SALT LAKE CITY — Utah is home to more than 100 residential treatment facilities for youth who are trying to improve their lives. And while the state takes care of some of its own kids, the facilities are drawing thousands of troubled youth from other states.
And with those youth comes hundreds of millions of dollars to Utah’s economy.
"Parents prefer Utah as a treatment venue," said Brent Hall, director at the Provo-based Discovery Academy and president of the Utah Chapter of the National Association of Therapeutic Schools and Programs. He said Utah laws "allow parents to be treated as parents and kids to be treated as kids."
He's referring to the legal age of majority for medical care. In Utah, a child becomes an "adult" at age 18 and is, therefore, able to accept or deny any treatment.
"Utah is also seen as the edge of the Earth," Hall said, tongue in cheek. The state, he said, has a "rural backdrop, where it is believed kids won't get into much trouble."
And, perhaps unrivaled, he said, is the staff, who mostly come from family friendly upbringings that profoundly influence mentoring styles.
Utah, which has more than triple the national average in the number of programs available, has been offering residential treatment programs to troubled kids since the early 1970s. It has decades of experience and refinement, even though the industry is ever changing to keep up with maturing generations and the myriad issues kids face.
"Utah is the epicenter for this kind of treatment," said Jenney Wilder, founder of All Kinds of Therapy, a comprehensive online database of youth therapeutic intervention programs throughout the country. She has experience referring kids to and counseling families on programs and is now based in Salt Lake City, helping people find their way through a confusing and often intimidating industry.
"It's an industry no one really knows about until they have to know about it and have a kid in crisis," she said. "It's a scary topic to talk about."
Wilder said the Beehive State has "figured out how to regulate this." And because the cost of living is relatively low, starting and managing a program is inexpensive, compared to other parts of the country.
"There is definitely a market here," said Heather Barnum, spokeswoman for the Utah Department of Human Services, which licenses 116 private residential youth treatment centers and 11 outdoor treatment programs throughout the state. She said Utah's laws are "accommodating" for programs, though they must adhere to standards and regulations set by Utah lawmakers.
Wilder believes Utah lawmakers, state agencies and others involved in adapting programs over the years should pat themselves on the back, because what they're doing has positioned the state well.
The revenue brought into the state by these programs is significant, according to an independent economic impact study released in May by the University of Utah's Kem C. Gardner Policy Institute. The group surveyed 59 of the Family Choice Behavior Healthcare Interventions industry programs across the state, finding that they provide 6,400 jobs, $269 million in earnings, $423 million in state gross domestic product and $22 million in state and local tax revenue.
"That's impressive. It's a big deal," Wilder said, adding that "the integrated health care that's happening at these programs is incredibly hard to create in a public environment."
Programs are held to a ratio of one staff member to every four students, facilities must be up to code and offer necessary space for various activities and functions and food services are tightly monitored, ensuring clients have access to nutritious meals. Tuition, which isn't typically covered by insurance, can run up to $500 a day for wilderness programs and up to $30,000 a month for residential treatment, including medical, therapeutic and educational services.
"When it works, it works so well," Wilder said. "Every minute of every day is scheduled. These kids work hard and are exhausted."
When it doesn't work, programs are required by state law to report mishaps and retool to get back on track, with corrective action where necessary, including license suspension or revocation in some cases and issuance of Notices of Agency Action. Thanks to a law passed in Utah earlier this year, such offenses and/or reports are searchable online. Though Barnum said none have been issued since the law took effect in May.
Actions taken prior to the law's passage, however, she said, can be requested through the Utah Department of Human Services.
"These are vulnerable youth by nature of the treatment or service they are seeking through these private programs," Barnum said. "Our responsibility for health and safety of the youth includes requiring all employees to undergo a background check and that the facility creates their own protocols to reduce safety risks and report all incidents."
She could not estimate the number of complaints or offenses that have occurred in any given time period, but said law enforcement is involved in every case of alleged abuse.
Rumors and allegations of abuse surround the industry, though; Wilder said much of that is in the past for Utah. Providers have worked hard to gain public trust and while dealing with adolescence isn't always easy, problems do arise.
"We think that these treatment programs have a fantastic reputation for being good for their communities, with providing jobs and kids doing service there," Hall said. "That, along with the economic benefits, make it win-win for everyone involved."
The National Association of Therapeutic Schools and Programs encourages each of its member programs to conduct research and track client success to develop better outcomes for clients and their families.
"Lives are changed, but there's always an equal number of people who are unhappy with it," Wilder said. "The definition of success will vary from family to family."
But it takes work, not only from the "troubled teen" who is facing any number of neurological, social, emotional, mental or behavioral issues, but the entire family system must be committed to making it work, she said.
"Most kids fight it at the beginning … but they get used to it. For some kids, it's a hard process," Wilder said. "Ideally, their parents are on board."
She said it might seem counterintuitive to send a child away from their family in order to help the child and family function better as a whole, "but the entire system has to work." Families end up being an integral part of programs, with sibling and parent visits factored into the plan, to help everyone learn skills and see the participating child adapting and growing from their new environment.
The average stay is close to a year, but some choose or need to stay longer, depending on the program, Hall said. Some programs are shorter.
"They have staff with them around the clock, to help them get back on track," he said. "The end goal is to have them act their age, but more importantly, to do that when they don't have treatment incentives, to get them motivated about their lives and do it without the bad friends, drugs or identity issues that brought them down, and to live their lives no differently than anyone else."
Depending on the needs of the client, they learn in different environments — from boarding schools to isolation in the wilderness. Utah offers a variety of them, serving more than 6,000 clients in 2015, according to the U. study. Ninety-two percent of them were not residents of Utah.
In addition to being a major export industry of the state, Juliette Tennert, director of economic and public policy research at the U.'s Gardner institute and author of the economic impact study, said, programs exist in rural and urban areas, which is "significant." Twenty-one of Utah's 29 counties have at least one program available.
The report showed that as part of the treatment process, most families visit Utah several times for parent workshops or to transport kids from one program to another. Those visitors bring in about $16 million in hospitality dollars spent on local accommodations while they are in state, though Wilder believes that is a conservative estimate because most families are already paying a lot to have their kids treated in Utah and don't necessarily skimp on lodging for themselves.
It's a booming business, Hall said, adding that he believes the model is "recession-proof."
Having human beings at the core of the service, he said, makes what they do that much more important. Contrary to public opinion, residential treatment programs aren't filled with juvenile delinquents, Hall said, but rather kids "who fell off track at home," for any given reason.
"These are people's lives," he said, adding that healthy relationships within families are crucial for a lifetime of success and happiness.
"Our goal is that we're going to reunite families in a way that they can now live healthily and happily together."