A LETTER WHICH
MENTAL HEALTH PROFESSIONALS AND CHILDREN'S ADVOCATES CAN
SIGN AND SEND TO CONGRESS
July
8, 2005
Honorable Members of Congress
United States House of Representatives
Washington, DC 20515
Dear Members of Congress,
As mental health professionals and leaders in
the children’s mental health field, we join to express our
serious concern about the large number of youth with serious
mental disorders now housed in residential treatment
facilities referred to as therapeutic boarding schools. As
individual clinicians, we usually refrain from entering the
public policy arena, yet the threat posed by this new
institutionalization of children is so serious that we feel
we can no longer remain silent.
In the last fifteen years,
unlicensed privately run residential programs for youth with
mental and emotional problems have proliferated. Hundreds
of new programs now market aggressively over the Internet
preying upon desperate families who seek help for their
children. These worried families pay enormous
sums—facilities cost up to $100,000 per year—to obtain
“treatment” for their troubled children. The programs are
located around the country, and even outside the country,
and often times children are transported hundreds, if not
thousands, of miles across state lines to these programs.
The reality of what occurs in some of these
programs is often quite different from the highly
individualized, highly structured programs advertised to
parents. These programs are troubling for a number of
reasons:
- Children are often prohibited
from speaking with their own families for up to six
months, a practice which has been shown to have
significant negative clinical outcomes for children and
adverse consequences for families.
- Seclusion and restraint
procedures are significantly more restrictive than what
is generally accepted by mental health licensing and
accrediting bodies. These practices have resulted in
several documented deaths.
- Even though the needs of the
children housed in these facilities are great,
unqualified staff is charged with implementing treatment
plans and supervising children.
- The educational services
provided to the children often fail to meet even minimum
standards.
- No research has demonstrated
that these programs have long-term clinical
effectiveness.
Even more alarming is that
abuse and neglect are all too common within these
facilities. There have been many highly public media
accounts of atrocious examples of sexual and physical abuse
and medical neglect in these facilities. Yet, there is
still little to no public oversight, leaving these already
emotionally fragile children even more vulnerable. The lack
of oversight in these facilities also means that the full
scope of the crisis is unknown.
Alternatives exist to meet the needs of these
children—options that work better and cost less. As the
Surgeon General’s Report on Mental Health reported in 1999,
“the most convincing evidence of effectiveness is for
home-based services and therapeutic foster care.” A
comprehensive system of care would dramatically reduce the
number of children in these residential facilities because
children could be served in their own communities, at a
significantly reduced cost.
Today, we call on the General Accounting Office to conduct a
study into the issue of children housed in therapeutic
boarding schools, so that the full extent of the problems in
these facilities can be understood. We also urge Congress
to enact legislation to increase protections for children in
therapeutic boarding programs in the United States and
abroad and to improve access to essential community and
school-based mental health services.
Specifically, we urge lawmakers to enact the following
bipartisan, commonsense proposals that would effectuate the
President Bush’s New Freedom Commission’s call to “swiftly
eliminate unnecessary and inappropriate
institutionalization” and that would make the use of
therapeutic boarding schools both safe and rare:
- End Institutionalized Abuse
Against Children Act of 2005 (H.R. 1738)
- The Keeping Families Together Act
(S. 1704, H.R. 3243)
- The Mentally Ill Offender
Treatment and Crime Reduction Act (S. 1194, H.R. 2387).
Too little information is known about the extent
of the problems and abuses, and yet what is known is the
cause of great concern. As children’s mental health
clinicians, we believe that at best, these programs do not
meet the needs of most children with serious emotional or
mental health disorders and, at worse, they subject children
to abuse. We believe that parents unknowingly put their
children in harms’ way when they send their children to
these boarding schools, expecting good treatment and
education. The undersigned individuals look forward to
working with Members of Congress to enact these reforms.
ON BEHALF OF:
(If you would like to sign onto
this letter, contact Dr. Pinto at
apinto@fmhi.usf.edu
to let her know of your wishes and to give her your
credentials and contact information.
Lenore
Behar, Ph.D.
Director
Child & Family Program Strategies
Durham, NC
Monica
Epstein, Ph.D.
Assistant in Research
Mental Health Law & Policy
Louis de la Parte Florida Mental
Health Institute
University of South Florida
Robert Friedman, Ph.D.
Professor / Chair
Department of Child and Family Studies
Louis de la Parte Florida Mental Health Institute
Charley Huffine, M.D.
Child Psychiatrist
Former President American Association of Community
Psychiatrists
Wanda B. Mohr, Ph.D., A.P.R.N.,
F.A.A.N.
Associate Professor of Psychiatric Mental Health Nursing
School of Nursing
University of Medicine and Dentistry of New Jersey
Allison Pinto, Ph.D.
Research Assistant Professor
Department of Child and Family Studies
Louis de la Parte Florida Mental Health Institute