Dear Mr. Hunter:
Over the past several years, a series of reports have raised concerns about the conditions that children and youth experience in residential treatment facilities (RTFs).[1] While estimates vary, thousands of children and youth in the United States are placed in these facilities for therapeutic services such as mental health and substance use treatment or behavioral or emotional health treatment.[2] While there is a role for RTFs in the continuum of treatment, we are concerned by numerous stories of exploitation, mistreatment and maltreatment, abuse and neglect, and fatalities in these facilities. We therefore request information from Acadia Health Services to better understand your policies and practices in providing treatment to children and youth being served in your facilities.
Recent national reporting has detailed a number of instances of abuse and neglect in RTFs, including inappropriate use of and lack of reporting of restraint and seclusion, staffing shortages, a lack of appropriate and advertised mental health and substance use disorder services, and concerns about the education services being provided to children and youth.[3] These concerns are not new. In 2007, the Government Accountability Office (GAO) released a report that found “thousands of allegations of abuse, some of which involved death" at RTFs across the country.[4] This study found “untrained staff, lack of adequate nourishment, and reckless or negligent operating practices" among facilities.[5] In January 2022, GAO released a subsequent report finding RTFs have failed to prevent instances of abuse and neglect.[6] Children and youth who have been in RTFs have reported harm and abuse - either at the hands of staff or other children and youth in the facility - and that their time in the RTFs “negatively impacted their well-being, from being served meals that lacked proper nutrition and promoted undesired weight gain or loss, feeling over medicated or coerced into taking medication, being unable to feel a sense of normalcy or socialize with peers, lacking access to on-grade level school work which diminished their educational outcomes, being deterred from performing acts of freedom and self-expression, practicing their religion, or speaking their native language." [7]
Families and states place children and youth with the most intensive needs in the care of RTFs with the expectation that these children and youth will be given the supports and services they need. To ensure that children and youth placed in your care are safe and provided the care and treatment they need to be able to return to their homes and communities, we write to learn more about the policies and procedures at your facilities. We request that you provide answers to the following no later than August 4, 2022.
Please direct any questions and response to this letter to Amanda Lowe at Amanda_Lowe@help.senate.gov and Rebecca Nathanson at Rebecca_nathanson@wyden.senate.gov. We appreciate your timely attention to this issue.
Sincerely,
