On October 10, 2007, the U.S. Government Accountability Office (GAO)--a federal governmental entity that audits, evaluates and investigates for Congress--released a report on residential treatment programs (RTPs) entitled Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth. The report revealed widespread incidents of sometimes fatal child abuse among the programs.
The numbers in the report are heart wrenching. Even though the GAO admitted that the report might not be comprehen-sive due to a lack of any national regulatory agency, Web site or clearinghouse for regulating the programs or reporting abuse of program participants, it found allegations of child abuse involving 1,619 staff members in 33 states occurred be-tween 1990 and 2007. These cases were discovered by searching the Internet for Web sites making child abuse allegations, reviewing the National Child Abuse and Neglect Data Systems, and reading relevant federal and state civil and criminal court documents. Because of the methodology of collecting information, it was impossible to tell the difference between public and private programs, so allegations involving both types of programs were presented together. The report also examined in de-tail ten cases where participants in private programs died and all legal proceedings had been completed.
Three overlapping types of residential treatment programs were included in the study: Wilderness Therapy Programs (WTPs) and boot camps emphasize removal from “distractions” and “temptations” of modern life, forcing the teens to fo-cus on themselves and relationships. WTPs place the teens into primitive conditions, teach basic wilderness survival, re-quire physically strenuous activities such as multi-day hikes and require participants to keep a journal while in the pro-gram. The journals, which are read by staff, are used in individual and group therapy. Boot camps use strict discipline and military-style regimentation as their dominant principles. Often they emphasize austere living conditions and severely limit the personal property allowed to participants. The third type of program, boarding schools or academies, generally offer academic education and often include security fencing and other measures designed to keep unwilling participants from leaving the facilities. Each type of program may include elements of the other types and some programs include separate wilderness therapy, boot camp and boarding school options. Most of the programs offer ancillary services, including transportation services in which a group of staff members transport the unwilling teen to the program to prevent flight by the teen should the teen discover the parents’ intent. Each program has one common denominator--the participants are not free to leave--they are prisoners.
The report found an appalling lack of coordinated regulation of RTPs. Some states require licensing of RTPs, other have no oversight of the programs. In some of the license-requiring states, the licensing function is centralized in one agency, in others it is spread among several agencies. There are no federal laws to define and regulate these programs although three federal agencies administer programs that can provide funds to states to support some RTPs.
Some of the programs limited participant’s intake of food and water while requiring them to engage in physically strenuous activities. Some programs misrepresented the qualifications of instructors, staff to participant ratio and ability of the program to deal with special needs children (e.g. those with medical problems such as a prior head injury or psychological problems such as suicidal tendencies) or medical emergencies. Often serious medical conditions were shrugged off by staff who believed the teen was “faking it” to get out of the program. Lack of adequate nourishment was also a theme in many of the allega-tions of abuse. One program gave participants who were involved in a multi-day hike only one apple for breakfast, a carrot for lunch and a bowl of beans for dinner.
One of the saddest aspects of the report is that parents paid huge “tuition fees” to the programs to have their children abused. Frequently they had to take out a second mortgage to pay between $164.00 and $438.00 per day. The programs claimed these funds paid for highly-trained staff and state-of-the-art equipment, but often this was not the case. The ten deaths studied by the GAO revealed a pattern of poorly-trained staff and inadequate facilities that lead to the teens’ deaths.
A typical scenario in the death cases was as follows: a teen participant falls ill due to dehydration, malnourishment, hyperthermia (excessive body heating) or complications from a spider bite. The staff ignores the teen’s medical condition (which can include dizziness, vomiting, eating dirt and/or soling oneself)--often for days--until the teen collapses.
Some-times the staff continue to believe the teen is “faking” until there is no pulse detectable. Finally, emergency medical help is summoned (or not, if the teen is in the wilderness and the staff has failed to bring along qualified medical personnel, a first-aid kit or a radio). However, the medical help arrives too late and the teen is dead or dies soon thereafter. This de-scribes seven of the ten death cases investigated.
The other three involved a suicide after staff ignored self-mutilation and known suicidal tendencies; a fatal fall on a dangerous hike which had been understaffed and not scouted in advance; and a fatal injury caused by staff who held the teen face-first on the ground for 45 minutes until a major blood vessel in the teen’s neck ruptured.
An interesting GAO finding was that the owners and staff involved in the deaths of program participants were rarely prosecuted for crimes. Often they closed the program only to open another under a different name in a different state or go to work for another program. One program owner was involved in three of the ten death cases investigated by the GAO.
All in all, the situation in the programs was well summed up by Rep.
George Miller, D-CA, Chair of the House Commit-tee on Education and Labor and sponsor of a bill intended to encourage the states to regulate RTPs.
“This nightmare has remained an open secret for years,” said. Miller. “Congress must act, and it must act swiftly.” The report is available on PLN’s website.
Additional Source: USA Today.
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