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Regulating teen residential centers returns to Congress's agenda

April 1, 2009
by Gary A. Enos, Editor
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Reports of abuses in alternative placement facilities spur action

Congress once again is considering legislation that would establish tougher standards for the operation of boot camps, wilderness therapy programs and other residential treatment placements for troubled teens, programs that in some cases have been the target of harsh criticism in recent years.

The House of Representatives in February passed the Stop Child Abuse in Residential Programs for Teens Act of 2009 (HR 911), after passing similar legislation in 2008 that did not reach final adoption. The measure currently awaits action in the Senate.

Mental health groups such as the American Psychiatric Association (APA), Mental Health America and the National Association of State Mental Health Program Directors (NASMHPD) have strongly supported the goals of the legislation and its chief sponsor, U.S. Rep. George Miller (D-Calif.). Yet some associations in the addiction treatment community have been considerably more guarded about the bill because of serious concerns that its present language is too broad and therefore would apply to all residential treatment programs serving adolescents with substance use problems or other behavioral health disorders.

The House’s effort stems largely from Government Accountability Office (GAO) reports in 2007 that documented more than 1,000 cases of abuse and neglect in residential treatment programs for youths with behavioral health needs over a 17-year period. HR 911 would establish program standards for residential programs that are consistent with current child protection laws, would require the programs to be family-centered and developmentally appropriate, and would provide state grants for the prevention of child abuse and neglect.

In a Feb. 10 letter to Miller, about two dozen mental health groups wrote, “Too many families struggle mightily in nearly every state to find placements, when appropriate, for their children that will address their complex mental health needs. These facilities flourish, in part, because parents lack the necessary information about the operation and practices of these programs. The promise of help cannot be allowed to obscure the fact that these kinds of programs are not science-based and have not been forthcoming about the incidence of neglect or abuse.”

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