Struggling teens and their families, desperate for help, find themselves trapped in a shadowy industry that cons parents and abuses children. With a mental health crisis and lack of adequate services available, the Troubled Teen Industry has found an opportunity to prey upon children and their families. The concept of “tough love” has become a profitable, unregulated business model and children have become a commodity.

The “Troubled Teen Industry” is a network of Private Youth Programs, Therapeutic Boarding Schools, Residential Treatment Centers, Religious Academies, Wilderness Programs, Bootcamps, and Drug Rehabilitation Centers.

Thousands of youth are held captive by the Troubled Teen Industry every year. With a lack of government oversight, these highly profitable facilities are allowed to operate with near impunity. Children, as young as 5 years old, can be held against their will in facilities for years. Due to the lack of Federal oversight defining comprehensive industry standards, most facilities are not properly regulated by government agencies. Without oversight, this approach of totalistic treatment often results in institutional child abuse.

These Private Youth Programs claim to rehabilitate defiant teens and instill strict values. The reality is a fraudulent industry, based on false claims. Deceptive marketing tactics are used to convince desperate parents that long-term residential treatment is the only option. These specialty programs exceed the tuition of most Ivy League Universities and burden taxpayers who unknowingly fund these institutions through Medicaid, local school districts, social services or juvenile justice.

Countless former students from facilities within the Troubled Teen Industry have reported serious allegations of abuse and lasting negative psychological effects. In spite of the prevalence of abuse complaints, state agencies fail to investigate or regulate problematic programs, which often reopen and re-brand once exposed, in order to escape their negative reputations.

ICAPA NETWORK

The Institutional Child Abuse Prevention and Advocacy Network is dedicated to authoring and supporting legislation aimed to reform the troubled teen industry and protect youth from institutional child abuse.

We advocate for a systemic change in the standards of mental health care and addiction services for youth. We defend the civil rights and safety of youth and argue for the standardized use of ethical, evidence-based methods of treatment.

Our mission is to bring an end to institutional child abuse.

WHAT IS INSTITUTIONAL CHILD ABUSE?

The term “institutional child abuse” means-        
    (i)      child abuse or neglect by a person who is an employee of a public or private institution; or        
    (ii)     institutional practices, policies, or conditions that are reasonably likely to result in child abuse or neglect.  

When referring to institutional child abuse, we must first define what constitutes abuse in a therapeutic setting. Many private youth programs use behavioral modification models which focus on compliance and control. These methods can be cruel, unethical, and blatant violations of human rights. Use of such negligent procedures often lead to physical abuse, sexual abuse, and psychological trauma. The use of these methods listed below and their resulting trauma is what we refer to as institutional abuse.

Physical Abuse

• Physical/Mechanical restraint and use of Prone (face-down) and pressure point restraints;
• Misuse of restraint as punishment.
• Use of chemical restraint methods (such as injection of heavy sedatives).
• Use of electroshock techniques for the intent of behavior control.
• Stress positioning/infliction of physically painful punishments.
• Improper usage of medication that results in overmedication/sedation.
• Use of extreme and/or long periods of calisthenics that result in exhaustion and dehydration.

Psychological Abuse

• Behavior Modification utilizing a punishment-based behavior control.
• Solitary confinement/isolation
• Social ostracism – Not allowed to speak nor non-verbally communicate with others
• Utilizing higher-level students to police and punish lower-level students.
• Lack of proper social interaction, prolonged periods of silence where speaking results in punishment.
• “Attack therapy”
• The use of “cruel and unusual punishments,” punishment that is carried out in a way that humiliates, hurts, or psychologically affects the subject.

Sexual Abuse

• Forced medical procedures/pelvic exams/abortions.
• Strip searches are used repeatedly or as a manner of humiliation.
• Sexual abuse, forced sexualized behavior, sexual shaming.
• Any of the methods used above for the sole purpose of “conversion therapy” or for any reason to discourage sexual orientation or chosen gender identity.
• Lack of trauma-informed care for sexual abuse survivors.

 Neglect

• Deprivation of sleep, adequate nutrition, and access to proper hygiene.
• Overcrowding in conjunction with unsanitary living conditions.
• Denial of clothing, including weather-appropriate attire.
• Denial of adequate medical care, in a timely manner, by a licensed clinician.
• Denial of necessary medical treatment/procedures/medications.
• Being denied access to school
• forced labor during school hours.

Denial of Basic Human Rights

• Admittance without consent or due process by involuntary and forceful transport to the facility.
• Denial of direct and unmonitored communication with law enforcement, legal representation, and child protective services.
• Monitored phone calls with parents and retaliation, if abuse is reported.
• Mail censorship.
• Forced labor.

Lack of Transparency and Accountability

• Operating as a private/unlicensed/unregulated “treatment center” without being subject to the regulation of clinical standards inpatient care.
• Accredited by Program Trade Organizations that DO NOT properly monitor or enforce standards of care to ensure the safety and wellbeing of all students. Often spearheaded by the program owners themselves and only misrepresented as a third-party “accreditation” agency. Membership status does not depend on proof of standards being met, the only requirement is a payment of dues. Agencies such as (but not limited to):

NATSAP – National Association Of Therapeutic Schools and Programs, NWAC – Northwest Accreditation Commission, NAAS – Northwest Association of Accredited Schools, OBHIC – Outdoor Behavioral Healthcare Industry Council, ACRC – Association of Children’s Residential Centers.

THE URGENT NEED FOR REFORM

With a history of abuse, neglect, and wrongful deaths within the “Troubled Teen Industry” the urgency for reform to protect youth from institutional abuse is imperative.

