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A Look at Private Residential Treatment Facilities for Youth

FMHI Interim Dean Robert Friedman was quoted in the October 23, 2006 issue of People Magazine. Maria Eftimiades' article, School of Last Resort, profiles a boot camp for troubled teens and shares several views from child-development experts, including those of Friedman.

Over the past decade in the United States, hundreds of private residential treatment facilities for youth have been established, and many are neither licensed as mental health programs by states, nor accredited by respected national accrediting organizations. Unfortunately, reports from a number of these programs reveal that a significant number of children are being mistreated, and in some cases, are even dying in them.

In order to address the rising concerns of mistreatment and financial gain at the expense of desperate parents, a multi-disciplinary group of mental health professionals and advocates formed the Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START). A START was initiated in 2005 as a collaborative effort involving the Louis de la Parte Florida Mental Health Institute (FMHI) at the University of South Florida and the Bazelon Center for Mental Health Law. A START members, including FMHI interim Dean Robert Friedman and Allison Pinto from the institute’s Department of Child & Family Studies, recently contributed to an article published in a special issue of the American Journal of Orthospychiatry focused on residential treatment for children and adolescents. The Journal is dedicated to informing public policy and professional practice and expanding knowledge related to human rights and social justice.

Unlicensed Residential Programs: The Next Challenge in Protecting Youth reviews the licensing, regulatory and accrediting procedures associated with the protection of youth in residential programs, or the lack thereof. It describes a range a mistreatment and abuse described by youth, families and journalists, listing poor quality education, harsh discipline, inappropriate seclusion and restraint, unqualified staff, medical and nutritional neglect, rights violations and even death. The article also outlines policy implications and provides recommendations for the protection of youth and families who pursue residential treatment.

“A START recognizes that residential treatment is an appropriate placement for some youngsters and that there are high quality programs being administered by committed and competent staff,” write the authors, “and therefore does not wish to see residential options eliminated, but believes that there is a great need to understand more specifically about unlicensed and non-accredited programs and their level of effectiveness.” The programs of concern are typically proprietary, for-profit programs and may be campus-based or wilderness-based; may call themselves schools, camps, programs, or centers; and are spread around the country.

A START gathered information from a variety of print and electronic media, interviewed and surveyed state policy-makers, reviewed existing state documents and statutes, talked with parents and children who have been directly involved with the residential facilities, and consulted with former staff members of the programs.

The article ends with the recommendation that “a powerful and effective response to this latest trend in residential care is now needed if we are truly committed to safeguarding and promoting the well being of youth and families.” For additional information, visit the American Journal of Orthopsychiatry website, or contact Allison Pinto, PhD at 813-974-9179, or apinto@fmhi.usf.edu

Authors of Unlicensed Residential Programs: The Next Challenge in Protecting Youth.
Friedman, Robert M.; Pinto, Allison; Behar, Lenore; Bush, Nicki; Chirolla, Amberly; Epstein, Monica; Green, Amy; Hawkins, Pamela; Huff, Barbara; Huffine, Charles; Mohr, Wanda; Seltzer, Tammy; Vaughn, Christine; Whitehead, Kathryn; Young, Christina Kloker

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