First, many children and teens are forced into psychiatric-behavioral programs based on their being labeled with “disorders”—ADHD, Conduct Disorder, Disruptive Behavior Disorders, etc.—from the American Psychiatric Association’s “billing bible,” The Diagnostic and Statistical Manual of Mental Health Disorders (DSM). Experts criticize DSM because it pathologizes childhood and teen behavior as a medical illness. “Troublesome behavior” can then be drugged into submission, creating even more dangers to the child. A University of Birmingham study found, “It detracts from considerations of what is best, educationally, for individual children. And it encourages a reliance on definitions of mental disorder to account for childhood normality or abnormality.”
The drugs prescribed to teens in these facilities can induce aggressive and violent behavior that can lead to them being physically restrained or dragged to a seclusion room. Restraint use can be deadly and children as young as seven have died. But, as has been documented in the multi-billion-dollar “troubled teen” behavioral industry, there are also restraint injuries, including nasal fractures and broken arms. Teens have also been terrifyingly body slammed against hospital walls. There are sexual assaults by both staff and fellow patients with known histories of sexual assault. And teen suicides that could have been prevented with proper staff monitoring; and much, much more.
In the compelling Paris Hilton documentary, This is Paris, Hilton exposes how she was assaulted and traumatized in one of these behavioral facilities, Provo Canyon behavioral “school” in Utah at the age of 16. Hilton describes the 11 months she spent there in 1999, and describes how she was forced to take psychotropic drugs, was placed in solitary confinement and beaten. She has now launched a national campaign to prevent other children from being abused in such facilities, and helped launch a petition with the group #BreakingCodeSilence, calling for Provo Canyon to be closed.
Provo Canyon used to be owned by the Charter Behavioral Hospital chain, in which hundreds of cases of abuse were found. In 1999, 60 Minutes II produced an exposé on this, called “Unsafe Haven,” helping lead to Charter’s closure. Charter had unsuccessfully attempted to stop the CBS telecast of hidden-camera footage 60 Minutes obtained that showed dangerous conditions and falsified records, including changing a patient diagnosis to capture more insurance rebates. Sixteen-year-old Tristan Sovern died in Charter Greensboro in North Carolina in 1998 after he was placed in restraints as “punishment” for leaving a group-therapy session. In response to his screams of, “You’re choking me…I can’t breathe,” a towel was shoved over Tristan’s mouth.
From the patient’s perspective, if they don’t die, they certainly never forget a restraint experience. In a statement for a California court case related to restraints, Ron Morrison, a registered psychiatric nurse, said, “...an individual who is restrained feels vulnerable, inadequate, humiliated and unprotected. This may result in mental deterioration and exaggerated resentment or contempt for those responsible for the restraint procedure, and may actually aggravate a potentially violent situation, or create the potential for continued violence in the future.”
Following Department of Justice and Health and Human Services investigations, Charter agreed to pay $7 million to settle allegations of overcharging Medicare and other federal programs, and in 2000 the company filed for bankruptcy.
Eight years earlier, Congresswoman Pat Schroeder, then chairwoman of the House of Representatives Select Committee on Children, Youth and Families, had delivered a scathing rebuke of the “unethical and disturbing practices” discovered in for-profit teen behavioral facilities. She said even then that “thousands of adolescents, children, and adults have been hospitalized for psychiatric treatment they didn’t need…that patients are kept against their will until their health insurance benefits run out...[and] that bonuses are paid to hospital employees, including psychiatrists, for keeping the hospital beds filled.” It was “big business,” she said.
That big business expanded when in August 2000, the behavioral hospital chain owned by Universal Health Services (UHS) acquired Provo Canyon and about 11 other Charter psychiatric facilities. Like many of these teen behavioral facilities that still exist, there are company platitudes, of how it is “committed to providing high-quality care to youth.” While UHS distanced itself from Paris Hilton’s allegations from 1999, The Salt Lake Tribune reported that there have been 341 investigations into Provo by the Utah Department of Licensing in the last five years,” with 27 of those investigations substantiated.
Don’t expect the system to be properly inspect facilities or regulated them to protect your child.
Often government inspections allow the facility to propose a “plan of correction,” setting out actions they will do to correct the abuses found. Or they may pay a substantial fine to the government or even settle lawsuits, but all without admitting liability.
The Dallas Morning News, which conducted its own investigation into UHS, concluded, serious safety problems have plagued dozens of UHS’ hospitals and the violations were “so egregious that the hospitals faced expulsion from Medicare and Medicaid programs….” Most of the hospitals came up with correction plans to avoid expulsion. David Wright, deputy regional administrator in Dallas for Centers for Medicare and Medicaid Services (CMS) told The Dallas Morning News that “patient complaints against the company aren’t just isolated to one region, but extend across the country.”
Abused in the “Troubled Teen Industry” can continue unabated, unless parents are better informed and effective official action is taken.
It was the restraint deaths and abuse of children in Charter and the apparent parallel to those found in UHS facilities that first raised the alarm bell about UHS, starting with its CHAD Youth Enhancement Center in Tennessee.
2005: A Philadelphia child-care investigator learned that a staff member of CHAD had been fired after he allegedly slammed a boy to the floor so hard the child fouled himself. In September, 14-year-old Linda Harris, an African American girl, collapsed at the CHAD center and died of a heart attack while being escorted to a "time-out" room. She died of heart failure.
