Feature

When 16-year-old Aaron Bacon started dabbling in drugs and slacking off at school, his parents thought two months at a Utah-based "wilderness therapy" camp might get him back on track. Aaron enjoyed the outdoors and was an aspiring writer, so the program's emphasis on nature and on daily journaling sounded like a perfect fit. Convinced by a meeting with the camp's owners and a slick brochure that touted the facility's staff as caring professionals experienced in drug counseling and wilderness survival, Aaron's parents sent him off.

Within a month their son was dead, testified Aaron's father, Bob Bacon, of Phoenix, at an Oct. 10 hearing on Capitol Hill.

Hosted by the House of Representatives' Committee on Education and Labor, the hearing featured testimony from families, child psychologist and APA member Allison Pinto, PhD, and investigators from the U.S. Government Accountability Office, which has released a report detailing thousands of reports of abuse--and in some cases death--at residential treatment programs for troubled youth from 1990 to 2007.

Case studies of 10 fatal incidents found ineffective management, untrained staff, lack of adequate nourishment and negligent operating practices.

"For a number of years now, I have been deeply concerned about allegations of child abuse in private residential treatment programs," said Committee Chair Rep. George Miller (D-Calif.). "These allegations range from neglect to torture--a word that I don't use lightly."

Aaron's bloodstained and tattered journal told the tale of a hellish struggle for survival in the wilderness as participants were denied food for 14 of the 20 days on the trail while being forced to hike eight to 10 miles a day.

"On the days he did have food, it consisted of undercooked lentils, lizards, scorpions, trail mix and a celebrated canned peach on the 13th [day]," recounted Bacon's father. The campers also endured little or no protection or shelter from the cold. On the third day of the program, Aaron complained of stomach pain, but was denied medical assistance, his father said. By the 10th day, Aaron had lost control of his bodily functions. In the following days, he continued to get weaker, but the company-hired emergency medical technician insisted he was faking. He collapsed on his 31st day and was airlifted to a hospital, where he died from a perforated ulcer.

When Aaron's parents arrived to identify their son, they found him virtually unrecognizable due to bruises, cuts, lesions, rashes and open sores that covered his body.

Reports of mistreatment, medical neglect, violation of human rights, physical and sexual abuse and inappropriate use of seclusion and restraints at facilities that bill themselves as alternatives to traditional residential mental health-care are widespread, testified Pinto, an assistant professor at the University of Florida.

For the past three years, Pinto has been the coordinator for the Alliance for the Safe, Therapeutic and Appropriate Use of Residential Treatment, a national coalition of mental health-care professionals and others who work with children, which formed in response to increasing allegations of abuse at these facilities. The alliance posted an online survey to gather reports from people who had participated in these programs as adolescents.

"Within six months, over 700 people responded to the survey," said Pinto.

She received reports of amateur psychological interventions and treatment, medications administered or stopped without medical supervision, weeks of enforced isolation, deprivation of food, sleep and shelter in response to rule-breaking and youth being transported to the facilities without their consent, sometimes in handcuffs and leg chains, she continued.

"If those of us who are mandated reporters of child abuse learned of such treatment occurring in a family's home, we would be required to file a suspected child-abuse report," Pinto emphasized. "We must consider the reports of mistreatment and abuse occurring in residential facilities just as carefully."

Regulation of the industry is virtually nonexistent, said Miller.

"In light of the findings we will hear today," he said, "Congress must act, and it must act swiftly, to ensure the well-being of children participating in these programs."