MEDICAL INCARCERATION MONDAY: Seeking Justice for Victims of Alleged Abuse in Los Angeles Group Home
Laura Topete embraces her son, Gregorio. She says his rates of self-injury have skyrocketed since the summer. (Mel Melcon / Los Angeles Times)
This story of abuse in an LA group home for people with IDD (intellectual/developmental disabilities) is the perfect example of how systems designed to provide supportive services often replicate the punitive and controlling attitudes found in jails and prisons. Not all individuals residing in group home settings are there against their will, but even if it’s their choice, it underscores a system where the only available “choice” sometimes leads to understaffed environments with underpaid staff. The understaffing in residential settings for people with IDD is partially due to the low wages these workers receive, fostering cultures of violence.

I know this firsthand because I’ve worked in multiple residential settings for people with IDD, ranging from private homes, to 2-3 bedroom apartments with 2-3 adults living together, to a youth facility for those up to 21 with both an IDD diagnosis and a mental health diagnosis. The last experience was early in my career while I was pursuing my MSW. I served as a live-in staff member on weekends, staying from Saturday morning to Monday evening, with only 8 hours of personal time at night, when I wasn’t paid but also couldn’t leave the site. I worked in one of a series of row houses near the main office, but since the office was closed on weekends, there was minimal staff oversight.

At 23 years old, with no parenting experience and limited exposure to caring for children, it was not unusual for me to be alone for extended periods with 2 children in one house and 3 in another, all of whom were autistic and had mental health diagnoses. I often found myself alone overnight, even though I wasn’t compensated, despite the requirement for overnight staff due to a child with a seizure disorder requiring monitoring. At the time, I had undiagnosed narcolepsy, yet another reason it was an unsafe situation for all involved.

Because I was young, there were things that happened during my time there that I didn’t understand qualified for mandated reporting. I can also relate to feeling unsafe reporting issues to supervision, as the article describes. The one incident I did report resulted in my termination because it involved an allegation against a long-term staff member. This led to a situation where untreated narcolepsy and ADHD were used as grounds for my dismissal, despite the issues stemming from challenges with medication documentation rather than medication itself. My termination provided cover for those engaged in questionable, neglectful, and abusive behavior towards the children.

Unfortunately, this residential facility was known as the “last stop” for youth whom other agencies couldn’t accommodate. These adults provided stability for these kids’ as some of the only consistent figures in their entire lives, and the facility couldn’t function without them. They were protected because, given the meager compensation, few others would be willing to face the secondary trauma experienced by some of these kids, and there were limited alternatives for the children if the facility closed.

These were exceptionally challenging roles with inadequate support and supervision. I felt a sense of solidarity when I read the article describe that after Jude was punished for his behavior by being denied a shower, he “ran for the staff bathroom, where he emptied a container of disinfectant wipes and began to chug water out of it.” Yup, sounds about right, I know that life. That life taught me that all behavior is communication, and Jude’s words weren’t being respected, so he resorted to alternative ways of communicating. Rather than listening, the employees around him still chose not to understand. Though I did see staff weaponize their power against residents, I never witnessed the kind of degrading, punitive violence that continued to be used to assert domination and force compliance from Jude described in the article.

Residential facilities for people with IDD aren’t formally part of the incarceration system, and administrative and legislative safety measures to ensure compliance are insufficient. Therefore, it’s unsurprising that the staff member in the story was able to abuse vulnerable adults repeatedly without consequences. “When a licensing authority lets someone who is credibly accused of abusing a vulnerable person have a chance to go back and do that again rather than stripping their license, it’s absolutely a system failure,” said Larkin Taylor-Parker, legal director of the Autistic Self Advocacy Network. If I didn’t see how the same controlling violence that fuels policing also arises in these residential facilities, it would astonish me that staff in a group home called the police to come in response to Gregorio hitting his head. I’ve encountered similar situations, unable to stop a dysregulated adolescent from self-harming without any backup for safe physical intervention.

When envisioning the world we want to inhabit, we must prioritize disabled individuals, particularly the most vulnerable with IDD. People who don’t use words to communicate, and people who sometimes use behavior that those around them find challenging or dangerous, such as self-harm, are some of the most likely to have force used against their bodies in defiance of their consent. I imagine a world where a culture of consent is pervasive within our lives, instead of violence. I like to think we only resort to deeply ingrained patterns of abuse and neglect when we have exhausted all other options, which means we need to create new options. We have to be willing to let go of some of what we think we know in order to make room within ourselves to understand, interpret, and respect the consent of people with neurocomplex communication approaches.

The policies, laws, and courts governing these facilities are deeply intertwined with a justice system rooted in compliance and punishment, which fundamentally fails. Jude and Gregorio’s experiences underscore this failure. Reform alone cannot rectify the inherently violent outcomes when individuals with IDD are subjected to power dynamics. It’s imperative to center those receiving services within their communities and initiate small-scale experiments in creating communities where needs are met without coercion or threat of punishment.