|Type of paper:||Research paper|
|Categories:||Education Child development|
When a parent decides to place his or her child in a residential treatment center, the decision is often accompanied by fraught and anxiety on how the child will cope with the challenges of being in a boarding facility away from home. However, the concerns are often quelled by the fact that the decision was made based on the guidance and recommendations of a professional in the field of mental health, a judge, a counselor, or even a probation officer. The decision is often made using the thought it is in the best interest of the child. Nevertheless, deciding whether to place a child in a residential treatment program is a difficult and complicated process. The difficulty is particularly observed when one tries to match the treatment program's strengths to the child's needs.
However, contrary to a parent's expectations that the treatment program will be of benefit to the child, some residential treatment programs have been reported to exploit, mistreat and abuse youngsters who are enrolled into them. The occurrence is often bound to happen when the parents of the child fail to verify important elements of the institutions they enroll their children. It is required that parents conduct basic verification exercises to ascertain the credibility of these institutions. An example of a verification exercise is checking whether the institution is licensed to be in the State it operates.
In this paper, the reason as to why the State of Utah has the highest number of adolescent behavioral residential treatment centers will be analyzed. The paper will also provide an analysis of the problems that are bound from such as occurrence and the possible solutions to the problems.
Stating the Problem
Over the years, reports have emerged that there are mistreatment and abuse of American youth who had been enrolled in therapeutic boarding institutions or residential treatment programs that were unregulated. The concerns were highlighted in a multi-State survey where the majority of the respondents were from Utah. In the multi-State survey, the composition of youth from Utah who were respondents were 15.7%, those from Montana, New York, California, and Georgia were 13%, 10.8%, 7% and 5.7% respectively.
One of the concerns that have emerged includes the youth experiencing communication and privacy violations. For instance, while the young adults were in the institution's majority of them reported that their phone calls and their emails were being monitored. In other cases, their letters or conversations were either filtered, restricted or interrupted. For instance, one of the teens reported that the first contact he had with people from the outside world other than in the facility was six months after he had been enrolled in the program. Furthermore, he was only provided with 10 minutes to speak to his parents while a counselor at the facility was listening. They were also denied contact information belonging to an advocate.
Another form of mistreatment that the youths went through according to the report was being subjected to seclusion or physical restraint. Seclusion or physical restraint occurred despite the fact that an individual may not have committed an act that would require such intervention measures in a licensed or accredited treatment facility such as being aggressive towards staff members. They were subjected to restraint and seclusion for insubstantial reasons such as making a face, using a cursing word, or saying something disrespectful.
Apart from experiencing unwarranted seclusion and restraint and privacy violations, there were also reports of inhumane treatment from these facilities. For instance, patients in these institutions reported that they would be required to participate in forced labor or would be exposed to extreme weather elements such as snow, heat, and cold under the guise that they were medical interventions. In other cases, they would be deprived of nutritional intake as well as sleep. Also, the patients were subjected to the denial of use of the bathroom, undertook excessive exercise, where physically punished or were exposed to the use of scare tactics.
The problems are not only limited to inhumane treatment and mistreatment. Between the years of 1990 to 2003, there were five deaths in the state of Utah. The deaths were attributed to the inappropriate use of Wilderness therapy. For instance, there was an incident in a wilderness program were a boy ages 13 years died after being held in restraint for more than an hour. Apart from being held in restraint, the boy was denied his inhaler by counselors at the camp. Another case of inhumane treatment that occurred in Utah was that youth were restrained face done on manure.
In addition, there are some types of commonly used therapy in these centers that have previously been credited to resulting in loss of life for the youth exposed to them. For instance, Wilderness therapy has been subject to controversy in the past. There have been cases where children have been injured and eventually died within Wilderness or boot camps. Some of these deaths were also blamed to the fact that though the youth sustained serious injuries or had dire medical conditions, staff members at the camp failed to adequately responds to incidents thereby leading to the deaths.