2006: A boy was sent to an emergency room for cuts sustained in a restraint at CHAD. In another case, staff broke the left arm of a 16-year-old boy during a restraint. Later that year, CHAD told regulators another teenage resident was "taken to the floor" in a restraint that required four stitches for cuts on the lips. In May, Edith Ruland pulled her son, Dennis, 10, out of CHAD after she found numerous bruises on him, which the boy said staff had inflicted in a restraint hold.
2007: 17-year-old, Omega Leach, died after CHAD staff pushed him face-down to the floor, apparently cutting off his air, investigators said. According to an autopsy, the youth had "multiple superficial blunt force injuries" to his body as well as injuries to his neck muscles. He also sustained scrapes and bruises to both shoulders as well as a bruise under his left eye. Omega Leach's family subsequently sued UHS. In 2010, UHS settled with the family for $10.5 million.
Parents need to fully apprise themselves of the number of investigations, Health and Human Services (HHS) inspections, lawsuits and patient/family complaints against a behavioral facility they may be referred to. UHS is but one of the chains that profit from locking up teens and “treating” them. There are others such as, but not limited to, Acadia Healthcare; Sequel Youth and Family Services, which has innocuous sounding “academies” for youths; Strategic Behavioral Health and many more.
A Time Line of psychiatric abuses committed against children and teens at UHS (at the end of this article) supports the allegations being made and the need for places such as Provo Canyon to be shut down.
2012-13: UHS’s Milton Girls’ Juvenile Residential facility in Florida came under scrutiny, when the facility’s supervisor was charged and convicted of felony child abuse, involving a 15-year-old girl she brutally attacked. Surveillance videos showed her appearing to slam the teen into a cement wall, throw her to the ground, and then pinned her down for 20 minutes. The video “seriously contradicts its description to us by officials representing the facility,” said Department of Juvenile Justice (DJJ) Secretary Wansley Walters in a statement. “Facilities being monitored is a systemic problem,” said David Utter, an attorney with the Southern Poverty Law Center. Then followed a mental health technician who was charged, convicted and jailed for 25 years for the sexual abuse of residents.
2014: Bruce Maxwell, an attorney who filed lawsuits over the abuse of emotionally disturbed and autistic deaf children at UHS’s National Dead Academy (NDA), a psychiatric facility for the deaf, said: “My hope is that the NDA is shut down…This kind of conduct should not be tolerated.”
2015: Rock River Academy & Residential Center, a residential treatment center in Illinois for adolescent girls with emotional problems, came under scrutiny when Rockford Police Department fielded more than 700 reports “concerning victimization of girls…including rape, aggravated battery and sodomy.” One teen’s attorney noted, “Once we started digging into it, we just saw how bad their history is over there.”
2017: A 13-year-old girl was raped at UHS’s Timberlawn behavioral hospital in Texas The girl’s father told the Dallas Morning News, “This can’t happen to anyone else. The place needs to be shut down.”
2019: Shadow Mountain behavioral health in Tulsa, Oklahoma, closed, after health authorities investigated it when children as young as five were separated from their parents and held in dangerous situations. Allegations ranged from medication errors to incidents of sexual misconduct. Internal surveillance videos showed children being repeatedly physically restrained, including a 9-year-old boy that a mental health technician grabbed by the neck, pushed against a wall, then slammed to the ground.
All five facilities closed amid government agency investigations but there the accountability rested. (“…but there the accountability rested” The meaning of this is not clear.) The abuses continued.
Parents should be aware of the culture of abuse that is excused in behavioral facilities and teen “boot camps” or “wilderness camp programs.” In response to the outcry over the alleged teen rape at Timberlawn and other sexual assault allegations, the facility’s then- hospital chief executive, stated: “We believe our rate of serious incidents associated with the patient population treated at Timberlawn is within industry norm.”
A 1998 Hartford Courant series exposing teen restraint deaths in Charter and other behavioral facilities prompted action at the time. In 1999, federal regulations were passed to increase accountability for make psychiatric restraint deaths more accountable but, between 1999 and 2002, at least nine more children and teens who died from suffocation or cardiac arrest during violent restraint procedures. Based on ongoing abuses and restraint deaths being reported, regulations have been to no avail. Parents need to know this and insist on vital protections.
In 2006 the U.S. Center for Medicare and Medicaid Services (CMS) revised a notice of patient rights, including for the use of seclusion and restraints for behavior management. To remain eligible for Medicare participation, a hospital has to meet certain requirements, including mandatory death reporting.
Consumer advocacy groups argued for more stringent expectations for the care of children, citing special hazards and concerns that arise when children and adolescents are restrained.
Restraint use continues to be used as punishment, for staff retaliation, and, “assault and battery” in some cases. But clearly, no “physician or other licensed independent practitioner” approving a restraint resulting in death, appears to have been called to account.
If a parent finds their child has been restrained, ask for a copy of the physician’s order and report both the doctor and facility if this was violated. Make the complaint to the U.S. Department of Health and Human Services, the Department of Justice and local police. Call for prosecution and hospital closure, as necessary.
The entire system needs an overhaul—from diagnosis to treatment to outcomes.
No restraint should be used on a child or teen. The teen behavioral-treatment industry needs oversight and criminal and financial accountability.
The following is but a small example of cases of children alleged to have been abused in UHS-owned psychiatric facilities. As children and teens can be too scared to speak out or are silenced when forced into such abusive hospitals and “schools,” the problem is likely far greater than is being reported.