The mental health industry watchdog, which helped obtain restraint use reforms two decades ago, relentlessly continues to demand a ban on lethal restraint procedures. It says celebrity support for greater oversight and protections has been vital.

By CCHR International
The Mental Health Industry Watchdog
April 5, 2024

State governments are responding to concerning reports of restraint abuse and deaths in psychiatric and behavioral facilities—a measure the mental health industry watchdog, Citizens Commission on Human Rights International welcomes as vital for saving lives. The latest are in California and Alaska. In California, the introduction of Senate Bill 1043, the Accountability in Children’s Treatment measure, was spearheaded by Senator Shannon Grove (R-Bakersfield) and Paris Hilton, alongside Senators Angelique Ashby (D-Sacramento) and Aisha Wahab (D-Hayward). “The bipartisan initiative aims to enhance transparency in California’s youth facilities, particularly those licensed by the California Department of Social Services, by making information about the use of restraints and seclusion rooms accessible to the public,” the Times of San Diego reported.[1] 

In March, two bills were introduced into the Alaska Legislature aimed at reforming residential psychiatric treatment for youth, enhancing patient protections and increasing state oversight. House Bill 366, introduced by Rep. Maxine Dibert and mirrored by Senate Bill 231 introduced by Sen. Matt Claman, mandates unannounced facility inspections twice a year, and prompt reporting of restraint or seclusion incidents. Another proposed bill, House Bill 363, introduced by Rep. Andrew Gray, aims to expedite court hearings for foster children placed in psychiatric hospitals.[2]  

This followed a Mother Jones story in October exposing alleged abuse of foster youths in a for-profit behavioral facility in Alaska, that the behavioral hospital giant, Universal Health Services (UHS) owns. The case of a girl admitted at the age of 12, detailed how “Medical and court records show that she was repeatedly physically restrained, forcibly injected with a sedative, held in seclusion, and put on potent psychiatric medications.” For this, Alaska’s Medicaid program paid more than half a million dollars for her “care.”[3]

Mother Jones obtained data from 38 states on UHS placement of foster care children, of which 31 provided Medicaid data, showing $611 million was spent on the care of foster children and youth at the facilities.

As CCHR and others have exposed for more than two decades, and more recently recognized by the World Health Organization (WHO) and United Nations (UN), “There is a growing consensus that all forms of restraint and seclusion in mental health services should be eliminated.”[4]

In October 2023, the Los Angeles Times detailed the findings of its Freedom of Information Act (FOIA) requests, which uncovered shocking trends in patient restraints. It underscored the need for greater transparency and oversight in psychiatric facilities, as well as potential reforms needed to reduce the use of restraints.[5]

The death of 16-year-old African American foster care youth, Cornelius Frederick, following a restraint at the now-closed Lakeside Academy, a behavioral facility in Michigan, owned by Sequel Youth & Family Services, increased demands for such oversight and legislative reforms. His death in 2020 was ruled a homicide and three staff were prosecuted, pleading no contest.[6]

Geoffrey Fieger, a lawyer for the Frederick family commented on the abuse of teens in such facilities: “Unless you shine a light on insects and maggots, they proliferate. Certainly, this type of behavior is not human. It can only be akin to a subhuman-type species that would inflict this behavior on children.”[7]

“It’s high time that the dark underbelly of this industry is exposed and those responsible are held accountable,” Tommy James, another attorney representing victims of the industry and their families, told media.[8]

The WHO and the United Nations Office of the High Commissioner for Human Rights (OHCHR) guidance on Mental Health, Human Rights, and Legislation also urges accountability: “Effective remedies also entail the duty to investigate and bring to justice those who are responsible, to hold them to account, combat impunity and prevent repetition of violations.”[9]

Numerous states have prohibited sending their foster care children and troubled teens out of state to for-profit behavioral and troubled teen treatment facilities because of abuse and restraint deaths. As the Times of San Diego reported, previously, out-of-state facilities were disqualified through legislative actions like AB 808 and AB 153, which mandated the return of all California youth from these facilities by January 1, 2023, following reports of abuse in such facilities. SB 1043 seeks to further this progress by requiring the reporting of key data on a public dashboard, aiming to ensure accountability in children’s treatment.[10]

Ms. Hilton is a survivor of such facilities in Utah, where she was treated as a teenager. The facility, Provo Canyon, is now owned by UHS. “As a survivor of the ‘Troubled Teen Industry,’ I am proud to partner with Senator Shannon Grove – a champion for children in California – on the Accountability in Children’s Treatment Act to bring much-needed transparency to California youth facilities,” she said. “I look forward to collaborating with all members of the California legislature on this important bill in our shared pursuit for protection of our state’s most vulnerable youth.”[11]

CCHR says the celebrity’s voice and actions championing this important issue have been vital in the fight for children’s rights.

