Residential treatment centers (RTCs) are ineffective and expensive, and put children at risk of abuse and neglect.
The Bazelon Center is opposed to children with mental health needs being served in RTCs. Residential treatment centers and therapeutic boarding schools are secured facilities for children with mental health, emotional and behavioral health needs. As the most restrictive form of care for these children, other than psychiatric hospitalization, RTCs should be reserved for children whose dangerous behavior cannot be controlled except in the most secure setting. For the vast majority of children with mental health needs, RTCs are both ineffective and expensive.
The Bazelon Center disapproves of the use of public funds for restrictive, expensive residential placements that do not meet children's mental health or education needs and that put children at risk of abuse and neglect. Substantial numbers of children have been abused at RTCs, resulting in their serious injury and even death. We believe that public money should instead be invested in community-based services that are more effective and less costly--that ensure that students are served in the “least restrictive environment.”
However, parents who are desperate to meet their children's needs often turn to RTCs because they lack less restrictive alternatives. When making placement decisions, families in crisis and overburdened social workers often rely on the institutions' glossy brochures and websites with testimonials of "saved" children. But all RTCs are not alike. While some may be humane and effective, in general RTCs are under-regulated and under-supervised, and deserving of their notoriety. To make matters worse, far too many children are placed at great distances from their homes--sometimes many hundreds of miles. Many families find it impossible to have any meaningful visitation with their children.
Community-based alternatives such as wraparound services and therapeutic foster care produce better short- and long-term results at lower cost and are much less disruptive to children and families. These alternatives provide intensive mental health treatment, mobilize community resources and help children and their families develop coping mechanisms.
Also see the Forest Grove case.