Residential treatment programs for young people with behavioral or
emotional problems need increased state and federal oversight to eliminate
abusive and unproven treatment practices, said mental health advocates at a
meeting last month at the U.S. Capitol.
While many beneficial programs exist, many others are not accredited or
licensed, according to psychologist Robert Friedman, Ph.D., a professor of
child and family studies at the University of South Florida in Tampa."
Some of these programs are exploiting the desperation of parents and
mistreating the youth they serve."
At a meeting for Capitol Hill staffers, Friedman and others supported one
bill (HR 1738) to allocate funds to help states license and regulate these
facilities and a second (HR 823, S 380) to end custody relinquishment as a
requirement for coverage by public insurance programs.
Few data exist on the number of children sent to such programs or their
effectiveness, said Friedman. Regulatory policies vary, with some states
requiring licensing and others having no oversight at all. Fewer than 12
states regulate these programs.
At issue are unregulated facilities using methods with no grounding in
research or conventional practice, said Charles Huffine, M.D., of Seattle, a
past president of the American Association of Community Psychiatrists. These
programs offer only cursory assessment of new residents, followed by issuing
diagnoses that frighten parents into committing their children to the
facility. Young people are isolated from their families and then get unproven,
confrontational therapies. Several deaths have been reported, as well.
"Abuse is sold as treatment," said Huffine. "It's
advertised as `behavioral therapy' but as a researcher, I can tell you it has
nothing to do with behavioral therapy."
Parents often are so desperate for help that they fail to check the
credentials of program staff and are easy prey for fear-mongering sales
tactics. They end up paying thousands of dollars a month in the hope that
something will help their children.
Because these are private entities and not public institutions, they
function as parental surrogates.
"Kids have no rights and no diagnosis and can be sent away to age
18," said Huffine.
The offending residential treatment programs inhabit a nebulous world where
data are not easy to find. Many are set up to avoid regulation by mental
health, drug abuse, education, or child welfare authorities, said Maia
Szalavitz, a freelance journalist and the author of the forthcoming Help
at Any Cost: How the Troubled Teen Industry Cons Parents and Hurts Kids
(Riverhead Books, 2006), in an interview.
"We have more regulations for chickens then we do for these
kids," said Szalavitz.
Even the numbers are hazy. There may be 100 programs of concern, housing
10,000 to 20,000 children, and bringing in $1 billion a year in fees,
Szalavitz estimated. Many are based on outdated, abusive "attack
therapies" popularized in the 1970s by organizations like Synanon. The
programs often promote harsh discipline, deprivation, betrayal of peers, and
isolation from family. Some set up branches outside the United States, both to
escape regulation and to distance children from parents.
At present, any regulation is up to state attorneys general. In August, the
New York attorney general ordered one such boarding school, Ivy Ridge, near
the Canadian border, to refund $1 million to parents for "grossly
misrepresenting academic credentials." Despite its claims, the school
was not accredited and had no authority to issue the 113 high school diplomas
it handed out to students. The school is affiliated with the World Wide
Association of Specialty Schools, a group of seven schools in the United
States and abroad that have been investigated for allegations of child abuse,
according to the Salt Lake City Deseret News.
Passage of HR 1738, the End Institutional Abuse of Children Act, sponsored
by Rep. George Miller (D-Calif.), would provide $50 million to the states to
license and monitor programs, establish penalties for child abuse within them,
and require the State Department to report any abuse of American children
overseas, said Tammi Seltzer, senior staff attorney at the Bazelon Center for
Mental Health Law in Washington, D.C. The Government Accountability Office
should also investigate treatment practices and credentialing in the industry,
"For the first time, mental health stood up and opposed these
programs," said Szalavitz. "They need to be delegitimized by the
psychological and psychiatric establishments."
More information on residential treatment programs for children is