Children in Residential Treatment Facilities Face Multiple Risks: Senate Report

Children who are in residential treatment facilities are at risk for sexual and emotional abuse, physical restraint and overmedication, a new Senate report found.

The report, conducted by the Senate Committee on Finance and the Senate Committee on Health, Education, Labor, and Pensions, was created after an investigation examined allegations of abuse and neglect at residential treatment facilities (RTFs) operated by four companies.

The committees found that children are at harm because of the facilities’ operating model, which “incentivizes providers to optimize revenues” over proper treatment. The companies examined are Universal Health Services, Acadia Healthcare, Vivant Behavioral Healthcare and Devereux Advanced Behavioral Health.

In a statement, Senate Finance Committee Chair Ron Wyden (D-Ore.) criticized the facilities, arguing they are warehouses to store as many children as possible while keeping costs low.

“Too often, abuse and neglect is the norm at these facilities, and they’re set up to let this happen,” his statement said. “These findings demand bold action.”

The report earned bipartisan support, as ranking member Sen. Mike Crapo (R-Idaho) delivered remarks at Wednesday’s hearing urging his colleagues to intervene. He said work must be done so RTF placement is a “last resort” and efforts are made to reintroduce children to the community “as soon as possible.”

The children who are placed in RTFs often need mental and behavioral help, but the organizations fail to individualize treatment to adequately treat each child, the report found.

Additionally, the report found children “suffer routine harm” inside the facilities like sexual, physical and emotional abuse; unsafe and unsanitary conditions; and inadequate behavioral health treatment.

The report detailed one incident in Oklahoma, where a staff member admitted to molesting a girl, but the facility moved the staffer to another place after the misconduct was reported instead of terminating the employee. The staff member continued to stand outside the patient’s bedroom window each night, the report said.


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