Five Facts About the Troubled Teen Industry

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The “troubled teen” industry is a network of private youth programs, therapeutic boarding schools, residential treatment centers, religious academies, wilderness programs, and drug rehabilitation centers and it dates back at least 50 years. The facilities are operated by private companies, nonprofits, or faith-based groups and they promise to help youth with problems related to behavior, addiction, and eating disorders, and in some cases sexual orientation and gender identity. Despite numerous allegations of serious abuse that date back decades, they continue to operate in a largely unregulated way. To better understand this issue, here are five facts about the industry:

1. Youth can end up in the “troubled teen” industry in a variety of different ways. They can be privately placed by their parents or families; state and local governments can pay these programs to take youths from their foster care and juvenile justice systems; school districts can place youth through their individualized education programs; refugee resettlement agencies can place youth; or they can be placed by mental health providers.
2. In 2008 the U.S. Government Accountability Office (GAO) published the report “Residential Programs: Selected Cases of Death, Abuse, and Deceptive Marketing.” The report “identified thousands of allegations of abuse, some of which resulted in death, at residential programs across the country and in American-owned and American operated facilities abroad.” Despite these findings more than a decade ago, there is no federal regulation or oversight of these programs, nor are there consistent regulations among states. Furthermore, many states completely exempt religious boarding schools from licensing requirement and from oversight from education and child welfare authorities. States and facilities do not even keep track of the number of placements nor length of stay.
3. It is estimated that between 120,000–200,000 young people reside in some type of group home, residential treatment center, boot camp, or correctional facility. While the exact number of private placements are unknown, estimates are that more than 50,000 of those youth were placed privately by their parents.
4. The “troubled teen” industry is a big business. It receives “an estimated $23 billion dollars of annual public funds to purportedly treat the behavioral and psychological needs of vulnerable youth.” Many residential facilities operate as for-profit organizations. One such for-profit facility, Sequel, has an annual revenue that “regularly tops $200 million; as of 2017, 90% of their revenue came from Medicaid, Medicare, and approximately 500 additional federal, state, and local programs. Programs pay Sequel as much as $800 per day for each child at a facility.”
5. #BreakingCodeSilence is a survivor-led campaign created in 2014 to encourage people who have endured abuse in the “troubled teen” industry to speak out about their experiences. Descriptions of experiences in the industry include descriptions of strip searches; physical abuse; sexual abuse; physical, mechanical and chemical restraint; conversion therapy; lack of appropriate health treatment, including mental health; forbidding communication; and lack of basic needs like food and water.

For more information about the “troubled teen” industry, see:

• The Troubled Teen Industry, a multi-series webinar event
• Troubling Treatment: Efforts are underway to reform teen behavioral programs
• Breaking Code Silence—BCS Network
• The Shadow Penal System for Struggling Kids | The New Yorker
• Quality of experience in residential care programs: Retrospective perspectives of former youth participants
• Away From Home
• Desperation without Dignity: Conditions of Children Placed in For Profit Residential Facilities—NDRN

Cathy Krebs is the director of the Children's Rights Litigation Committee.

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