A child dies in “residential treatment.” But the heart of the problem is “residential treatment” itself.
This post has been updated to reflect the fact that the Philadelphia Department of Human Services says it had no role in the placement of this particular child in this particular residential treatment facility.
Suppose, hypothetically, we were building our public child welfare and mental health systems from scratch. We could design them any way we wanted.
Now, suppose somebody said: Hey, I have a great idea! Let’s take the young people we believe have
the most serious emotional and behavioral problems, at the very age when they
are most susceptible to peer pressure and put them all together in the same
place! Won’t that work well?
Odds are most people would think it’s the guy who thought up
the idea who really needs a mental health intervention.
Yet that’s exactly what we do. We slap a nice, reassuring label on it –
residential treatment – dress it all up with psychobabble and try to make the
grounds look as pretty as possible to impress visitors, but at bottom it’s an
approach doomed to failure.
This is one of the relatively few areas in child welfare
where the research is close to
unanimous. Even when the institutions do not devolve into hellholes,
residential treatment is a failure that does terrible harm to children – and
costs a fortune. (The link to the research also goes to an
all-purpose foster care-industrial complex excuse
check-list, which lists all the standard rationalizations for residential
treatment, and why they don’t stand up to scrutiny.)
There is nothing – nothing – that residential treatment
supposedly does that can’t be done better and safer with intensive in-home
services. In this video, a pioneer
in providing such services explains how it’s done:
The death in Philadelphia
All these problems are inherent in the RTC model. In other
words, these problems exist before we even reach the issue of horrible
conditions and abuse at RTCs – issues that are now getting attention in
Philadelphia because a 17-year-old, known only as “Child 1” died
in one of them, a place known as Wordsworth Academy.
It took that death, and a litany of other failures, before
the state stepped in and shut down the residential treatment program. The state did it, not the Philadelphia
Department of Human Services, actually placed “Child 1” at Wordsworth, which actually oversees child welfare in the city and which has contracted with Wordsworth to provide an array of services
to the city’s vulnerable children. DHS says it was not involved in placing "Child 1 at Wordsworth. DHS can't pull a facility's license, but it certainly could have pressed the state on the matter before a child died.
Indeed, when you lock away a large group of people who are
overwhelmingly poor, disproportionately people of color, people we don’t want
to think about or fear, then keep them out of sight and out of mind, what do
you expect? That’s why these kinds of
scandals happen over and over again.
So why does DHS keep relying on these places?
Because DHS is begging for beds and beggars can’t be
choosers.
Though DHS has reduced its reliance on all forms of
“congregate care” – group homes and institutions – it still uses these
facilities at a rate above the national average. It has to. Because DHS tears apart families at the second highest rate
among America’s big cities, even when you factor in rates of child poverty.
When you don’t factor in poverty, Philadelphia is number one.
Philadelphia's high rate of removal
The rate of removal in Philadelphia is triple the rate of
New York City and quadruple the rate of Chicago. Does anyone really think Philadelphia
children are three times safer than New York children and four times safer than
Chicago children.
And no, that’s not some inevitable result of a bunch of
terrible new state laws passed in the wake of the Jerry
Sandusky scandal that encouraged child abuse hysteria and foster-care panic. Philadelphia’s dismal record predates those laws. The
figures cited above are from 2014. And
those same laws apply in Pittsburgh, where, unlike Philadelphia, the foster
care population did not increase
after those new laws passed.
This latest tragedy is one more consequence of years of
willful blindness at DHS, an agency that has refused to learn from other cities
and states that do a far better job keeping children safe while taking
proportionately far fewer children.
Yes, those other places also use group homes and
institutions – but they use them less.
So tragedies like the latest death in Philadelphia are less likely.
There’s a lot we still don’t know yet about this latest
tragedy. We don’t even know the boy’s
name. Surely he deserves at least to be
known in death by his own name. And we
deserve to know if he ever really needed to be in “the system” at all, much
less how he wound up institutionalized.
Perhaps it will turn out his removal to substitute “care,” however it happened, was entirely justified. Perhaps it will turn out that the child was placed "voluntarily" by parents or other caretakers who felt they had no other choice - because no one offered them better alternatives. Or perhaps there was some other set of circumstances. But that would mean only that some other child, who did not need to be taken, was in the safe placement that should have been reserved for the youth we now know only as “Child 1.”
Perhaps it will turn out his removal to substitute “care,” however it happened, was entirely justified. Perhaps it will turn out that the child was placed "voluntarily" by parents or other caretakers who felt they had no other choice - because no one offered them better alternatives. Or perhaps there was some other set of circumstances. But that would mean only that some other child, who did not need to be taken, was in the safe placement that should have been reserved for the youth we now know only as “Child 1.”