In his book, Maia Szalavitts exposes the harsh conditions that tactics that are deemed as brutal used to punish adolescents with behavioral issues instead of rehabilitating them. The adolescents are booked into institutions that charge as high as $2000 a month or even more to a lockdown facility that resembles a prison. The author, however, states that it is fascinating that the amount of money paid by parents to these institutions is more than the amount paid to Ivy League educational institutions. The occurrence is despite the fact that in some case when their children are enrolled into these institutions they are subjected to routine exercises that are inappropriate such as the attempt to brain wash them or using placing their bodies in stress positions. The author further states that the severity of the situation is amplified by the fact that little evidence supports the assertion that these facilities can treat behavioral problems. Maia Szalavitts further states that some of the outcomes of subjecting youth to such institutions are the development of post-traumatic stress disorders. In some cases, teens die under the care of counselors in the facility.
Exact Utah State Regulation
In 2005, Utah's state legislature made an amendment to its licensure laws. The amendment created a law whereby all programs except private residential schools would be subject to regulations. Therefore, in Utah, private and residential treatment centers meant for children, adolescents and young adults are neither regulated nor monitored. These facilities are also not categorized as either educational institutions or mental health centers. The occurrence is despite the fact that Utah regulates and monitors other privately administrated facilities that provide services such as nursing care, hospitals, day care centers and restaurants.
Incorporation of Legal Precedent
The United States Constitution dictates that the regulation of all private or public residential facilities is a jurisdictional mandate of a state. Conventionally, the policies that govern the regulation public, as well as private institutions, lie within the discretion of an individual state. It is often upon a state to decide whether to employ administrative action, state legislation, or regulation in providing oversight on both public and private residential menta
Mechanisms used to Fund these Centers
Varieties of revenue streams are us to fund mental health services in Utah. Some of the funding sources include general fund revenue, county funds, Medicaid and Medicare, out of pocket payment, and third party insurance. Other sources of funding include the Mental Health Block Grant which is primarily meant to supplement other sources of financing. In all of these funding sources, Medicaid is the primary financier of mental health medical services in Utah.
In Utah, adolescent behavioral residential treatment centers are primarily funded by Medicaid which is also a major funder of the State's public mental health system. The state also provides funding to non-eligible Medicaid populations. However, the funding is limited and does not cater for all the mental health and behavioral needs in the state.
At the federal level, the ratification of the Health Information Portability and Accountability Act made it possible that in all states, Medicaid and Medicare would pay for behavioral health assessment as well as intervention.
According to Utah's Health Behavioral Advisory Committee, in 2015, the planning council ratified legislation that supported budget recommendation meant to reimburse payment for services in such institutions. The ratified legislation for the budget made recommendations that local authorities would provide a Medicaid match fund that would total $6.4 million which was meant to enhance the provision of mental and behavioral health medical service to an estimate of over 40,000 people residing in Utah. In addition, it ratified the provision of $1.2 million, which was meant to restore Medicaid funding loss that resulted from changes in allocation methods hence preventing a bed loss capacity that would have served 30 persons at Utah State Hospital. In addition, the ratification meant that early intervention for mental health would receive a boost of $1.5 million. The boost was meant to allow the continuation of the provision of mental health services that was earlier funded using the one-time revenue. The funding would have also increased its beneficiaries from 3892 to 5761 individuals.
Other than Medicaid, these centers are also funded private insurance. The Mental Health Parity Act of 2010 also funds these institutions. The Act provides braided funding to school districts where behavioral health services are provided to schools through a partnership with Valley Mental Health. Similarly, a partnership with Intermountain Healthcare has made it possible for the provision of mental health services to approved institutions. Funding for these institutions is also obtained from the Utah Division of Substance Abuse and Mental Health in collaboration with the State's office for education. Another source of funding is the Northeastern Counselling Center and the Individuals with Disabilities Educational Improvement Act.
Previously, treatment centers, such as those that offered Wilderness therapy were out of reach by many of those who were in need of them and only the rich could afford them. The therapy was out of reach for many since it was not covered by insurance agencies. The reason was that at times, the therapy could have cost up to $500 a day yet it could run for weeks. Fortunately, in 2008, a shift in federal laws made the therapy accessible through insurance. The Affordable Care Act was credited to forcing insurance firms to cover mental health, and substance abuse treatment needs thereby forcibly including wilderness therapy.
Reasons why there is a Problem
Utah, a state that is located on the western side of the United States has in the past encountered substantial issues that arise from having questionable programs that exist while being exempted from regulation. Since the discretionary rule applies to all states, the state of Utah has employed it to its possible disadvantage particularly in regulating how minors are attended to when enrolled in residential mental health facilities. Utah is believed to have m...
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