Desperation without Dignity: Conditions of Children Placed in For Profit Residential Facilities.
National Disability Rights Network.
Published: October 2021
National Disability Rights Network
820 First St. NE Suite 740
Washington, DC 20002
Tel: (202) 408-9514
Fax: (202) 408-9520
TDD/TTY: (202) 408-9521
Sponsoring Organization: United States. Administration for Community Living. United States. Substance Abuse and Mental Health Services Administration. United States. Rehabilitation Services Administration.
This federally funded report shares the findings of an examination of for-profit residential treatment facilities (RFs) by Protection and Advocacy (P&A) agencies, agencies created by the U.S. Congress in the 1970s to advocate for persons with disabilities in every State and territory. Information was gathered during P&A monitoring and investigations conducted over many years. The report provides a brief history of RFs and describes the negative developmental impact of residential treatment on children. The benefits of community-based treatment over congregate care are highlighted, as well as successful treatment interventions for children with mental and behavioral health disorders. The role of P&A agencies is then explained and problems uncovered at RFs are shared. Abuses by RFs are described and include physical and sexual abuse by staff, forced isolation, failure to provide mental health treatment, lack of evidence-based treatment, the systematic use of restraint and seclusion, the lack of reporting, overuse and misuse of psychiatric medication, chemical restraint, harmful behavior management practices, limited education resources, staffing shortages, inadequate living conditions, and inadequate COVID-19 pandemic precautions. The role of the State in sending children to RFs is discussed, as well as the role of private equity in facility finances and monetary incentives driving the operations of some RFs. The report closes with recommendations for State and county governments to immediately stop placing children in dangerous residential facilities, and for community-based systems of support to provide a continuum of services to meet the needs of children and youth with disabilities. Specific recommendations are made for the federal government, State governments, and local agencies.
DISABILITIES; CHILDREN WITH DISABILITIES; CHILDRENS RIGHTS; HUMAN RIGHTS; LEGAL RIGHTS; RESIDENTIAL TREATMENT; PREVENTION PROGRAMS; CHILD ABUSE; INSTITUTIONAL ABUSE AND NEGLECT; CHILD NEGLECT