Discovery Ranch staff failed 17-year-old boy before his death, family alleges in legal notice

Editor’s note • This article discusses suicide. If you or people you know are at risk of self-harm, call or text 988 to reach the Suicide & Crisis Lifeline for 24-hour support.

The family of a 17-year-old boy who died at a Utah County teen treatment center earlier this month alleges that medical malpractice and staff negligence led to his preventable death, according to two legal notices filed Monday.

The boy, Biruk Silvers, was living at Discovery Ranch Academy in Mapleton when he died by suicide on Nov. 5, according to authorities. His parents, Kathryn and Joshua Silvers, now allege that a belt “provided by or allowed by” staff contributed to his death, according to a copy of a notice of claim provided to The Salt Lake Tribune.

A notice of claim is a required “first step” in Utah before beginning legal action against a state entity, such as the University of Utah, said Alan Mortensen, the attorney representing the family, during a Monday news conference. In this case, the family intends to sue Discovery Ranch and several staff members, including staff psychiatrist Jonathan Birnkrant, who is employed by the U., which is also listed as a respondent.

The family on Monday also filed a request for the allegations to be heard by a screening panel that must review potential medical malpractice cases brought against health care providers in Utah.

When Biruk checked into Discovery Ranch in April, he did not bring a belt with him and a belt is not listed on the inventory of items that residents should bring when admitted, the family says in its notice of claim.

The notice also alleges staff at Discovery Ranch knew about Biruk’s plans to self-harm for “over half a month” but “failed to recognize clear signs of escalating mental health crises, ignored suicidal ideations, and inadequately addressed Biruk’s needs.”

In an email Monday, Discovery Ranch’s executive director, Clinton Dorny, said the facility has been “fully cooperative and transparent with the authorities and their investigations.” Dorny, who is also named as a respondent, previously shared the same statement with The Salt Lake Tribune on Nov. 8.

“We are deeply saddened by the loss, and we grieve with the family,” Dorny said.

Mapleton Police and the Utah Department of Health and Human Services continue to investigate the boy’s death, officials said, but they said they were not aware of the family’s allegations ahead of the Monday news conference.

“We just don’t understand how [Biruk] could have been left alone,” said Mortensen in a call with The Tribune on Thursday, “especially from a facility that markets itself for these types of children to come and be protected and get real treatment.”

Months of concerns

Biruk was sent to live at Discovery Ranch on April 17 by his parents to receive treatment for his depression, suicidal ideation and trauma, according to the notice. It said the parents believed the facility to be a “safe and supportive environment.”

But days after he arrived, the family says, Biruk shared during a call with his parents and a licensed mental health counselor — William Perry Garso, who is also listed as a respondent — that he was allegedly “choked and tackled” by a relative of an employee of the center. The alleged assault, the notice of claim alleges, was not disclosed by the center to the parents or authorities. The parents say they received a report about it only after demanding it from Discovery Ranch.

Months later, on Oct. 14, Biruk’s mother emailed the same counselor expressing frustration over what she felt was a lack of communication from the boy’s psychiatrist, Birnkrant.

On Oct. 17, during another family call with Biruk and the counselor, the parents asked whether their son had started taking any medications as part of his treatment. The next day, Biruk was prescribed Lexapro; when the parents expressed concern that Lexapro can carry a heightened risk of suicide for those under 25, they were “dismissed,” the notice states.

The notice states that on Oct. 23, during a session with Birnkrant about two weeks before the boy died, Biruk disclosed a “detailed plan” to die by suicide, according to the notice of claim. He also expressed feelings of hopelessness, worsening depression and ongoing suicidal ideation.

But Birnkrant, who only met with Biruk virtually, did not instruct staff to initiate one-on-one supervision with Biruk and did not disclose Biruk’s thoughts to his parents or authorities until after his death, the notice alleges.

Instead, he made a note to “check in” with Biruk one week later, the notice states.

On the same day, the parents also met for another family call with Biruk and Perry Garso. During the call, Biruk did not mention suicidal ideation, depression or a plan for self-harm, the notice states. But he did tell them that he had been playing a game that involves using a belt to temporarily deprive the brain of oxygen.

According to the notice, Biruk said he engaged in the “life-threatening” activity after counseling sessions “10-20 times a day for over a week.” When the parents expressed worry, the counselor told them it was “low on the totem pole of concerns,” the notice states.

Perry Garso was not aware at the time that Biruk had disclosed a plan to die by suicide to Birnkrant. The counselor later reported that he did not become aware until Nov. 4, the day before Biruk died, when he signed off on a report from Birnkrant, according to the notice.

Kathyrn Silvers, who adopted Biruk and his brother from Ethiopia, said she grew more and more concerned, sending about 25 emails to Discovery Ranch staff in the nine days before her son’s death, some of which noted their son appeared disengaged during family calls and that she and her husband worried about the seemingly worsening effects of his medication.

Birnkrant ultimately recommended doubling the medication dose, the document notes. On Nov. 1, the boy again disclosed a plan to die by suicide and possibly harm others, which Birnkrant again did not relay to his parents, the notice alleges.

“We were assured we would be partners in his care and kept informed every step of the way,” the mother said during a Monday news conference. “But they broke that promise. They kept us in the dark about the very things we needed to know to protect our son.”

When Biruk died, he had been left alone with no staff present as fellow teens participated in “another activity,” the notice states. His parents allege he either carried out the self-harm plan he had previously disclosed or accidentally died while playing the game which they contend staff knew he was playing.

The day after his death, Dorny explained in an email to Biruk’s parents that Discovery Ranch allowed teens in the facility to have belts so that their “cracks would not show,” the notice states.

In an email to The Tribune, a DHHS spokesperson noted that facilities are required to ensure “client health and safety,” but belts or other “basic everyday items” are not specifically restricted.

The parents contend the facility failed to supervise their son, failed to communicate critical information, mismanaged his medication, minimized self-harm behaviors, failed to act on psychiatric evaluations, neglected his medical needs and breached parental trust, as well as other allegations, according to the notice.

As of Monday, DHHS has not issued a compliance notice to the treatment facility. In an email to The Tribune, the agency spokesperson said licensed providers are required to develop and follow policies around suicide prevention.

They are also required to report “critical incidents” to a client’s guardians within 24 hours of occurrence. “Critical incidents” do not include suicidal ideation but can include medication errors, an allegation or confirmation of abuse or neglect, and the death of a minor.

“To any parent considering placing their child at Discovery Ranch Academy, we have a clear and urgent message to you: don’t,” Biruk’s mother said Monday, sitting next to her husband and a childhood photo of their son. “Discovery Ranch markets itself as a therapeutic haven for vulnerable children, but it is anything but. They failed to protect our son when he needed them the most, and his loss is a tragic reminder of how easily vulnerable children can fall through the cracks when those responsible for their care don’t do their duty.”