LOS ANGELES - Marylandian -- A recent paper published in The Journal of Legislation about the need for greater oversight of the "troubled teen" behavioral industry conveys how "there has never been a more opportune (and critical) time to regulate and reform the troubled teen industry."[1] The Citizens Commission on Human Rights (CCHR) International, a mental health industry watchdog that has been exposing abuse of children and teens in residential psychiatric hospitals and behavioral programs such as "wilderness" and "boot" camps for more than 30 years, welcomes the analysis of legislative needs.  It agrees with the recommendations the paper highlights on the urgency for reform. Morgan Rubino, a J.D. Candidate at the Notre Dame Law School in Indiana, concluded in his paper, "The concerning number of abuse and neglect allegations and rising reports of injury and death occurring at residential treatment facilities reflect the sheer urgency."

That urgency will likely be addressed in a hearing being held in June by the U.S. Senate Finance Committee. Since 2022 it has been investigating teen and youth abuses in four behavioral hospital chains.[2] Paris Hilton, who has been passionately campaigning for reform in this area, has urged victims of abuse in these facilities to testify. Anyone who has been abused in one of the four behavioral hospital chains can sign up here: https://docs.google.com/forms/d/e/1FAIpQLSe-OErNiH0QoTkh8syrLU8HUK2vWeZ3o9Pg-V8iyvszMkZHiA/viewform

In 2015, CCHR began increasing its efforts to expose psychiatric and psychological abuse in these facilities, alerting all state and federal legislators about the lack of oversight and accountability that has contributed to patient suicides, restraint deaths, and patients being sexually assaulted, especially in for-profit behavioral and state-run hospitals. The issue came to national attention in 2020, following the death of 16-year-old Cornelius Frederick, an African American foster care youth, from a restraint at the now-closed Lakeside Academy, a residential behavioral facility for teens, in Michigan. The Kalamazoo County Medical Examiner's office determined Frederick's cause of death was a homicide and three staff were charged with involuntary manslaughter and second-degree child abuse.[3]

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Several months later, Paris Hilton spoke publicly for the first time about being sent as a teen to a behavioral facility in Utah where she was abused. This ignited a firestorm of media and public awareness. CCHR launched a website page on the number of child restraint deaths and abuse at one behavioral hospital chain that now owns the facility where Hilton was abused.[4]

Rubino points to Hilton's diligent work raising awareness on this issue, detailing: "The use of restraints and seclusion can cause serious physical and psychological trauma to minors, and there is 'no evidence that using restraint or seclusion is effective in reducing the occurrence of the problem behaviors that frequently precipitate the use of such techniques.' That is why, as some states have started doing, the use of restraints and seclusion as discipline should have to be reported and documented, and eventually outlawed."[5]

He continues: "Drugs are also administered as a restraint to manage behavior and temporarily restrict freedom of movement. Reports indicate that residential facilities severely overmedicate residents, often with antipsychotics and sedatives…." Residents in the programs have alleged staff also "placed them in solitary confinement for long periods of time, ranging from days to weeks, as punishment for bad behavior."[6]

CCHR acknowledges the importance of the groundswell of media and other coverage on the need to eliminate coercive and abusive psychiatric practices.

In January 2024, Psychiatric Services published a study, "Toward the Cessation of Seclusion and Mechanical Restraint Use in Psychiatric Hospitals: A Call for Regulatory Action," in which the authors emphasized "the importance of external regulatory oversight and mandates to safely achieve and sustain the cessation of S-R [seclusion-restraint] use in psychiatric hospitals." They urged the Center for Medicaid and Medicare (CMS) and The Joint Commission (TJC) to update their regulations to more effectively mandate the reduction and eventual cessation of seclusion and restraint use in psychiatric hospitals.[7]

The American Bar Association estimated that between 120,000–200,000 young people reside in some type of group home, residential behavioral treatment centers, boot camps, or correctional facilities, which is a lucrative $23 billion a year industry.[8]

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Since 2019, some states have started to enact regulations toward enforcing patient protections in behavioral, psychiatric or "troubled teen" programs. These include Illinois, Missouri, Montana, Michigan, Ohio, Oregon, Utah, and in March this year, Indiana.[9] In 2024, bills were also introduced in New Hampshire, Alaska, and California. CCHR has posted summaries of these bills on its website.

CCHR says the passage of the Stop Institutional Child Abuse Act, introduced into Congress last year, is a vital first step towards regulating the troubled teen behavioral treatment industry nationally. The bill, introduced by Rep. Ro Khanna is supported by Hilton and many groups, including CCHR International.[10] Ultimately, CCHR wants to see all coercive psychiatric practices prohibited in alignment with the October 2023 World Health Organization and United Nations guidance on "Mental Health, Human Rights and Legislation."

About CCHR: CCHR was founded in 1969 by the Church of Scientology and the late Dr. Thomas Szasz, Professor of Psychiatry, State University of New York Upstate Medical University. It has helped achieve over 190 laws that protect patients from coercive psychiatric practices.

Sources:

[1] scholarship.law.nd.edu/jleg/vol50/iss2/6/, p. 455

[2] www.help.senate.gov/chair/newsroom/press/murray-wyden-demand-answers-on-mistreatment-at-youth-residential-treatment-facilities

[3] www.cchrint.org/2020/10/05/paris-hilton-speaks-out-about-behavior-modification-abuse-of-teens/

[4] www.cchrint.org/2020/10/30/child-abuse-allegations-in-the-behavioral-psychiatric-industry-universal-health-services-uhs/

[5] scholarship.law.nd.edu/jleg/vol50/iss2/6/, p. 449

[6] scholarship.law.nd.edu/jleg/vol50/iss2/6/, p. 449

[7] pubmed.ncbi.nlm.nih.gov/37461820/

[8] www.americanbar.org/groups/litigation/resources/newsletters/childrens-rights/five-facts-about-troubled-teen-industry/?login

[9] www.propublica.org/article/indiana-law-abuse-youth-treatment-centers; indianahousedemocrats.org/news-media/op-ed-garcia-wilburn-this-child-abuse-prevention-month-im-calling-for-accountability-for-the-residential-care-facility-industry

[10] scholarship.law.nd.edu/jleg/vol50/iss2/6/, p. 451; thehill.com/blogs/in-the-know/3976271-paris-hilton-pushes-bipartisan-bill-to-reform-troubled-teen-industry/