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Saving Troubled Teens: A Greedy Industry?

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"I thought it would be money well spent," said Dana Blum. She never dreamed her son Brendan would pay the ultimate price.

Dana Blum

Gina Kaysen Fernandes: In a frantic rush to help her troubled teen, Dana Blum made a decision that she regrets every day of her life. As a single mother, Dana had to make the excruciating choice to send her son out-of-state to an expensive residential facility because she believed that she had no other option. Many distressed parents with out-of-control kids are increasingly willing to throw money at a growing number of facilities that promise to treat their child's emotional or drug addiction problems. In a moment of desperation, parents will spend whatever it takes. It's an impulse purchase that has turned the troubled teen industry into a money-making machine. "I thought it would be money well spent," said Dana. She never dreamed her son Brendan would pay the ultimate price.

In 2006, Dana found herself in a terrible predicament. Her husband had died and left her alone to raise two children, one of whom had special needs. Diagnosed with high functioning autism, 14-year-old Brendan Blum became unmanageable, exhibiting aggressive behavior and lacking communication skills. After years of family counseling, in-home therapy, and several arrests, Dana urgently needed a respite that she found in the form of a private residential treatment program. She hoped around-the-clock care would keep her child safe, "where he would learn coping skills that would enable him to successfully live at home and go to public school again," said Dana.

Brendan spent nearly five months at Youth Care in Draper, Utah, until the final night of his brief life on June 28, 2007. According to news reports, Brendan had severe stomach pains and had been vomiting and suffering from diarrhea all night. But instead of contacting the facility's on-call nurse, staff members gave Brendan medicine and placed him in isolation. The next morning, the staff found Brendan dead on his mattress. An autopsy revealed Brendan died of an obstructed bowel, a treatable condition if responded to in a timely manner.

When Dana enrolled Brendan into Youth Care, she knew there were no guarantees of success, but she never thought her child's life would be put in danger. "From your perspective, you're placing your child in an extension of a hospital treatment program. So you let your guard down," said Dana. "It's a decision I now regret and kick myself for every day."

For every horror story, there are many teenagers who believe the treatment was a lifesaver. "I believe they gave me back my son," said Wendy Thompson who sent her 11-year-old son to a wilderness therapy program called SUWS. "I shudder to think where we would be without that experience." Her son spent 58 days in the Idaho desert, where Wendy says he found personal accountability, self-esteem, and left behind pent-up anger. "That's not to say we don't have bumps in the road, but the path is much clearer."

Before treatment, the boy had violent outbursts that once escalated into a confrontation with police. When Wendy shipped off her son, she assumed the wilderness camp would perform "in-your-face" tactics. But she observed the opposite during a family visit. "I was impressed with the way the counselors interacted with the students," said Wendy. "Both the tone of voice and the volume I witnessed were so understated." Wendy received weekly progress reports via e-mail and photographs of her son.

Dana Blum insists she thoroughly researched Youth Care, ensuring it had the proper state licensing and accreditations. She calls her dilemma "a double-edged sword" because the $15,000-a-month program was her only choice. "I couldn't find any community-based programs for him," said Dana. State-run facilities generally offer services only to low-income families with children covered by Medicaid. That means that most kids living above the poverty line are out of luck. "There are far less options available for the large number of children in need," said Lenore B. Behar, Ph.D., a clinical psychologist and the former chief of Child Mental Health Services for North Carolina's Division of Mental Health. "The private programs are trying to fill this void," said Behar.

Brendan Blum Youth Care

Privately operated companies, like the Aspen Education Group, dominate the Internet and the industry by offering parents hundreds of options in the form of wilderness-therapy programs, "tough love" boot camps, or residential treatment facilities. Aspen owns Youth Care, SUWS, and the majority of the troubled teen facilities operating in the U.S. When parents visit these programs nestled in sleepy, rural communities, they get a family-friendly, homey feeling. "There was a living room with couches," recalls Dana.

