There’s a lot of evidence that residential treatment can be abusive, and none that it helps
Imagine for a moment that leaders of a group called the Association of Really Good Police Departments wrote a column proclaiming their sympathy for the #BlackLivesMatter movement, and even used their rhetoric, beginning the column with “Say his name. George Floyd.”
Then they explained that the solution was simple: Just get rid of those few bad apples on their forces, and sign a lovely statement of principles.
Would you buy it?
Now consider the column that ran in The Imprint on August 5, by two leaders of the Association of Children’s Residential Centers.
“Say his name,” the column begins. “Cornelius Fredericks” – a Black 16-year-old killed as a result of a restraint performed by staff at a residential treatment center.
The column continues:
“The murder of George Floyd sparked a national conversation and lit a fire under the movement to eradicate racial violence and inequity. It would be an absolute injustice to Cornelius if his death doesn’t also ignite a sustained national campaign to …”
OK, let’s stop right there. The logical conclusion to that sentence would have been “…eradicate residential treatment.”
But instead, the sentence concludes with:
“…ensure that children and families are only served by professionals who can safely, compassionately and effectively meet their needs.”
In other words: get rid of those rotten apples and all will be well.
The column goes on to imply that the real problem is confined to McTreatment chains that allegedly “prioritize profits over people.” But for most of the 150 plus years that we’ve been institutionalizing children, they’ve been institutionalized by governments and nonprofits – and their track record isn’t stellar either.
Last year the Philadelphia Inquirer exposed horrific widespread abuse at what was long thought to be a model institution, the Glen Mills Schools – a nonprofit. In New York, the Pleasantville Cottage School has been the subject of one horrifying incident after another for decades. It’s run by the Jewish Child Care Association – another nonprofit, and a member of the Association of Children’s Residential Centers.
And then there’s Illinois’ Maryville, considered a model institution until its main residential program was exposed as a hellhole and ultimately shut down. Maryville also is a member of the Association of Children’s Residential Centers.
It’s not just individual institutions. The widespread doping up of institutionalized children on potent, sometimes dangerous psychiatric medications exposed by the San Jose Mercury News in 2014 was not limited to for-profit institutions. In fact, the concluding part of the series focused on alleged abuses at Hillsides, in Pasadena – a nonprofit that is, yes, a member of the Association of Children’s Residential Centers.
The long litany of exposed abuses in congregate care facilities is harder to fathom when weighed against the dearth of evidence that this strategy works even when it’s said to be done well. A review of the scholarly literature by the office of the U.S. Surgeon General found only “weak evidence” for the success of residential treatment. A second review, by the University of North Carolina, found “when community-based services are available, they provide outcomes that are equivalent, at least [to residential treatment centers (RTCs)].”
Residential treatment is not necessary for young people who supposedly can’t handle a family setting – the youth who as providers like to claim, supposedly “blow out of foster homes.” Nor is it necessary because of a shortage of therapeutic foster homes. In fact, there is nothing an institution can do that can’t be done better with wraparound programs that bring everything a child needs right into the child’s own home or a foster home. In this video, Wraparound pioneer Karl Dennis explains how wraparound kept safely at home a youth supposedly so difficult that even the local jail couldn’t handle him:
Get the children who don’t need to be in foster care at all back into their own homes, give foster parents the backup they need via wraparound programs, and there will be plenty of therapeutic foster homes for the youth we now institutionalize.
The #BlackLivesMatter movement isn’t about getting rid of a few “rotten apples” in police departments. It’s about defunding or abolishing the police. Even those not ready to scrap the entire child welfare system should be ready to eliminate its ugliest corner, institutionalization, in all its forms, including residential treatment.
At a minimum, at least have the decency not to invoke the rhetoric of radical reform if you’re not prepared to embrace the solutions put forward by radical reformers. Because when it comes to institutionalizing young people, the problem isn’t rotten apples or even rotten barrels, it’s a concept that is rotten to the core.
Richard Wexler is executive director of the National Coalition for Child Protection.
