Abusive residential programs

sipriano-89Two stories from the past, but in the news this week, resonate with implications for today's services for troubled youth. The first was the NPR story of the laundries run by the Catholic church to which thousands of young Irish girls were sent for minor transgressions. The second piece, in the New York Times today, about the suspected deaths from years of abuse at the Arthur G. Dozier School for Boys in Florida, reminds us that this is not just a story about the unquestioned authority of the Catholic Church in Ireland. It is a story about a lack of oversight, a lack of checks and balances, and thousands of employees and consumers who somehow never managed to get the truth out during the time when it could have mattered most.

It is also a reminder that in our own era, such scandals continue to brew. A few years ago, journalists, former consumers, and a small number of academics began to write about unregulated residential programs for youth. The most troubling of these programs shared several commonalities. They offered discipline oriented programs in remote areas. They separated children from families. They claimed to cure an incredible range of problems. They only operated in jurisdictions where there was no state oversight. They offered to "escort" youth to the facility by barging into their rooms in the middle of the night and taking them away. Kids suffered consequences if they complained to their families about their treatment. There were no licensed mental health professionals involved. They diagnosed your child's problem over the phone. They cost a lot of money.

A rough outline of an organization, the Alliance for the Safe Therapeutic and Appropriate Use of Residential Treatment was started out of the University of South Florida. I went to one of their presentations at a children's mental health conference in Tampa. It featured a teen who told her story of emotional abuse. I came out convince the abuse was real and that this was a cause that deserved my time and attention.  A book, by a freelance journalist, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids, by Maia Szalavitz, briefly caught some press attention. A GAO report, issued two years later, echoed the same concerns. Today, the ASTART website serves as a resource for parents considering residential treatment for troubled teens. It advocates for federal oversight of residential programs to overcome state resistance to providing this oversight, as the residential industry and some religious organizations oppose any attempt to regulate this industry. It offers no data that the abusive programs have been reined in or run out of town.

As the reports on past abuses in Florida and in Ireland demonstrate, facilities where such abuses occur require codes of silence, strong barriers to keep the public at bay, and an imprimatur of authority. The capabilities of the internet, coupled with the presence of oversight inspectors, offer the best defense against such abusive programs.


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