June 28, 2005

Honorable Members of Congress
United States House of Representatives and United States Senate
Washington, DC 20515

Dear Members of Congress,

            As parents concerned about the emotional well-being of children, we join to express our serious concern about the large number of youth with serious mental disorders now housed in unlicensed and unmonitored residential treatment facilities referred to as therapeutic boarding schools.  As parents, we usually refrain from entering the public policy arena.  Yet, we feel so strongly about the threat posed by this new institutionalization of children and the need for appropriate and effective services that we must write at this time.

            In the last fifteen years, unlicensed privately run residential programs for youth with mental and emotional problems have proliferated.  Hundreds of new programs now market aggressively over the Internet preying upon desperate families who seek help for their children.  Many families pay enormous sums—facilities cost up to $100,000 per year—to obtain “treatment” for their troubled children.  The programs are located around the country, and even outside the country, and often times children are transported hundreds, if not thousands, of miles across state lines to these programs.

            The reality of what occurs in some of these programs is often quite different from the highly individualized, highly structured programs advertised to parents.  These programs are troubling for a number of reasons.

¨      Children are often prohibited from speaking with their own families for up to six months, a practice which has significant negative consequences for child and parent relationships;

¨      Seclusion and restraint procedures are significantly more restrictive than what is generally accepted by mental health licensing and accrediting bodies.  These practices have resulted in several documented deaths;

¨      Even though the needs of the children in these facilities are great, unqualified staff are charged with implementing treatment plans and supervising children;

¨      The educational services provided to the children often fail to meet even minimum standards;

¨      No research has demonstrated that these programs have long-term benefits.

Even more alarming is that abuse and neglect are all too common within these facilities.  There have been many highly public media accounts of atrocious examples of sexual and physical abuse, and medical neglect in these facilities.  Yet, there is still little to no public oversight, leaving these already emotionally fragile children even more vulnerable.  The lack of oversight in these facilities also means that the full scope of the problem is unknown.

            Alternatives have been developed to meet the needs of our children—options that work better and cost less, but they are frequently not available.  As the Surgeon General’s Report on Mental Health Reported in 1999, “the most convincing evidence of effectiveness is for home-based services and therapeutic foster care.”  A comprehensive system of care would dramatically reduce the number of children in these facilities because children could be served in their own communities, at a significantly reduced cost.

            Today, we join with others in calling on the General Accounting Office to conduct a study into the issue of children housed in unlicensed therapeutic boarding schools, and the conditions that they are required to endure, so that the full extent of the problems in these facilities can be understood.  We also urge Congress to enact legislation to increase protections for children in therapeutic boarding programs in the United States and abroad, and to improve access to essential community and school-based mental health services.

            Specifically, we urge lawmakers to enact the following bipartisan, commonsense proposals that would support the call from President Bush’s New Freedom Commission on Mental Health to “swiftly eliminate unnecessary and inappropriate institutionalization,” and that would make the use of therapeutic boarding schools both safe and rare:

¨      End Institutionalized Abuse Against Children Act of 2005 (H.R. 1738);

¨      The Keeping Families Together Act (S. 1704, H.R. 3243);

¨      The Mentally Ill Offender Treatment and Crime Reduction Act (S. 1194, H.R. 2387).

Too little information is known about the extent of the problems and abuses, and yet what is known is the cause of great concern.  As parents, we believe that at best these programs do not meet the needs of many of our children, and, at worst, they subject children to abuse.  The undersigned individuals look forward to working with Members of Congress to enact these reforms. 


(If you would like to sign onto this letter, contact Dr. Pinto at apinto@fmhi.usf.edu to give her your name and contact information.

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