New York Times exposé on unethical practices in Acadia Healthcare psychiatric hospitals prompts push for the removal of involuntary commitment accreditation from abusive facilities and CCHR urges victims to come forward.
By Jan Eastgate
President CCHR International
September 5, 2024
A groundbreaking New York Times investigation has found Acadia Healthcare, a monolithic national chain of behavioral hospitals and centers, has lured patients into its facilities and held them against their will until their insurance ran out. The article was headlined: “How a Leading Chain of Psychiatric Hospitals Traps Patients: Acadia Healthcare is holding people against their will to maximize insurance payouts, a Times investigation found.”[1] Since 2015, CCHR International has had Acadia Healthcare behavioral facilities under scrutiny for patient abuse, filing tens of thousands of complaints to legislators about its unscrupulous practices.
In light of the New York Times findings—vindicating CCHR’s concerns—CCHR wants hospitals that detain patients against their will for profit to be stripped of any license they may have allowing them to receive patients to involuntarily commit them. For example, the Florida Administrative Code allows hospitals to obtain a license and be a designated “receiving facility” to involuntarily commit patients under the state’s civil commitment Baker Act.
The Times pointed out that in Florida, hospitals can hold people for 72 hours unless the patients agree to stay longer or a judge or a medical professional determines that they are not ready to leave. Acadia’s North Tampa Behavioral Health Hospital found a way to exploit that, current and former employees told the Times. From 2019 to 2023, North Tampa filed more than 4,500 petitions to extend patients’ involuntary stays, according to a Times analysis of court records.
CCHR Florida has been exposing this for many years, and CCHR International has drawn attention to similar practices in other states. The Times also found that in at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law. In some cases, judges have intervened to force Acadia to release patients. Patients are often held for financial reasons, according to more than 50 current and former executives and staff members.
CCHR launched a new public service announcement to help people abused in behavioral facilities to report abuse and seek redress, as well as hospital whistleblowers to come forward:
Have you been abused in an Acadia Healthcare behavioral/psychiatric facility? Recent media has exposed Acadia Healthcare for allegations of abuse and illegal detainment of patients. If you were abused in one of these facilities (click here to see full list), held against your will, or have insider information about such abuse, you can report it to the mental health industry watchdog, Citizens Commission on Human Rights (CCHR) at reportabuse@cchr.org or 800-869-2247. We may be able to assist you to take action regarding your Acadia experience. All information is kept in strictest confidence.
Other practices The Times found include:
- Acadia has exaggerated patients’ symptoms. It has tweaked medication dosages, then claimed patients needed to stay longer because of the adjustment. And it has argued that patients are not well enough to leave because they did not finish a meal.
- Acadia pitches itself to staff in hospital emergency rooms. Business-development teams make sales calls to the doctors and other hospital workers, passing out brochures and talking up the expertise of Sometimes, they come bearing doughnuts.
- Acadia, which charges $2,200 a day for some patients, at times deploys an array of strategies to persuade insurers to cover longer stays, employees said.
- Unless the patients or their families hire lawyers, Acadia often holds them until their insurance runs out.
- The Times identified eight instances of Acadia’s holding people who had voluntarily checked themselves in but then changed their minds.
Once admitted, patients can be subjected to sexual abuse, restraint and physical assaults from staff, and other atrocities—all points CCHR has documented and reported to authorities.
The Times reported:
- Many inspection reports described rapes, assaults and filthy conditions.
- Georgia: In December 2019, more than 50 police officers descended on Acadia’s Lakeview Behavioral Health psychiatric hospital north of Atlanta. The police had opened an investigation into the hospital after numerous incidents, according to police records. After police officers raided an Acadia hospital in Georgia, 16 patients told investigators that they had been kept there “with no excuses or valid reason,” according to a police report. Acadia held all of them under laws meant for people who pose an imminent threat to themselves or others. But none of the patients appeared to have met that legal standard, according to records and interviews.
The previous January, a boy staying at Lakeview was taken to a nearby emergency room. He had so many bruises that staff suspected child endangerment. A few months later, police officers witnessed three Lakeview employees assaulting a patient. Over the next six months, they interviewed dozens of patients who said they had been held against their will or had seen patients, including children, being assaulted or neglected.
- Utah: Acadia closed its Highland Ridge Hospital in Utah this year after state regulators investigated reports of dozens of rapes and assaults.
- Pennsylvania: In 2022, state inspectors criticized an Acadia hospital in Reading, Pa., for having instructed workers to avoid adjectives like “calm” and “compliant” in a patient’s chart.
- Ohio and Michigan: In 2022, employees at Acadia hospitals in Ohio and Michigan complained to their state regulators that doctors had written false statements in patients’ medical charts to justify continuing their stays.
- Tennessee: In 2022, Tennessee inspectors faulted Acadia for falsely claiming in medical charts that a patient in Memphis had been checked on every 15 minutes. He was found in rigor mortis hours after he died.
All U.S. states have statutes that authorize emergency and inpatient civil commitment, such as involuntary hospitalization.[2]
The process implicates constitutional concerns and constraints under the Fourteenth Amendment Due Process Clause of the U.S. Constitution, specifically with regard to the liberty interests of the confined patients. Legal issues related to a committed individual’s right to receive or to refuse medical treatment during confinement also appear throughout the relevant case law.[3]
In 1975, the U.S. Supreme Court determined that a “State cannot constitutionally confine… a non-dangerous individual who is capable of surviving safely in freedom by himself or with the help of willing and responsible family members or friends….”[4]
Yet privately owned psychiatric facilities such as those owned by Acadia and other hospital chains violate this regularly and with impunity, and are allowed to bilk Medicaid, Medicare and other government and private insurance to profit from the abuse. This keeps filling investors’ pockets despite the devastation caused to patients. It’s a shocking comment on the psychiatric industry that it relies on coercive practices that breed patient abuse.
Other dangers of involuntary commitment include patients being billed for “treatment” they neither asked for nor wanted. According to the American Journal of Psychiatry, “Billing patients for involuntary psychiatric care deserves more attention for several reasons. First, these patients may be held financially liable for care they did not authorize and even actively refused.”[5]
The late Dr. Thomas Szasz, professor of psychiatry and prolific author on psychiatry stated, “The most important deprivation of human and constitutional rights inflicted upon persons said to be mentally ill is involuntary mental hospitalization….” He added, “Involuntary mental hospitalization is like slavery. Refining the standards for commitment is like prettifying the slave plantations. The problem is not how to improve commitment, but how to abolish it.”[6]
On 12 June 2024, the U.S. Senate Finance Committee released the findings of its 2-year investigation into Acadia Healthcare, Universal Health Services and two other behavioral residential treatment facilities. Their report, “Warehouses of Neglect: How Taxpayers Are Funding Systemic Abuse in Youth Residential Treatment Facilities,” was damning, and mirrored what CCHR Int has been exploiting for a decade and aligns with the findings of the New York Times investigation. According to the Senate report, “The harms, abuses, and indignities children in [RTFs] have experienced and continue to experience today occur inevitably and by design: they are the direct causal result of a business model that has incentive to treat children as payouts and provide less than adequate safety and behavioral health treatment in order to maximize operating and profit margin.” Further, “Providers will continue to operate this model because it’s good business, unless there is some bold intervention.”[7]
The Times report reinforces the urgent need for bold intervention, including harsher penalties for abusive hospitals, revoking their licenses to involuntarily commit, shutting down facilities with repeated violations, and ensuring compensation for patients harmed by forced treatment—including those subjected to involuntary detainment.
CCHR urges anyone who has been abused or unlawfully detained in a behavioral facility to come forward, along with whistleblowers who can expose further wrongdoing. You can submit a report to CCHR here.
