Sep 4, 2016

“Treatment Centers” for Troubled Teens Are Gothic Nightmares

Slate.com
Nora Caplan-Bricker
August 24, 2016

Most residential treatment centers that promise they can turn around the lives of troubled teenagers are dangerous places with a proven track record of making things worse, according to a disturbing longread published Tuesday by the Huffington Post.

Reporter Sebastian Murdock tells the appalling story of a facility in Utah, formerly known as Island View, and now, under new management, called Elevations RTC. But the takeaway from his extensive reporting is that the options pushed on struggling parents may be hurting, not helping, their at-risk kids. The authoritarian tack that most centers take won’t turn their charges into functional adults, Ira Burnim, legal director of the Bazelon Center for Mental Health Law, told HuffPo. “You can teach them to be compliant in an institution because they get the reward of ... getting out,” he said, “but once they get out, it’s the same old problem, and they haven’t learned how to better manage their condition.” Worse, these centers often deeply traumatize their inhabitants. A 2014 lawsuit against Island View’s parent company, Aspen Education, alleged that the center “maintained a prison-like environment where physical and psychological torture were used against students,” Murdock writes. As one former Island View resident, a 25-year-old named Michelle Lemcke, told him: “Long-term treatment facilities are like ... a jail without having done anything illegal.”

Anyone who wishes to understand the gothic list of abuses suffered by Island View’s teenage residents should read Murdock’s piece, but even a brief perusal is enough to make the blood run cold. A former staff member named Vlad Diaz who quit in 2008 told the journalist that he “wouldn’t treat a dog” the way he was ordered to handle the children. He claimed he saw multiple kids attempt suicide at the facility. One former resident told Murdock about being strip-searched on arrival; when he refused to remove his piercings, he said, “They restrained me on my back and physically removed each one of my piercings, which tore my flesh open … I still have scars from it.” Teens were required to publicly criticize and humiliate one another during so-called Problem Solving Groups. They were harshly and physically restrained by staff; one family sued unsuccessfully in 2014 after the guards “mangled [a student's] arm, causing severe and irreparable orthopedic and neurological damage,” per the suit. Murdock also found that staff’s policy was to sedate students with high doses of antipsychotics—drugs whose efficacy at combating conditions like depression and bipolar in adolescents has never been established.

Perhaps worst of all, though, was the “time-out room,” described by Murdock as a “small white chamber, approximately 4 by 4 feet, with a large metal door,” where students were subjected to solitary confinement—a disciplinary tactic whose use on juveniles is outlawed in federal prisons because of its harrowing psychological effects. The doors remained unlocked when the students were inside, but staff monitored them from the other side. A site inspector for the Utah Department of Human Services told Murdock that the rooms were a place for struggling students to “cool off,” not a punishment—but that’s not what the reporter heard from Island View’s former charges. One of his sources, Emily Graeber, told him she can’t expunge the mental image of her friends trapped in the tiny cells. “I’m still really haunted by the screams,” she said. “Sometimes I have nightmares just from the screaming.”

Much of this torture was probably legal. “The troubled-teen industry is almost entirely unregulated,” Murdock writes. “In 2011, a federal bill that would have banned physically abusing or starving children at such facilities died in committee. … [L]ike most states, Utah has no rules outright prohibiting isolation, humiliation or physical restraint. So facilities like Island View still can—and do—isolate, humiliate and physically restrain children. In many states, they can withhold food and water as punishment.”

So what should be done to reform nightmare institutions like Island View? Murdock suggests that the answer is to abandon this failed model altogether. Instead, parents of disturbed children should be able to get the support and expert guidance necessary to keep their young ones at home. There is a “virtual national consensus among people in the mental health field that children with mental health difficulties and behavioral problems should be treated at home,” Burnim, the mental health law expert, told Murdock. “I don’t think you need to legislate against RTCs. You just need to create an alternative that sells itself.” Of course, that’s easier said than done.

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