamed into the general ed population, but many couldn't be, as they posed too much of a risk to other students and to themselves.

Those risks were neither hypothetical nor minor. The more severe of these cases were children who typically could not last a single school day without inflicting harm on themselves or on others. I have personally witnessed a 10 year old lift his 40-pound desk from the floor and hurl it towards the head of another student. I have witnessed a student jump from her seat to claw and bite at another, with almost no provocation. I have seen kids go from seeming calm to punching other kids repeatedly in the back of the head without warning. The self-harm was even worse. I had to intervene when a child, frustrated with his multiplication homework, struck himself repeatedly in the face with a heavy fake gold medallion, to the point where he drew his own blood. I saw a student try to cut his own lip with safety scissors. I saw a girl tear padding from a padded wall and eat it; when she eventually had to be removed from the school via ambulance, she urinated on herself, rubbed her face with her urine, and attempted to do the same to paramedics.

Mental illness is powerful and terrible and that's the world we live in.

Part of the response to this kind of behavior was restraint. I didn't enjoy doing it; none of the staff did. Hated it, in fact. We were all trained in how to provide restraint as safely as possible, but that didn't mean we were under any illusion: we knew that these techniques were uncomfortable and potentially harmful to students. Injuries to staff members were common. A fellow staff member badly broke her tailbone in the process of restraining a child, an injury that left her unable to work for a calendar year. There was something gross about the euphemism "therapeutic hold," and we talked about the trainings with black humor. I left, after that year and a half or so, because I could not take the emotional toll. There were women there who had been working with such children for over 30 years. I couldn't make it two. The notion that these women were somehow callous or unconcerned about these children is ludicrous and defamatory. They had dedicated their lives to helping these kids, for terribly low pay. They had to watch these kids grow up and get shipped to the middle school level where there was no similar program. And we were the last stop, for these kids, before the state mental health system. That was the stark choice: if it didn't work here, the only alternatives were either special private schools, which given that the students were overwhemingly from poverty, was not an option at all, or being committed to the state mental system, which most likely meant institutionalization and constant medication. Those were the stakes.

I have struggled to write about that period of my life for years, as I am still unable to adequately process the emotions I felt. I do know and will loudly say that the women (and besides me they were almost all women) who worked as teachers and paraprofessionals were an inspiration in the true sense, working quietly and without celebration to bring a little education and relief for children who life had treated terribly. They shame me with their dedication. To see them and people like them repeatedly represented as serial abusers who don't care for if they harm children is infuriating, baseless, and wrong.

The question I have for someone like Heather Vogell, who wrote this sensationalistic and damaging piece for ProPublica, and for all of the people sharing that map with breathless outrage, is this: what alternative would you propose? I am not kidding when I tell you that dozens of times, there was no choice but to physically restrain a child. The only alternative was to allow that child to badly hurt another or him- or herself. If you think that a 7 year old is incapable of badly harming another person, I assure you, you're wrong. I have seen many people arguing that there is never a situation where such restraint is necessary, and all I can say is that you're ignorant, and that your ignorance is dangerous. To say that all children can be verbally calmed in all situations is to betray a stunning lack of understanding of the reality of childhood mental illness. Vogell mentions in passing that there are situations in which restraint is necessary, then spends thousands of words ignoring that fact. At every time when she is faced with a journalistic or stylistic choice, she opts for the most sensationalistic and unsympathetic presentation possible, minimizing the other side and failing to even pretend to have genuinely wrestled with the topic before coming to a conclusion. It's not just that she insults thousands of nameless, faceless public servants who no capacity to fight back or even be seen as potentially-sympathetic human beings. It's just lousy journalism, written for a clickbait culture, utterly credulous to one set of opinions and utterly dismissive of another. It's an embarrassment.

Meanwhile, childhood mental illness continues to wreak its terrible havoc, and educators will be forced to make terrible choices. I hated restraining those children, but I saw with my own two eyes the incredible violence that mental illness made possible, and I do not for one minute regret properly restraining children when that was the only way to save that child or another from bodily harm. I invite Vogell, or any of the people loudly expressing their outrage, to take jobs in special education or child mental health services. You can actually get involved, you know. See it with your own eyes. Help actual human lives get a little bit better. See what choice you're able to make when it is clear that you must intervene or allow injury to another person. But I'm afraid that takes more time and effort then launching a tweet.

Years from now, when people like Vogell are no longer wasting a second of their time thinking about physical restraint of children who are a danger to themselves and others, the women in my old program will be working, quietly and selflessly and for awful compensation, trying to help the children they are now accused of abusing.