Editor’s Note: This story was produced as part of “Sent Away,” an investigative podcast from The Salt Lake Tribune, KUER and APM Reports that examines Utah’s teen treatment industry. You can listen to Episode 6 here.
For years, Utah has been the epicenter of the nation’s so-called “troubled-teen” industry.
Some 20,000 kids have been sent away since 2015 to Utah teen treatment programs catering to parents and state agencies desperate to find help for struggling teenagers.
Some are on juvenile probation. They may be struggling with drug misuse or eating disorders. Some are depressed or defiant. Some have cut themselves or attempted suicide.
And the businesses that have taken them in have been lucrative, with parents or state agencies paying hundreds of dollars per day for the promise that the child will be helped. It’s estimated these teens bring hundreds of millions of dollars into Utah’s economy every year, according to a research brief from the University of Utah’s Kem C. Gardner Policy Institute.
There are more kids sent to Utah for treatment than to any other state — and it’s not even close. Over six years, from 2015 to 2020, 34% of all teens that crossed state lines to enter a youth treatment facility ended up in Utah.
So, how did Utah become the place entrusted to help so many struggling young people? It’s a complex combination of history, culture and Utah’s rules and regulations.
Utah’s squeaky-clean reputation
The industry was first sparked in the 1960s, when a Brigham Young University student named Larry Dean Olsen started leading wilderness outings with his classmates.
Leaders at BYU, which is owned by The Church of Jesus Christ of Latter-day Saints, noticed that students who went on these journeys seemed to be doing better in school and were more well-mannered at home. So school officials developed a course that offered failing BYU students a shot at readmission if they learned survival skills and went on a monthlong backpacking trip through the Utah desert.
That was the foundation on which the lucrative wilderness therapy industry was born.
Programs catering to parents promised that wayward teens living and hiking in Utah’s picturesque deserts and mountains would have a transformative experience that would change their lives for the better.
Republican state Sen. Mike McKell, who last year sponsored the first reform in more than a decade to the state’s oversight of the teen treatment industry, said that origin story at the private religious institution gave the industry “instant credibility” to parents in other states looking for solutions for their teenagers.
“Utah has a very clean look to it, a clean feel,” he said. “And we pride ourselves on strong family values. I think that all plays a part.”
A ‘pioneer’ in Provo Canyon School
By the 1970s, Utah’s youth treatment programs had expanded beyond hiking kids through public lands. They also included congregate care facilities.
One program in particular that started around that time remains one of the most prominent: Provo Canyon School.
“You had kind of a pioneer in youth treatment programs with Provo Canyon School,” said Ken Stettler, a former regulator who used to run the Utah Office of Licensing, which oversees treatment programs throughout the state. “Probably almost anybody that’s involved with youth treatment nowadays can probably draw some tie back to Provo Canyon in some way or another. And the fact that a goodly number of people that worked there broke off and started other treatment facilities.”
Just take the men who founded Provo Canyon School in 1971: Eugene Thorne, Robert Crist and Jack Williams. They all went on to start their own facilities in Utah — four in total — most of which are still in operation today. Other workers at the facility over the years, including therapists and administrative staff, have since opened their own programs, too.
“You had all these offshoots that started,” Stettler said, “and most of them were people that worked there. So they were locals. They wanted to start their own program. They don’t want to go to some other state.”
The age for medical consent
Utah is considered a “parent’s rights state,” which means that parents get to make medical decisions on behalf of their children. So if a child is in Utah for treatment, they aren’t able to leave the facility unless their parents agree to it.
That’s not what it’s like in other states.
In California, for example, a child must consent to mental health treatment if they are 12 or older. In Washington state, that age is 13.
Relatively cheap land and an eager workforce
A lower cost of living in Utah compared to other states was another reason the teen-treatment industry has grown, according to Megan Stokes, the director of the National Association of Therapeutic Schools and Programs.
“There’s lots of land available,” she added.
Stokes also said that Utah has an eager workforce, often college students who take lower-paying frontline worker jobs to help care for kids — either because they are majoring in social work or feel called to help young people.
“That’s where you have the pool of talent,” she said.
About 30% of her organization’s members are from Utah, according to a review of their membership records.
Stettler, the former regulator, said that’s where Utah’s culture and deep connections to the LDS faith also come into play.
“People of that faith believe their role and responsibility on Earth is to help one another and to help others that need help,” he said. “So the idea of working in a facility where you can help a kid turn their life around is appealing.”
As the teen treatment industry grew in Utah, problems came along with it. There have been allegations of abuse. Riots. Deaths in wilderness programs. Sexual assault. Lawsuits.
Historically, there’s been little state regulation of these programs; they are often allowed to stay in business despite regulators finding that a facility violated state rules or that a worker harmed children in their care.
Utah regulators haven’t shut down a facility in the last five years. The closest the state came was in 2019, when Red Rock Canyon School voluntarily relinquished its certification after a riot and media scrutiny highlighting increasing violence at the facility.
Regulators are now looking into these facilities more closely than ever after Utah legislators updated the law last year.
The new law placed limits on use of restraints, drugs and isolation rooms in youth treatment programs. It required facilities to document any instance in which staff use physical restraints and seclusion, and it mandated that they submit reports to state licensors. It also upped the required number of inspections that state regulators must conduct.
Amanda Slater was the director of the Office of Licensing for three years until she recently took another job within the Utah Department of Health and Human Services. She said the new law has put regulators in facilities more often, which has helped them identify problems more quickly. Previously, regulators only visited a program once a year, and the inspection was pre-scheduled.
“Most people would clean up their house before you show up, right?” she said. “So you don’t always find the problems. If we’re aware of it, we take action. We are a lot more aware because we’re in there more frequently.”
KUER reporter David Fuchs contributed to this article.