title: Unlicensed residential programs: the next challenge in protecting youth.
abstract: Over the past decade in the United States, the number of private residential facilities for youth has grown exponentially, and many are neither licensed as mental health programs by states, nor accredited by respected national accrediting organizations. The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) is a multi-disciplinary group of mental health professionals and advocates that formed in response to rising concerns about reports from youth, families and journalists describing mistreatment in a number of the unregulated programs. This article summarizes the information gathered by A START regarding unregulated facilities. It provides an overview of common program features, marketing strategies and transportation options. It describes the range of mistreatment and abuse experienced by youth and families, including harsh discipline, inappropriate seclusion and restraint, substandard psychotherapeutic interventions, medical and nutritional neglect, rights violations and death. It reviews the licensing, regulatory and accrediting mechanisms associated with the protection of youth in residential programs, or the lack thereof. Finally, it outlines policy implications and provides recommendations for the protection of youth and families who pursue residential treatment.
authors.affiliation: Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa 33612, USA. friedman@fmhi.usf.edu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Friedman
authors.forename: Allison
authors.initials: A
authors.lastname: Pinto
authors.forename: Lenore
authors.initials: L
authors.lastname: Behar
authors.forename: Nicki
authors.initials: N
authors.lastname: Bush
authors.forename: Amberly
authors.initials: A
authors.lastname: Chirolla
authors.forename: Monica
authors.initials: M
authors.lastname: Epstein
authors.forename: Amy
authors.initials: A
authors.lastname: Green
authors.forename: Pamela
authors.initials: P
authors.lastname: Hawkins
authors.forename: Barbara
authors.initials: B
authors.lastname: Huff
authors.forename: Charles
authors.initials: C
authors.lastname: Huffine
authors.forename: Wanda
authors.initials: W
authors.lastname: Mohr
authors.forename: Tammy
authors.initials: T
authors.lastname: Seltzer
authors.forename: Christine
authors.initials: C
authors.lastname: Vaughn
authors.forename: Kathryn
authors.initials: K
authors.lastname: Whitehead
authors.forename: Christina Kloker
authors.initials: CK
authors.lastname: Young
mesh_terms: D000068:Accreditation / Q000941:ethics / Q000331:legislation & jurisprudence; D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000941:ethics / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D003255:Consumer Organizations / Q000941:ethics / Q000331:legislation & jurisprudence; D004991:Ethics, Institutional; D006801:Humans; D008006:Licensure, Hospital / Q000941:ethics; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team / Q000941:ethics / Q000331:legislation & jurisprudence; D011785:Quality Assurance, Health Care / Q000941:ethics / Q000331:legislation & jurisprudence*; D012114:Residential Treatment / Q000941:ethics / Q000331:legislation & jurisprudence*; D014481:United States