What's striking about all of the incidents caught on video is the absence of clinical staff on the scene.
Connecticut's Office of the Child Advocate has released a follow up to their July report on conditions at the state's two juvenile detention centers.
The addendum includes some corrections and clarifications to the July report, as well as comments from the Department of Children and Families, which oversees the Connecticut Juvenile Training School and the Pueblo Girl's Unit, in response to the OCA's original report.
A big part of the follow-up report is a suicidal behavioral chart, an in-depth look at the 55 suicide threats or attempts at two facilities during a 12-month period.
The incidents are strikingly similar. Every child who attempted or threatened suicide has significant mental health issues, like PTSD and bipolar disorder. Many reportedly have issues with drug and alcohol dependence.
The circumstances which led to the suicidal incidents also have some disturbing similarities. Most of the incidents started after a seemingly minor infraction that quickly escalated into a violent skirmish with line staff, and ended with unlawful restraints and hours of seclusion -- a protocol that caused further harm to the juvenile.
"In a therapeutic, trauma-informed environment, this would not have escalated to this point," said state child advocate Sarah Egan. "And you wouldn't be by yourself. You'd be with someone you have a relationship with, avoiding the escalation of incidents into what we have here."
The follow-up report also included some disturbing videos of some of these incidents, a mix of security cameras and video footage shot by staff members.
In one of the videos released Tuesday by the OCA, "Jennie," a girl detained at the Pueblo Girls Unit, accidentally entered a "no access" area and refused to return to her room.
After line staff tried several times to escort Jennie back to her room, she was suddenly and violently tackled and pushed to the floor in a prone position. After being restrained, Jennie was placed in an empty cell, where she took to a corner of the room not visible from the door, tied her shirt around her neck, and began to hang herself.
Staff eventually had to use a rescue hook to save the girl.
What's striking about all of the incidents caught on video is the absence of clinical staff on the scene when the incident occurred.
Chris Liddy, Chief Operating Officer of Advanced Trauma Solutions, and the mental health consultant for the OCA report, said that line staff should be better trained to handle and defuse these situations until clinical staff can intervene.
"What's critically important is that the line staff are equipped, that they are competent, and that they fully understand how to integrate these skills and concepts with the youth on the floor," said Liddy.
Following the OCA's report in July, DCF implemented a set of emergency measures to address many of the problems at CJTS and Pueblo, including adding more clinical staff at both facilities.