In the first weeks of December, a short video — just three minutes and 22 seconds — started zipping around certain circles of the internet.
In it, Megan Stokes, the head of the “troubled teen” industry’s largest trade group, can be heard on a conference call advising members on how to spot warning signs that their programs might be the subject of a Disability Law Center investigation and cautioning them to tread lightly.
“Please find out if you have had an increase in records requests over the last two to three weeks,” Stokes said on the recording. “If you have, you can talk to me privately. You can talk to me publicly, however you want to do that. Call my cell, call the home office. Let’s not email.”
Stokes represents the largest network of privately owned residential treatment centers, therapeutic boarding schools and wilderness therapy programs in the country. Her organization is the National Association of Therapeutic Schools and Programs, or NATSAP. Of the trade group’s nearly 200 members, 55 — or almost a third — are in Utah.
Over the past 50 years, the industry has become larger in Utah than anywhere else in the country. Tens of thousands of troubled youth have been sent here by parents, school districts, child welfare agencies and juvenile justice departments. And over the years many former residents have spoken up about mistreatment. Federal attempts at reform have failed. And for decades, little changed.
But this fall, something did.
In September, well known entertainer and heiress Paris Hilton released a YouTube documentary detailing abuse she says she experienced at Provo Canyon School. The film has accrued nearly 20 million views online, and a petition calling for the school’s closure has since collected close to 200,000 signatures. The documentary also featured the work of the advocacy group Breaking Code Silence, a viral movement dedicated to raising awareness about and ending mistreatment at youth treatment facilities.
One month later, Breaking Code Silence and Hilton’s team organized a rally and silent march in Provo. While the event was focused on the school a few blocks away, it drew more than 100 self-described survivors of treatment center abuse from all across the country. Some had attended the school. Others had been to programs like it. But all shared a common message: Abuse in the industry must end.
A Close Up View
Emily Graeber never expected to return to Utah.
Now 28 years old, she spent nearly a year and half here as a teenager at a program called Island View in the late 2000s — a period of time she still refers to as her “personal hell.”
“I was put in isolation for 58 days, made to stare at a wall, not speak, pee on myself and sit in it,” said Graeber, describing the punishment she received after her short-lived escape attempt made headlines in Utah and beyond. “I wasn’t even allowed to look at other people.”
But after reconnecting in the lead-up to the Provo protest, she and a small group decided to return to the Syracuse facility.
Island View technically closed in April 2014 — the same time the business was drawing heat for an incident in which staff had broken the arm of a patient sent there very publicly by Dr. Phil McGraw of the "Dr. Phil" television show.
The facility was sold to a new company and renamed Elevations RTC. The Huffington Post covered the change in detail in 2016, with a focus on the two programs’ similarities.
KUER has separately spoken with 14 former residents at Island View and Elevations whose attendance spanned from 1996 to 2020. All alleged some form of physical, sexual or psychological abuse.
“It’s pretty eerie to know that in the years that passed ... it didn’t change a bit,” Graeber said. “Here I am 13 years later, talking to survivors of Elevations and it’s the exact same place.”
Utah’s Regulatory System: What’s Tracked And What’s Not
In Utah, oversight of places like Island View and Elevations rests with a state human services division called the Office of Licensing. The office doesn’t keep a database — either publicly or internally — on the number of violations or investigations associated with any of its licensees, which makes it challenging to know if conditions are generally getting better or worse.
The office’s director, Amanda Slater, said they don’t aggregate data because their recording-keeping system doesn’t have that capability.
Slater also said her licensing officers and investigators do not have any numerical tools to detect a pattern of violations at a given facility, apart from reviewing each individual record and tallying the results. Though she acknowledged her office is the state's primary regulator of youth residential treatment facilities, she stressed its mandate is to enforce licensing violations specifically and that complaints involving abuse or neglect allegations are turned over to other agencies, including the Division of Child and Family Services and law enforcement.
Slater added her office began the process of acquiring a new database system roughly one month after she started as director in May of 2019. She said the new system, which she expects to be up and running midway through 2021, will have the ability of making care providers’ inspection reports and compliance histories available to the public without a public records request. She declined to comment on whether it would have data-tracking capabilities.