Parents can expect to shell out six-figure fees for the promise of straightening out their dysfunctional child. Insurance covered Brendan Blum's treatment for 90 days, but Dana was told it would take six to eight months to see meaningful results. When insurance coverage runs out, the facilities typically push parents who don't have cash on hand to borrow money. In fact, Aspen has a link on its website to a financial company that specializes in these types of loans.

"If you're going to do it right, it's going to be costly," said Behar. The biggest expense for these programs is staffing well-trained, qualified people who can make good decisions in an emergency situation. In Behar's 32 years of experience overseeing state-run facilities, she knows it's very difficult to turn a profit. Yet many of these private facilities are making money, hand over fist. "In order to make a profit, they have to cut in some way, and since manpower is the biggest expense, that's where the cuts come," Behar said. The companies are saving money by hiring younger, less experienced people and are providing less expert supervision. Critics argue this cost-cutting measure puts the children at risk.

Dana Blum believes the staff's negligence is to blame for her son's death. "They killed my child when they didn't attend to him. I feel like he was murdered." The Salt Lake City District Attorney took Aspen to court. But ruling there was no "intent" to kill Brendan, a Utah judge dropped the criminal charges filed against the two employees. The state put Youth Care on probation, requiring it to retool its employee training. The facility never faced any fines, and remained open for business.

Devastated and distraught, Dana began looking online into Aspen's public financial statements. She learned that the Cupertino-based company is actually owned by a health care corporate giant, CRC Health. And Bain Capital, a multibillion dollar private equity firm, owns CRC.

Dana has filed a civil suit against the financial goliath, which could settle out of court. Critics believe this is why so few stories of abuse, neglect, and death at these facilities are made public. Aspen has enough money in its war chest to make these allegations go away. "If you look at their daily profit numbers compared to what they charge, it's obscene," Dana said. "It made me very angry that they couldn't provide better emergency services for my son."

Watchdog groups like Teen Advocates USA are keeping track of the grim statistics. According to estimates, more than 100 children have died in the past two decades in residential or wilderness programs. This past August, Sergey Blashchishen, a 16-year-old boy from Portland, collapsed and died while hiking at the Aspen-owned SageWalk Wilderness Program in Redmond, OR. A criminal investigation into his death is ongoing.

Aspen Education Group disputes these claims, saying their focus is on safety. Kristen Hayes, Communications Director CRC Health Group, tells us, "We are proud to state that we have established comprehensive standards of quality and safety protocols that exceed state and industry standards, and have implemented best practices and risk management procedures to ensure constant assessment, feedback and innovation and, most importantly, to enhance the care that each student receives. Safety is paramount within each of our outdoor programs, therefore each group is supported by a professionally trained wilderness first responder. In addition, all direct care staff are First Aid and CPR certified."

The Government Accountability Office has uncovered many more reports of serious abuse and neglect in programs nationwide as part of an exhaustive 2007 report to Congress. The Federal Trade Commission warns parents on their website, "these programs are not regulated by the federal government and many are not subject to state licensing or monitoring as mental health or educational facilities, either."

Wendy Thompson can empathize with grieving parents whose children have died in a treatment program; she lost a child to cancer. But Wendy thinks vilifying the troubled teen industry in the media is a mistake. "I feel we are a society of blame. More children die each year by their own poor decisions than the result of wilderness programs," said Wendy.

"It's a complicated situation," said Behar. "I don't know of any program where everyone said it was awful." Behar suggests parents who are considering serious treatment for their child look into public programs first, especially those that provide non-residential, intensive programs, to see if they accept private insurance. "There's no shame in calling the local mental health department to find out what might be available," Behar said. The availability of care varies from state to state.

Wendy's son was fortunate enough to enroll in SUWS free of charge, but she doesn't think the price most people have to pay is unreasonable. "I think the 30 or 40 thousand dollars you invest in your child is a pittance," said Wendy. "These programs are effective in the long run by saving the general public money when these kids end up in prison."

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