The Kids Are Not Alright, We Could Do Better for Them
The Unregulated Troubled Teen Industry
At Curing Crime, we are rarely prescriptive. Frankly, neither of us is qualified to suggest, design, and implement policies related to the subjects that we write about. We add value (we hope) by using a historical lens to study events in the past that highlight concerns, questions, problems, lessons, and successes. Understanding these can help others think more clearly about the present. This column is a brief departure from this style.
This week, we make an emphatic call for reform and regulation.
The Troubled Teen Industry needs to be better regulated to avoid the suffering, traumatization, and abuse of vulnerable children and teenagers.
Programs aimed at helping troubled teens claim they can transform wayward adolescents into ideal citizens by changing their behavior and attitudes. However, there is no consensus regarding what makes a teen troubled, which we find troubling. These teens exhibit allegedly undesirable behaviors, may have participated in illicit acts, or may merely be deemed to be at risk. There is no nosology when it comes to troubled teens.
While this is primarily a US phenomenon, similar centers operate in other countries. According to a study by the US Government Accountability Office, this industry is largely unregulated (GAO, 2007). There have been several calls to regulate it, and a congressman has introduced a bill that, though insufficient, would be a first step. Program survivors have demanded reforms.
In 2019, it was estimated that over 57 thousand young Americans were interned in centers dedicated to the rehabilitation of so-called troubled teens (Chatfield, 2019). Another 50 to 70 thousand reside in some kind of treatment center. We are NOT implying that ALL these centers are a problem, but rather that lack of oversight and efforts to use best practices is a prescription for disaster.
Teens Injured and Dead at Treatment Centers
Earlier this year, a boy died at a wilderness camp run by Family Help and Wellness, which operates ten treatment centers across the US (Kingkade & Chuck). The wilderness camp called Elevations Residential Treatment claimed that it provides “guidance, support, and relief to students of all genders” in an allegedly safe place (Kingkade & Chuck). Recently, a news article reported that two former students claimed to have “incurred serious injuries while being restrained by staff” (Kingkade & Chuck).
Recently, a 12-year-old suffocated to death after being forced to sleep in a weatherproof sack at Trails Carolina (Kingkade & Chuck). Family Help also owns this center. Just last week it was reported that no criminal charges would be filed.
These kinds of institutions need to be more regulated and controlled. Several such organizations have failed to notify authorities about “critical incidents” such as injuries, abuse, and preventing children from contacting regulatory agencies (Kingkade & Chuck). NBC interviewed several people who had been at Elevations. They described them as poorly staffed and chaotic. Their testimony suggested that physical restraint and self-harm were common occurrences (Kingkade & Chuck).
A few vocal organizations track problems at centers that wrongly claim to help teens. You can see the work of Unsilenced, which tracks deaths.
Elevations: Saving Grace or House of Horrors?
Many of these centers continue to claim that those who complain are unreliable or avoiding help. The Seed, one of the first such centers, used to say that troubled teens would say anything to avoid facing their problems. In 2022, Elevations issued a statement decrying critics as unreliable narrators. Their lawyer stated that the organization had helped 700 children and provided hope to families that had “exhausted all other options to help their child” (Kingkade & Chuck). Despite these claims, the police reported getting even more calls from teens interred there (Kingkade & Chuck). For example, there were “at least 105 incidents of self-harm and 138 uses of physical restraints” between May 2023 and May 2024. Elevation uses a facility that initially operated under a different name until it was bought and rebranded. The previous operation was also allegedly abusive (Kingkade & Chuck).
Some states have even used state money to help parents pay for their children to go to Elevations. After this center failed to disclose allegations of sexual abuse, the state of California finally demanded evidence that Elevations provided adequate training to their staff (Kingkade & Chuck). To our knowledge, no such evidence has been provided. Elevations charges each family 500 USD per day per child (Kingkade & Chuck).