Local law enforcement agencies, however, maintain separate logs of whenever they respond to a facility.
In the case of Island View and then Elevations, the local Syracuse Police Department has responded to 219 emergency calls at the facility’s address between Jan. 1, 2005 and Oct. 27, 2020. Those calls have become 40% more frequent since the facility opened as Elevations RTC. And the rate of calls relating to abuse, sex offenses or suicide attempts has gone up even more.
But in roughly 88% of those calls, the department indicated nothing more was needed than a visit to the site. Only 14 calls, roughly 6%, resulted in arrests — all but one of which occurred during Island View’s ownership.
Elevations’ Response
Elevations referred KUER’s requests for comment to its legal counsel Steven Brigance, a lawyer who works with roughly 40 residential treatment centers across the United States. Brigance said the number of police calls is a sign youth at Elevations have good access to communication.
“Obviously, they’re calling the Syracuse police department,” he said.
Multiple alumni of the program told KUER calling outside of the facility was not possible unless a staff member first entered an access code into a building phone. When asked how youth would make unmonitored 911 calls, Brigance said students can always get permission from staff to call the police. He also said he did not know statistics pertaining to how frequently calls for service to the facility were placed by students, staff or parents.
Brigance said he did not know of a single substantiated instance of abuse — which he defines as a pattern of harmful behavior — that had taken place at the facility. He added, however, that physical incidents do occur.“Therapeutic holds are a necessary part of what we do,” he said of the youth residential treatment industry. “But I will also tell you [the holds] have changed dramatically since what was accepted in 2005 and 2010 and even 2015.”
A review of the facility’s inspection reports from 2015 through 2019 revealed 35 violations. Those included one violation for insufficient documentation pertaining to seclusion methods and repeated citations for missing paperwork related to staff training and mildew or mold in the bathrooms.
The Office of Licensing conducted a separate investigation into a 2020 incident in which a student’s head was hit two times — first by a staffer’s head and again by the ground — while being placed into a therapeutic hold. According to documentation provided by the office, the incident resulted in the termination of the involved staff member, the return of the student to their home state and an office employee reporting a physical abuse allegation to Child Protective Services.
Brigance said violations of some sort are common at every facility and that Elevations strives to implement all of the state’s corrective measures ahead of the mandated deadlines.
“Are we perfect? Nope,” he said. “But Elevations to me is the top of the mark. It is as good as it gets.”
Calls For Change
Elevations RTC is just one of nearly 100 residential treatment centers, therapeutic boarding schools, outdoor youth treatment programs and intermediate secure care facilities currently licensed in Utah.
And there are signs that growing public criticism from former residents of some programs is getting a reaction. After this fall’s events and related media coverage, some Utah lawmakers are taking notice.
“In reading those stories, I’m really struck by the fact that there’s inadequate regulation,” said Rep. Carol Moss, D-Holladay, who worked for decades as a high school teacher. “Deprivation and abusive language and physical and mental abuse — that doesn’t help anyone. That doesn’t make kids better.”
Moss has not yet announced any plans to introduce legislation on this issue in the upcoming session. But in late November, Rep. Paul Ray, R-Clearfield, told the Salt Lake Tribune he plans to draft a bill to create an abuse reporting hotline and a public-facing database where operators’ disciplinary histories would be displayed.
The independent Disability Law Center, or DLC, also opened an investigation into youth residential treatment facilities in Utah in October, citing media coverage from this fall.
The center is Utah’s official protection and advocacy organization — a designation that equips it with special investigative powers to look into instances of alleged abuse and neglect of disabled people or people with mental illnesses.
The goals of the DLC investigation are to pinpoint patterns of abuse within treatment facilities, diagnose regulatory failings and identify opportunities for improvement, according to a statement the center released in October.
But in the leaked NATSAP call, executive director Stokes warned of a more specific potential outcome of the investigation.
“Fun fact,” she said to the 130 members on the call, “the DLC can help to formulate a class action lawsuit.”