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The Unsilenced Investigative Research Team

The Troubled Teen Industry in New York

Impact Report

2022

Impact Report

2022

Introduction

The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.

Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.

Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.

An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.

It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.

Introduction

The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.

Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.

Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.

An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.

It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.

New York Statistics

$482+

Million Dollars

Federal funds spent on out-of-home child placement for New York youth in 2018.

$383+

Million Dollars

State/local funds spent on out-of-home child placement for New York youth in 2018.

$600

Per Day Per Child

New York pays facilities on average and advocates report that the state spends up to $800 per day for children with complex needs.

5,756

Foster Care Youth

placed in residential facilities through Child Welfare programs in 2019.

837

Juvenile Justice Youth

placed in residential facilities through Juvenile Justice programs in 2019.

  • 513 minors were committed as part of a court-ordered disposition
  • 318 minors detained while awaiting a court hearing, adjudication, disposition, or placement elsewhere
  • 3 minors were voluntarily admitted to a residential facility in lieu of adjudication as part of a diversion agreement

New York Statistics

$482+

Million Dollars

Federal funds spent on out-of-home child placement for New York youth in 2018.

$383+

Million Dollars

State/local funds spent on out-of-home child placement for New York youth in 2018.

$600

Per Day Per Child

New York pays facilities on average and advocates report that the state spends up to $800 per day for children with complex needs.

5,756

Foster Care Youth

placed in residential facilities through Child Welfare programs in 2019.

837

Juvenile Justice Youth

placed in residential facilities through Juvenile Justice programs in 2019.

  • 513 minors were committed as part of a court-ordered disposition
  • 318 minors detained while awaiting a court hearing, adjudication, disposition, or placement elsewhere
  • 3 minors were voluntarily admitted to a residential facility in lieu of adjudication as part of a diversion agreement

A New York Problem

A team of researchers reviewed 230 studies of residential treatment facilities from around the nation and found there was no evidence that they were effective.

In 2019, New York was home to 4,028,299 minors, including 15,717 minors in foster care.

New York has 92 Licensed Residential Facilities with a total capacity for 3,503 youth. The facility types with the highest capacity for housing youth in New York are:

  • Inpatient Psychiatric Hospitals with a total capacity for 2,327 minors
  • Private Psychiatric Hospitals with a total capacity for 573 minors
  • Community Residence with a total capacity for 305 minors
  • Residential Treatment Centers with a total capacity for 298 minors

Residential Facilities in New York cost the State and Federal government millions annually

The commissioner may provide program development grants to a voluntary not-for-profit organization developing a residential treatment facility.

Illustration by Spencer Holladay, USA Today Network; Getty Images

“Many kids don’t get help. Others never needed institutional care in the first place.”

Fred Clasen-Kelly, Amritpal Kaur Sandhu-Longoria, Rachel Berry, Brad Zinn, Kristen Johnson, Brian Gordon
The Fayetteville Observer

Current Oversight

New York requires Residential Facilities serving minors to obtain a license but allows for waivers by meeting one of the three following requirements:

The Office of Mental Health is responsible for licensing Residential Facilities, Community Residence and Inpatient Psychiatric Units that serve minors.

The residential treatment facility located in a rural area can demonstrate to the satisfaction of the Office of Mental Health the need for a waiver. The following sections of this Part are eligible for waiver:

  1. The Office of Mental Health may approve a resident capacity of less than 14 where the residential treatment facility can demonstrate that this limitation would adversely affect the services provided.
  2. The Office of Mental Health may approve the use of a physician in lieu of a psychiatrist where the residential treatment facility can demonstrate that a psychiatrist is unavailable to meet the requirement.
  3. The Office of Mental Health may approve the use of a person who has received a bachelor’s degree in one of the following areas, art education, drama, early childhood education, music education, physical education, psychology, rehabilitation, sociology or special education in lieu of a therapeutic recreation specialist in circumstances where the residential treatment facility can demonstrate that a therapeutic recreation specialist is unavailable to meet the requirement.

The residential treatment facility serves a specialized target population and can demonstrate to the satisfaction of the Office of Mental Health the needs for a waiver based upon the specialized needs of the target population.

The residential treatment facility has a physical plant with living units designed for more than 14 residents and the residential treatment facility can demonstrate to the satisfaction of the Office of Mental Health the need for a waiver.

Abuse and Neglect

Youth residing in Residential Facilities in New York are at-risk for abuse, neglect and long-term harm.

New York determined that at least 102 Group Home and Residential Facility Staff Members and 222 Foster Parents caused or knowingly allowed the maltreatment of a child in 2020

New York State Failed to Provide Legally Required Mental Health Care to Kids, Lawsuit Claims

New York’s Medicaid program has caused young people with serious mental health conditions to suffer unnecessarily, ending up in hospitals and residential treatment programs because they can’t access vital community services.

Because of the lack of home and community-based mental health services, Medicaid-eligible children across New York today languish as their mental health conditions deteriorate. Without intensive services in their homes and communities, children with mental health disabilities are unnecessarily placed in psychiatric hospitals and similar institutions for extended periods, where they are separated from their families and communities and fail to thrive.

Lawmakers, parents say state agency exploiting ‘loophole’ that prevent disabled from receiving least restrictive care. The parents of adults with conditions such as autism say they are being forced by a state agency to choose between sending their child to a fenced-in institutional facility in the far reaches of the Adirondacks, or face the prospect of losing funding for their long-term care.

Media Coverage

Additional Information

Unsilenced Program Database: New York Programs

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