After the California Department of Social Services announced that they were bringing all youth in out-of-state placements home by 2021 (due to rampant abuse at facilities) they began scrambling to find appropriate placements for their returning youth. Like California, other states such as Utah, Washington, and Texas have been forced to look at the limitations of services within their state and insufficient oversight that has led to ongoing systemic abuse in residential settings. With these issues being brought to the forefront of state agendas in recent months, it is the right time to develop new standards and systems.

In years past, we have supported attempts at attempted investigation and reform of the Troubled Teen Industry.

This included the GAO Reports on “Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth” which resulted in Congressional Hearings Chaired by Sen. George Miller.

Additionally, we supported the previously proposed (status: stalled) federal legislation The Stop Child Abuse in Residential Programs for Teens Act.

Only an inconsistent patchwork of state-to-state oversight exists to regulate this multi-billion dollar industry. Loopholes and exemptions in licensing have allowed many programs to fall through the cracks. While some states have outlawed some abusive practices, the majority have not. Some states attempt to protect youth from institutional abuse within their borders, yet, those rights and protections are circumvented after placing the child in an out-of-state program that does not operate under ethical regulations. In order to ensure the safety of every child in this country, we must utilize federal legislation to address the current inconsistencies in regulation, mandate minimum industry standards, and create regulatory systems that will be effective at protecting youth from institutional abuse.

We advocate for federal funding to be allotted to research the industry, identify industry problems, and develop protection systems to prevent institutional child abuse.

The Child Abuse Prevention and Treatment Act provides States with Federal grants to address the prevention and treatment of child abuse since 1974. By amending and reauthorizing CAPTA to include the definition of institutional child abuse and incentivizing states to address the prevention and treatment of institutional child abuse and neglect; we can empower our states to address the systemic abuse that many children are facing in residential care. See: Child Abuse Prevention and Treatment Act

We support a federal ban on the use of restraints that impair breathing or communication,  and seclusion. The use of these methods are archaic, dangerous, and unnecessary. As a result, they create an environment of violence and oppression that is often used as a means of control and coercion in the program. Programs frequently report that restraints are only used in the event that youth are a “danger to themselves or others” as this is the law that dictates their use of the method. However, evidence shows that restraints are often used as a form of punitive punishment. The use of bent wrist, limb submissions, and prone restraints are violent, painful, sometimes fatal. We advocate for a federal standard of training for all staff in the use of non-violent crisis intervention and de-escalation techniques. See: Keeping All Students Safe – 2021

We support any legislation aimed to protect the LGBTQ+ youth community from discrimination and abuse. In CA we were able to pass such a law with the California Community Care Facilities Act.

We advocate for the elimination of religious exemption loopholes that allow for facilities to operate with impunity.

 “WEST COAST PACT”

According to an article recently published by the Salt Lake Tribune, within the last 5 years, California has sent 3,846 kids to Utah, the Troubled Teen Industry’s top producer. Utilizing data collected from the Interstate Compact on the Placement of Children we can ascertain a total amount of 11,767 children were sent to Utah’s Troubled Teen Industry from out of state in the last 5 years. averaging a $60,000 year contract for each, this equates to $141.5 Million in annual revenue. These are funds that could be more appropriately utilized within the communities of the displaced children, to provide the least restrictive, evidence-based, outpatient services.

We propose a pact to retain all out-of-state placements for a standardized review and approval process by the sending states before any child is to be sent out of state for residential treatment. We propose an amendment of the current Interstate Compact on the Placement of Children laws to delegate the application approval from the receiving state (current) to the sending state. We propose to establish an approval process that includes training of placement officers, a rigorous approval process with a third-party medical assessment, and transparency with out-of-state placement.

Through this pact, we propose to:

• Establish a set of standards across to address out-of-state youth placement specifically addressing: Parent choice programs/Educational Consultants, IEP placement, foster youth placements, and juvenile justice alternative placements.
• Require tracking and notifying ALL states of placements, transfers, and any incidents or complaints against institutions. Develop a database to make this information available to each state’s departments and any substantiated complaints against the institutions public.
• Close religious exemption loopholes that allow Private Youth Programs to operate unlicensed and unregulated by the state.
• Work with Insurance to require licensing and standards of care for approval of coverage
• Research and develop resources for families to access community-based mental health care
• Allocate funding for research and development of the least restrictive, evidence-based therapy for teen behavior issues, addiction, and family dynamics.
• Outlaw the use of escort companies to transport children to placements out of state and any country outside the US.
• Restriction of all out-of-state placements until the internal approval process is completed by both sending and receiving states.
• Absolute ban on all placements/transfers outside of the US. (This may exclude private adoptions, but will not exclude foster care placements into youth care facilities.)
• Institute temporary measures to retrieve children placed out of state in residential treatment facilities.
• Assess all currently placed children and alternatively offer community-based services, or transfer them to facilities within the home state that adheres to the pact’s standardized care.

CONCLUSION

Our policies have been developed through decades of collaboration with survivors of institutional abuse and youth advocates. The collective experience within the survivor community is a testament to the reality that the system in place is flawed and reform is a matter of immediate necessity. Without a national standard of care for youth in place, our most vulnerable youth will continue to suffer as casualties to corporate greed. It is time to stand up and demand transparency and accountability in order to protect youth from institutional abuse and ensure that youth are provided with safe, ethical, and evidence-based care.

LEGISLATIVE RESEARCH

• CAPTA – Child Abuse Prevention and Treatment Act
• SCARPTA – The Stop Child Abuse in Residential Programs for Teens Act 
• ICPC – Interstate Compact on the Placement of Children
• KASSA – Keeping All Students Safe Act
• The California Community Care Facilities Act