In the White House’s 2024 proclamation on National Child Abuse Prevention Month, it wrote, “[t]here is no greater sin than the abuse of power, especially when that abuse is directed at a child.” When state and county child welfare agencies remove children from their homes, we expect that they are placed in safer environments. But that is not always true.
In the United States, approximately nine percent of the nearly 400,000 youth in foster care are placed in congregate care placements—group settings like emergency shelters, group homes, and residential facilities. Congregate care facilities are owned by state or county agencies, nonprofits, and for-profit companies. A few of the for-profit operators have made headlines in recent years for horrific abuses within their facilities.
Sequel, Acadia, and UHS
Sequel Youth and Family Services, Acadia Healthcare, and Universal Health Services are amongst the worst operators. Two of three former staffers at a Sequel facility in Michigan pleaded no contest to involuntary manslaughter after a 16-year-old died at the placement. A 2020 civil lawsuit labeled an Alabama Sequel facility a “house of horrors” for a 14-year-old boy. NBC News reported that children were physically and sexually abused at Sequel facilities. “A New Mexico facility run by Acadia Healthcare shut down in 2019 due to allegations of physical, sexual and emotional abuse, and another Acadia facility in Montana shut down after reports surfaced of antihistamines being used there to restrain children.” In 2020, following a Department of Justice investigation, UHS paid $122 million to settle False Claims Act allegations for failing to provide adequate and appropriate services and for billing unnecessary inpatient behavioral health services, among other things. And, in March 2024, an Illinois jury ordered UHS to pay $535 million in damages in a rape case.
Despite years of reported abuses, we continue to learn about children experiencing physical abuse, sexual abuse, and discrimination based on their disabilities within these facilities.
5 Tips if a Child is Abused at a Residential Facility
If you discover that a child was abused in a residential facility, here are five impactful things you can do:
- Believe and Support the Child: It’s essential to believe a child’s disclosure of abuse and provide them with unwavering support. Let them know that they are not to blame for what happened, that you believe them, and that you are willing to help them. Children in foster care are extremely vulnerable and were already removed from their homes due to allegations of abuse or neglect. When a child in harmed in foster care, they may feel as though they cannot trust the people operating within the system who are supposed to be keeping them safe. Therefore, it is especially important for players within the system—attorneys, caseworkers, therapists, volunteers, and other advocates—to listen to the child and take immediate action if that’s what they want.
- Report the Abuse to a Safe Authority Figure: The safety of the child is the top priority. If the abuse is ongoing, or if there are concerns about their safety, take immediate steps to remove them from harm’s way. This will involve contacting child protective services, law enforcement, the child’s lawyer, the state’s foster care ombudsman’s office, and/or a civil rights attorney to intervene. If the child is old enough to state a position, you should ask the child if they feel unsafe disclosing the abuse to anyone. For instance, if they were abused at a residential facility and are still at that facility, they may not want you to report the abuse to staff at the facility.
- Document Everything: Document any visible injuries or signs of abuse, including with photographs. Keep a detailed record of every report, interaction, and communication regarding the incident, noting the name of the person to whom you spoke, the date and time of the conversation, the method of communication (telephone, email, in person, etc.), and the substance of the conversation. Additionally, save copies of all written communications, including letters, emails, text messages, or other documents you receive.
- Seek Medical and Mental Health Support: Ensure that the child receives appropriate medical and mental health care to address any physical injuries or trauma resulting from the abuse. When a child is in foster care, the child welfare agency is supposed to recommend services and placements (in the least restrictive, most family-like setting) that are in the best interest of the child. Services would include any necessary healthcare or therapy services. If these services are not being offered or provided, that deficiency should be raised at the child’s next foster care court date.
- Understand the Child’s Legal Rights and Advocate for Justice: When a child is physically or sexually abused in a residential facility, especially by an adult, that abuse most likely constitutes a crime, and the perpetrator should be held accountable for committing the crime. Moreover, when a criminal case is pending, the victim is usually entitled to an order of protection.
Additionally, when young people are in foster care, the agency is required to keep them safe from known or foreseeable harms under the Fourteenth Amendment. Therefore, if a child is abused in a residential facility, they often have civil rights claims, along with state law tort claims, that they can bring in a lawsuit for monetary damages.
An added benefit of these lawsuits, like the ones brought against UHS, Acadia, and Sequel is that they bring public attention to problematic facilities and can help spur change and prevent similar incidents from occurring in the future.