The California bill requires reports on restraint/seclusion use that include actions taken during the incident, the rationale for it, and who the personnel were that implemented the restraint. The bill sets a deadline of January 1, 2026, for the data to be posted quarterly to a dashboard on a state website.[12]

Jan Eastgate, President of CCHR International, said this is an important aspect of the bill—a public reporting of restraint use to ensure accountability. But ultimately, she said, all states need to heed the WHO recommendations and ban the practice completely. According to the WHO, “Not only are seclusion and restraint contrary to international human rights law, their use is incompatible with a recovery approach, counters the purpose of care and can lead to physical and psychological harm, even death.” As such, legislation should “prohibit the use of seclusion and restraint in any health or social care facility.”[13]

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[1] “Paris Hilton, CA Sen. Shannon Grove Announce Children’s Protection Measure,” The Times of San Diego, 2 Apr. 2024, https://timesofsandiego.com/politics/2024/04/02/paris-hilton-ca-senator-grove-announce-childrens-protection-measure/

[2] “2 bills seek reform of Alaska’s youth psychiatric residential treatment system,” AOL.com, 15 Mar. 2024, https://www.aol.com/2-bills-seek-reform-alaskas-035900814.html

[3] https://www.cchrint.org/2023/10/23/mother-jones-behavioral-facility-abuse-foster-children-applauded/; Julia Lurie, “Inside the Psychiatric Hospitals Where Foster Kids Are a ‘Gold Mine’: How a scandal-plagued health care giant profits off a failing child welfare system,” Mother Jones, Sept.-Oct. 2023, https://www.motherjones.com/crime-justice/2023/10/foster-kids-psychiatric-hospitals-universal-health-services-uhs-alaska-cps/

[4] WHO, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023, p. 72, https://www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf

[5] “Why high rates of restraint at L.A. General haven’t raised alarms,” Los Angeles Times, 19 Oct. 2023, https://www.latimes.com/california/story/2023-10-19/restraint-psychiatric-patients-oversight-los-angeles-general-hospital; “Strapped down: Psychiatric patients are restrained at sky-high rates at this L.A. hospital,” Los Angeles Times, 19 Oct. 2023, https://www.latimes.com/california/story/2023-10-19/psychiatric-patients-restraint-high-rate-california-los-angeles-general-hospital

[6] Justin Carissimo and Li Cohen, “Three charged in death of black teen who died after being restrained at youth facility,” CBS News, 27 June 2020, https://www.cbsnews.com/news/cornelius-fredericks-death-lakeside-academy-staffers-charged-kalamazoo-michigan/; Jim McKinney, “Former nurse at Lakeside Academy pleads no contest in death of student,” WIN 98.5, 1 Aug. 2021, https://wincountry.com/2021/08/01/former-nurse-at-lakeside-academy-pleads-no-contest-in-death-of-student/; Marie Weidmayer, “Lakeside Academy buildings demolished as Kalamazoo Country Club plans expansion,” MLive, 18 Apr. 2022, https://www.mlive.com/news/kalamazoo/2022/04/lakeside-academy-buildings-demolished-as-kalamazoo-county-club-plans-expansion.html; Anthony Sylvester and Katie Sergent, “Former workers enter plea in Lakeside Academy teen’s death,” CBS News Channel 3, 16 Mar. 2023, https://wwmt.com/news/local/michael-mosley-zachary-solis-lakeside-academy-cornelius-fredericks-death-2020-sandwich-restraint-manslaughter-homicide-crime-kalamazoo-county-west-michigan; “Thousands of Foster Children Were Sent Out of State to Mental Health Facilities Where Some Faced Abuse and Neglect,” ProPublica, 11 Mar. 2020, https://www.propublica.org/article/illinois-dcfs-children-out-of-state-placements; Sara Tiano, “Family of Foster Youth Slain by Staff at For-Profit Group Home Files $50 Million Federal Lawsuit,” The Imprint, 6 Oct. 2021, https://imprintnews.org/top-stories/family-of-foster-youth-slain-by-staff-at-for-profit-group-home-files-50-million-federal-lawsuit/59482

[7] Tyler Kinkade, “Video shows fatal restraint of Cornelius Frederick, 16, in Michigan foster facility,” NBCnews.com, 7 July 2020, https://www.nbcnews.com/news/us-news/video-shows-fatal-restraint-cornelius-fredericks-16-michigan-foster-facility-n1233122

[8] Carol Robinson, “Teen ‘brutalized’ at Alabama Sequel youth facility attempted suicide after ‘unspeakable abuse,’ lawsuit states,” AL.com, 23 Mar. 2023, https://www.al.com/news/2023/03/teen-brutalized-at-alabama-sequel-youth-facility-attempted-suicide-after-unspeakable-abuse-lawsuit-states.html

[9] WHO, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023, https://www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf

[10] “Paris Hilton, CA Sen. Shannon Grove Announce Children’s Protection Measure,” The Times of San Diego, 2 Apr. 2024, https://timesofsandiego.com/politics/2024/04/02/paris-hilton-ca-senator-grove-announce-childrens-protection-measure/

[11] Jacque Porter, “Paris Hilton, state lawmakers announce new social services transparency bill,” Fox40, 3 Apr. 2024, https://fox40.com/news/california-connection/paris-hilton-state-lawmakers-announce-new-social-services-transparency-bill/; Julia Lurie, “Inside the Psychiatric Hospitals Where Foster Kids Are a ‘Gold Mine’: How a scandal-plagued health care giant profits off a failing child welfare system,” Mother Jones, Sept.-Oct. 2023, https://www.motherjones.com/crime-justice/2023/10/foster-kids-psychiatric-hospitals-universal-health-services-uhs-alaska-cps/

[12] Jacque Porter, “Paris Hilton, state lawmakers announce new social services transparency bill,” Fox40, 3 Apr. 2024, https://fox40.com/news/california-connection/paris-hilton-state-lawmakers-announce-new-social-services-transparency-bill/

[13] WHO, OHCHR, “Guidance on Mental Health, Human Rights and Legislation,” 9 Oct. 2023, p. 72, https://www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf