The Profitability of Child Abuse

Let me preface this article by saying that I am no opponent to the mental health industry. I personally have benefitted greatly from both psychiatry and psychotherapy, and do not consider all practitioners to be quacks and hacks. Certainly, psychology as a science is limited by its subjectivity, keeping it from being as cut-and-dried as regular medicine―as complicated as the human body is, the human psyche is more so. But this is not to say that there is no value in seeking help with depression, anxiety, post traumatic stress, or any of a number of other conditions that make life difficult to live. However, amongst the ranks of any profession there are those who are good at their jobs and those who fall short, those who sincerely work to better the conditions of their clients and those who work simply for the benefit of a paycheck.

I cycled through a number of therapists and psychiatrists before I found a working combination: every person is different, every practitioner is different, and you have to look around to find one that suits you. If you find yourself engaged in a course of treatment that doesn't seem right, or doesn't suit you, or just plain isn't working, then just stop and seek help elsewhere. Seems obvious, doesn't it?
But this article is going to be about people who don't have that option.

Residential Treatment Centers (RTCs), better known as rehab clinics, may bring to mind celebrities who, after making some sort of gaffe or mistake (or inebriated crime), go there to repair their reputations and restore their family-friendly images. But RTCs aren't only for adults―many children and teenagers also suffer from problems of substance abuse and debilitating mental health issues, and where there is demand, supply shall follow. A report entitled "State Regulation of Residential Facilities for Children with Mental Illness" found that, as of 2002, over 3,500 such treatment centers especially for youth were in operation in the US, and their popularity has only grown since then.
While there is certainly a looming mental health crisis at work in this country, this explosion of RTCs may not be the solution, for any of a number of reasons.

They are typically involuntary. Remember, this is not juvenile detention―these children never had to have done anything illegal, or even immoral, beyond invoking the displeasure of their parents. These programs tend to be a bit more intensive than your ordinary boarding school and claim to have a larger mental health focus than a boot camp, and due to the types of kids that end up in these places they have been colloquially known as "brat camps." So it should go without saying that the kids would rather stay home with their friends and family than be shipped away to undergo a treatment they view as invasive and unnecessary.

And that is actually a very, very big problem, for more reasons than you might suppose.
First of all, ask any therapist how easy it is to make any kind of progress with a patient who has zero interest in undergoing therapy. That ought to be enough right there to make the price tag of thousands of dollars a month not worth it.

Second of all, imagine an environment in which kids are removed from every semblance of autonomy, self-possession, or rights. Imagine the concept of "tough love," but from strangers who feel no love towards the kids they are being tough to. Imagine the types of adults this situation might attract, with complete control to wield over a mass of vulnerable, discredited young people.
Which is why it ought to come as no surprise that there have been several stories surfacing in the news of various forms of abuse, countless personal anecdotes, video evidence, and a number of lawsuits filed. So the important question to ask is this: Where is the outrage? Where are the investigations? Where is the 24-hour news coverage? Why do parents continue to send their kids to these places, and refuse to remove them, even when their kids tell them what is happening there?

By way of answering that question, I am now going to ask you to engage in a brief thought experiment: Take your average, everyday teen. Now, imagine that teen has something to tell you. Is your first impulse to listen closely and consider his or her points? Of course not, because teenagers are stupid, inexperienced, hormonal messes. Now add to that effect the unfortunate label of "troubled" teen, and what happens to his or her already negligible credibility then? Thus the double bind in which many of these kids are placed.

And of course it doesn't help that, in addition to limiting phone contact between kids and their parents, a number of these institution use their supposed positions of expertise to explicitly tell parents not to believe any of their children's complaints, as in this passage from the West Ridge Academy's website:

Typically your child will be uncomfortable or in denial as to the reasons he/she is here. He/she may try several types of manipulation to get your attention and to help himself/herself cope …

• Triangulation/Splitting. Example: Your child gets you alone and tells you about the mean things staff members are saying to him/her.
  
  This is where your child will try to split one parent against the therapist or the other parent to get his/her way. The child's goal is to dismantle those who are holding him/her accountable for his/her actions. Your child may even say, "Don't tell the therapist because I will get into trouble." ...
   
• Fear Factor. Example: "All my roommates are drug addicts or gay." "I am not as bad as everyone else here." "The staff beats up the students." "The food isn't nutritious." "The school isn't very good." This is probably the most subtle and commonly used tool. If your child uses this technique, his/her goal is to split us. Your child is playing upon your fears to attempt to change the outcome. Your child wants West Ridge Academy to become the bad guy. If you have concerns, please check them out with your therapist in a way that continues to support the therapy we are doing. Fears are normal but usually based on false evidence. Never let your child see you challenge staff or West Ridge as a whole. Always bring your concerns to us outside of your child's presence.

Some of these precautions seem like they would be a natural part of a youth RTC's boilerplate concerns.  But again, what recourse does this allow kids if their allegations of abuse are legitimate?  Absolutely none.  In fact, policies as stated above would only lead to the punishment of children who try to speak out for attempting to, in their words, "split" their parents from the staff, which would be viewed as a breach of their program.

Another problem is the fact that a significant number of these places claiming to be practitioners of mental healthcare are actually thinly-veiled religious re-education establishments. West Ridge Academy, in particular, has faced some scrutiny regarding their religious focus in the wake of a series of lawsuits. Their current website has been carefully restructured to be more secular, but a brief perusal of their old site on web.archive.org turns up this policy gem under "A Message from our Director:"
"As tragic as it might seem to some of us, the facts indicate that our government believes the laws governing separation of church and state are violated when governmenr (sic) dollars are used in any program that promotes and teaches religious principles." (Second to last paragraph)

In should go without saying that non-profit mental health institutions are required to be non-denominational.  However, looking over a number of websites for various youth residential treatment centers it is hard to find one that doesn't mention religious or spiritual education and values, and given the nature of the country we live in, they almost definitely are not referring to Judaic, Islamic, or Buddhist values.

At what age is it appropriate for a person to choose what he or she believes in?  In practice, it appears to be the age of 18, but should a young person who displeases his or her parents by exploring alternative belief systems to theirs be legally shipped off to be re-educated?  That is one of the pressing questions of this article.

Now, is all of this to say that residential treatment for youth ought to be eschewed entirely?  Certainly not.  There is a legitimate need for these establishments to exist, or else there wouldn't be so many already.

What needs to happen is an extension of government oversight into the practices of these establishments.  There need to be regular inspections by Child Protective Services, hefty fines and immediate shutdowns of places failing these inspections, and mechanisms in place to ensure that such locations are not taking advantage of children and parents by promising to provide treatment for conditions for which it has been demonstrated that residential treatment is ineffective or inappropriate.