A New Hope Dashed: Congress Considers Bill to Protect Children
Current regulations allow many of these centers to operate with little oversight. For example, Katie England from the Department of Health and Human Services in Utah said that they do not have the “statutory authority to use facility violations or adverse incidents in other states” when making decisions about licensing in their state (Kingkade & Chuck). Therefore, a parent company found guilty of gross violations in one state can continue to operate without consequence elsewhere. The GAO Report and work done by Chatfield, Szalavitz, newspapers, and a few organizations demonstrate that this is still a problem.
The Stop Institutional Child Abuse Act (HR 2955, SICAA) is a bill that attempts to protect children from institutional abuse. The short bill was referred to the Subcommittee on Health. Even if the bill passed with overwhelming support, the abuse, coercion, and mistreatment of young Americans would continue. The bill merely calls for the creation of structures that could, theoretically, regulate such centers and encourage best practices.
Representative Ro Khanna introduced the SICAA on April 27th, 2023. Another 112 congress members, including 49 Republicans, cosponsored the bill. Khanna and other sponsors called for implementing “best practices” and creating systems and structures that would ensure the safety of institutionalized children and teens. The bill also calls for regulating which treatments and interventions can be used, affecting how these centers use restraints, punishments, seclusion, and alternative approaches. We also applaud that the bill uses broad definitions, allowing it to evaluate and regulate a wide berth of institutions.
Despite these strengths, the bill merely calls for forming a work group “to support and implement best practices regarding the health and safety, care, treatment, and appropriate placement of youth in youth residential programs”(Congress). Further, the group would devise a way to collect data across treatment centers to evaluate processes and outcomes. Their findings would then be used to train others. Finally, it calls for the Department of Health and Safety and the National Academy of Science to advise on the “oversight” of these programs (Congress).
In 2023, Paris Hilton shared that she had been sexually abused when she was a student. She spoke movingly about her experiences and called for the bill to pass. Despite bipartisan sponsors, the bill has not been moved out of committee. Sadly, despite having over one hundred sponsors, it is unlikely to pass.
Conclusions
At Curing Crime, we rarely are prescriptive, but given the possible magnitude of the problem, we agree that further regulation, inspection, and intervention are necessary. There are several ongoing reports of mistreatment and abuse even when most of these centers restrict contact with the outside world. We call on for further evaluation and action.
We support the passage of the Stop Institutional Child Abuse Act.
We encourage people to read and learn about the Troubled Teen Industry and its problems.
While we do not deny the effectiveness or usefulness of some of these approaches, we urge State Offices to investigate not only centers but also the parent companies and their practices.
We fully support the creation of a national registry. This registry should include outcomes, details of treatments and interventions, incidents involving violence, sexual abuse, and other allegations. This is not an exhaustive list, and given our lack of knowledge in this area, we do not feel comfortable creating one.
This registry could be used to continuously assess the efficacy of different treatments and alternatives, thus providing opportunities to minimize risks and negative externalities.
Furthermore, we encourage state licensing procedures to consider information from the aforementioned national registry when evaluating whether to license programs.
We amicably suggest parents investigate programs thoroughly before committing their children to a specific one.
Some programs have helped kids even if they have not used best practices. We think many well-intentioned programs exist. However, the lack of oversight and regulations makes it hard to investigate programs regardless of their intentions and successes.
As we usually conclude, societies should be cautious in embracing technocratic solutions, which offer easy solutions to sophisticated problems. While we think that science and medicine are splendid tools to address issues, we also continuously find that they can offer false but alluring justifications.
Over a series of articles, we have covered the rise and popularity of the Troubled Teen Industry. If you would like to learn more, we invite you to take a look at them:
Several centers continue alleging they can help troubled teenagers (Orlic, 2024). The troubled teen industry’s origins have wrongly been linked to a religious cult/sect called Synanon (Chatfield, 2024; Orlic, 2024). One of the first such centers was the Seed, and many of its interventions inspired other centers.
The following two articles describe this intellectual milieu.
The Seed had a program that was widely criticized and lauded. In 1974, a Congressional report likened their practices to those experienced by American prisoners of war in North Korea. You can learn about their program here:
Sources
