National Alliance on Mental Illness
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A Resource for Families Considering Residential Treatment Programs for Their Children

September 2008

If you care for a child with a serious mental illness, you are not alone. According to the Surgeon General, 1 in 5 American children and adolescents live with mental illnesses and nearly 5 million suffer from a serious mental disorder that significantly interferes with daily functioning.

Caring for a child with a mental illness can be overwhelming and often strains marriages and family relationships. Children with serious mental illnesses may struggle in school, threaten violence to themselves or others, or get caught in the juvenile justice or criminal justice systems. Meanwhile caregivers often experience frustration, guilt, or anxiety as they struggle to find help for their child.

Although most children with mental illnesses respond to standard treatments, some children with more serious mental illnesses continue to struggle. If you are a caregiver who has utterly exhausted community mental health care resources, you may be considering sending your child to a residential treatment center.

In the US, private residential treatment facilities for youth serve 10,000 to 14,000 children and adolescents. Many residential programs are not subject to any state licensing or monitoring as mental health facilities. While some residential programs offer nurturing and caring environments and use evidence-based interventions, others are highly dangerous and damaging. The most concerning programs are those that operate under the philosophy that young people must be broken before they can be helped. These programs use disciplinary techniques such as degrading confrontation, deprivation of basic physical needs, and alienation from family. These abusive methods can confer permanent psychological damage and divide the young person from his or her family.

Residential treatment is an extreme measure that should only be taken if local resources have proven inadequate. Conscientious residential programs that use proven interventions such as evidence-based psychotherapy, drug and alcohol counseling, parent support and education, and social-skills training can strengthen families and help facilitate live-saving changes.

The time spent in a residential program should be as short as possible, with the goal of returning the child to his or her family and community with the least amount of stress and disruption possible.

The following five lists of suggestions and information have been compiled from various sources to help you make an informed decision about sending your child to residential treatment.

Download the Complete Resource Guide for Families Considering Residential Treatment Programs for Their Children.

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