Kenneth R. Rosen: How ‘troubled’ teens might be troubled no more

Paris Hilton brings overdue attention to an industry in need of greater oversight.

(Trent Nelson | The Salt Lake Tribune) Paris Hilton after speaking on SB-127 to the Senate Judiciary, Law Enforcement, and Criminal Justice Standing Committee in Salt Lake City on Monday, Feb. 8, 2021.

Paris Hilton made quick work of spreading awareness of a problem long sequestered to private Facebook groups and reunions of so-called “troubled teens,” young boys and girls on rebellious streaks who are sent away to programs which promise to turn those wayward teens around.

The attention Hilton brought to the Provo Canyon School and her allegations of abuse during her time there in the 1990s has stirred up an extraordinary public reckoning among former clients of similar behavioral treatment programs, both in Utah and nationwide.

Progress toward curbing the hurt — physical, emotional, sexual — inflicted upon clients at these programs seemed imminent this September when Hilton’s documentary, “This Is Paris,” was released. Former clients rallied behind social media cries of #breakingcodesilence and #iseeyousurvivor, sharing tales of what had happened to them at Provo Canyon and behavioral modification programs like it over the past several decades, many young women and men disclosing their pain for the first time.

Missouri and Montana saw modest success in reforming how they licensed those programs and in Oregon the state canceled its contracts with a private healthcare provider which operated programs in which teens were seriously abused and, in one case, killed.

Now the state is making known these voices are being heard as Sen. Mike McKell introduced legislation in January that would limit restraints, drugs and isolation rooms at similar programs across Utah.

“There’s a lot of money in this industry. It’s a large, large industry,” McKell said. “And I have become increasingly concerned that the appropriate amount of regulation has not caught up.”

But where hope had once dawned, a disturbing memory resurfaces and I am reminded of when I first set out to document my time at three “tough love” treatment programs over 288 days, one a therapeutic ranch in southern Utah. I long sought to understand what became of those who I met during time spent in the shadowy system. Had they been harmed? If so, had they gotten justice? If now, how come?

When Utah’s Disability Law Center announced in October an investigation into troubled teen facilities like the one I attended in Loa, the thriving industry responded as it always had in the course of my reporting: quick disregard and dismissal of claims of abuse.

The executive director of the National Association of Therapeutic Schools and Programs, Megan Stokes, whom I interviewed for my latest book, on the troubled teen industry, was last month discovered to have directed facilities to characteristically subvert the Disability Law Center’s investigation, believing investigators were looking for abuse where none existed, “that even if there isn’t smoke, there’s still fire,” Stokes said in a recording.

This is par for the association that once marketed itself as an accrediting body until a Government Accountability Office investigation in 2007 led the organization to change to a membership-based system which falsely legitimized programs that pay an annual fee. In the case of the Provo Canyon School, which once was run by Charter Behavioral, administrators with the current owner, Universal Health Services, say they aren’t their predecessors. They’ve changed, they say. They’ve done better.

In 2010, Universal Health Services Inc. operated more than 200 behavioral health facilities in thirty-seven states, Puerto Rico, and the Virgin Islands. Its behavioral health division alone produced revenues of $3.4 billion.

Associations and research bodies (like the Outdoor Behavioral Healthcare Council, funded primarily by the stakeholders they help to establish across Utah) advocating for non-evidence-based behavioral treatment have long used the tactic of blaming the industry’s troubled past for tainting current standards which still remain questionable. But those methods of treatment (medical sedation, restraining children, violence) haven’t changed since the treatment’s rise starting in the 1980s.

Many of the more than 100 interviews I conducted for my book “Troubled: The Failed Promise of America’s Behavioral Treatment Programs” were with former behavioral modification clients who spent time at programs in Utah. They often approached government officials in the years before Hilton’s documentary, attempting to get anyone to hear their stories. But the government also has a history of inaction and the burden of this nonintervention rests equally on the state of Utah as it does organizations like NATSAP and OBHC.

One young woman, whom I’ll call Tara, shared an email exchange with the Department of Human Services to report abuse at Discovery Ranch, in Mapelton. “All of these things take time and precision,” the investigator wrote. “We take all concerns seriously and will investigate them.”

Hearing a person in power say they can help, that they are listening, is a story I heard dozens of times and that story always ended the same. Finally, after years labeled a troubled teen, the former clients, now survivors, were being heard. Then their phone calls go straight to voicemail. No charges are brought. Investigations peter out. The clients are forgotten and, as they had been when they were first sent away, their voices disappear.

If the state of Utah is impelled now to address the abysmal conditions of these programs, it must not stop at McKell’s singular bill. It must pursue regulation of the programs more broadly, to include staffing requirements, the banishment of “transportation” services which cart teens off to these programs, and an abuse and neglect reporting program that answers to a nonpartisan board for review.

Until then, the voices of the thousands who’ve suffered through and after these programs will be silenced.

(Photo by Earl Wilson | The New York Times) Kenneth R. Rosen

Kenneth R. Rosen is the author, most recently, of “Troubled: The Failed Promise of America’s Behavioral Treatment Programs” and a former client of three “tough love” facilities. He previously spent six years on staff at The New York Times.