Senate investigation reveals abuses, neglect at federally funded youth treatment centers

Monique Payne was just 14 years old when she was placed in a youth residential treatment facility (RTF) in Massachusetts. Her mother sent her there to get mental health treatment.

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Tragically, Monique died while in the facility’s care in 2006 from an untreated brain tumor that swelled.

“I sent my child to get the care she needed, and she was brought back in a casket to me. How does that happen?” Monique’s mother, Theresa Payne, told our Washington News Bureau.

An investigation found Monique had been complaining for days about headaches, but 911 was only called “after she stopped breathing and turned blue.”

Her family came to Capitol Hill to spread awareness about Monique’s story this week and to shine a light about dangers inside RTFs that are supposed to help kids and teens.

“They’re children being treated as animals,” said Miriah Payne, Monique’s twin sister. “They’re treated as if they’re disposable.”

“I want change,” said Ashley Sweatman, Monique’s sister. “I think less money should go in the pockets of the CEOs and more into the institution around rehabilitation… These kids need clinical intervention and they need adequate care.”

They shared their story alongside other family members, survivors and advocates as new findings were released from a two-year-long Senate investigation led by Sen. Ron Wyden (D-Oregon), Senate Finance Committee chairman.

Wyden said the investigation included reviews of four big companies: Universal Health Services, Acadia Healthcare, Devereux Advanced Behavioral Health, and Vivant Behavioral Health Services. Wyden said staff examined more than 25,000 pages of company documents, conducted dozens of conversations with experts, and toured some facilities first-hand.

“The Committee’s investigation found that children at RTFs suffer harms such as the risk of physical, sexual, and emotional abuse at the hands of staff and peers, improperly executed and overused restraint and seclusion, inadequate treatment and supervision, and non-homelike environments,” the report said. “These harms amount to acute safety concerns and have long-term effects, including suffering, trauma and even death.”

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The report points to cases of unqualified or poorly trained staff.

“Children at RTFs are often supervised by staff who are ill-equipped to address their complex behavioral health needs and, in some cases, children interact with staff who pose a direct threat to their wellbeing,” the report said. “Poor staffing leads to elopements from facilities, self-harm attempts by children, and child fatalities.”

The report said children often don’t get the mental or behavioral care they need, despite these facilities getting federal taxpayer dollars to provide those services.

“That means that American tax dollars are funding the kind of abuse our investigators found,” said Wyden during a hearing on Wednesday.

“Hardworking taxpayers should not be funding anything less than superior care,” said Sen. Mike Crapo (R-Idaho).

The report calls for Congress to require higher standards of care at youth RTFs and increased oversight of the companies running them.

The facility where Monique Payne was sent closed in 2017 after multiple patient safety incidents. Her family took their case to court. While a jury did find there was some negligence, it did not find that negligence caused Monique’s death.

Her family says they’re now calling for more accountability as they honor Monique’s memory.

“She doesn’t get to get married,” said Theresa Payne. “She doesn’t get to have children. I can’t see what she was going to be.”

The companies highlighted in the report who responded to our request for comment said they disputed the characterization of the Senate investigation’s findings.

In a statement, a spokesperson for Universal Health Services (UHS) said:

“We recognize the importance of the Senate Committee’s work in this area and share their concerns regarding the treatment of children at Residential Treatment Facilities (RTFs) across the country. We regret that, despite our cooperation with the Committee throughout the course of a two-year investigation of RTFs, the report is incomplete and misleading and provides an inaccurate depiction of the care and treatment provided at UHS RTFs, as well as the safety of the residents at those facilities. The report attempts to extrapolate certain incidents and survey reports into a false narrative regarding the treatment provided, environment of care and regulatory compliance at our facilities. We vehemently dispute this characterization of our facilities.

We acknowledge that there have been incidents over our many years of dedicated service at some of our facilities where the treatment of residents has not met our expectations and have suffered harm. Such incidents belie our commitment to provide a safe and therapeutic environment as well as the policies, procedures, protocols and training for our facilities. There is no place for any such incidents in our facilities and we are committed to ensuring such events are reduced with a goal of zero. Whenever such incidents occur, remedial action is taken.

A spokesperson for Devereux Advanced Behavioral Health said in part:

It’s unfortunate that Devereux has been lumped together in this report with three other for-profit companies that do not operate in a similar manner, but the facts on the ground tell the truth. We were saddened that during an otherwise very productive two-year partnership, the committee did not visit a single Devereux program. That said, we heartily endorse their recommendations for strengthening the overall system of residential care across the nation.

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