Sample of CCHR Articles Exposing Acadia Healthcare
August 17, 2016: CCHR Calls for Legislative Intervention Against For-Profit Psych Facility Planned for Pennsylvania
January 16, 2017: Psychiatric Chain Under Investigation for Billing Fraud & Abuse in U.S. Now Buys U.K. Behavioral Facilities
June 5, 2017: Universal Health Services Psychiatric Hospital Chain Under Department of Defense & FBI Investigation
July 28, 2017: A 48-Year Mission to Bring Criminal Psychiatrists Under the Law
December 19, 2017: Patient Abuse, Potential Fraud in Largest U.S. Psych Hospital Chain Expands to the UK
January 15, 2018: Behavioral Health Malpractice: CCHR Calls for Termination of Medicare and Medicaid Contracts with For-Profit Psych Hospital Chains
July 5, 2018: Drugging and Restraint Use on Migrant Children
October 23, 2018: More For-Profit Psychiatric Facility Closures
January 23, 2019: Psychiatric For-Profit Hospitals—Rife with Fraud, Patient Abuse, Rape, and Suicide
February 13, 2019: Acadia Healthcare: More Abuse, More Need for Government Oversight of Fraud and Abuse in Behavioral Health Industry
April 26, 2019: A-Z Update on For-Profit Psychiatric Industry Abuse
July 29, 2019: Psychiatric Industry and Behavioral Centers Profit from Opioid Crisis
August 27, 2019: Multi-Million Dollar Fines Insufficient to Curb Fraud & Patient Sexual & Other Abuses in For-Profit Behavioral Health Industry
October 25, 2019: CCHR, Mental Health Industry Watchdog, Rails Against Use of Commitment Laws That Detain Patients for Profit
November 5, 2019: UK Legislators Called On to Increase Oversight and Criminal Accountability in U.S. Owned For-Profit Behavioral Hospitals
November 19, 2019: Sexual Assault, Restraint Abuse, Deaths and Children Put at Risk: The “Return” for Billions Wasted on For-Profit & Private Psychiatric Facilities
February 11, 2020: The Risky Business of Foster Youth Drugged in For-Profit Behavioral Hospitals
March 10, 2020: More Patient Sexual Assault and Abuse Allegations Against For-Profit Psychiatric Hospitals: When Will Governments Step in to Protect Patients?
October 13, 2020: Paris Hilton Continues to Speak Out About Child Abuse in Universal Health Services Facility and Other Teen Behavioral Centers
October 27, 2020: UHS: Multiple Child Sexual Abuse Charges and $127m Lawsuit
December 10, 2020: UN Human Rights Day Should Tackle Cruel & Inhuman Psychiatric Treatment
December 22, 2020: More Media Urged to Expose Youth Behavioral “Houses of Horror” & “Death traps”
January 18, 2021: New Year Starts with Continuing Child Abuse and Deaths in For-Profit Psychiatric Facilities
February 17, 2021: Utah State Law Curbing Behavioral Restraint Use on Children & Youths is Applauded But Unconditional Ban is Needed Nationwide
November 1, 2021: Mental Health Abuse Reforms Aim to Protect Against Behavioral Abuse of Children
February 21, 2022: “The Kids Are Not Alright” Report Confirms Profit is Put Before Troubled Teens’ Mental Health & Safety
October 14, 2022: CCHR Issues Resolution to Replace Forced Psychiatric Treatment and Torture with Human Rights
October 21, 2022: Proposed Child Mental Health Screening is Scientific Deception To Hook Millions More on Drugs
July 18, 2023: For-Profit Psychiatric Hospitals Need Stronger Penalties for Abuses and Deaths
October 4, 2023: Racism Task Force Warns That Coercive Psychiatric Practices Cause Harm and Death
October 23, 2023: Mother Jones Story on Behavioral Facility Abuse of Foster Children Applauded
April 12, 2024: CCHR Asks Whistleblowers to Report Mental Health Hospital Fraud in the U.S.
April 19, 2024: CCHR Condemns Mental Health Industry Putting Children at Risk of Sexual Assault
May 24, 2024: CCHR Recaps Mental Health Awareness Month: The Silent Epidemic of Patient Abuse Cover-Ups
May 31, 2024: Journal Urges It’s Time To Regulate Troubled Teen Behavioral Programs
June 21, 2024: CCHR Praises Senate “Warehouses of Neglect” Report—Calls for Stronger Penalties
August 30, 2024: Youth Mental Health Abuse: Drugs, Sexual Assault, and Electroshock Exposed
[1] Jessica Silver-Greenberg and Katie Thomas, “How a Leading Chain of Psychiatric Hospitals Traps Patients: Acadia Healthcare is holding people against their will to maximize insurance payouts, a Times investigation found,” New York Times, 1 Sept. 2024, https://www.nytimes.com/issue/todayspaper/2024/09/02/todays-new-york-times
[2] Nathaniel P. Morris, M.D. and Robert A. Kleinman, M.D., “Involuntary Commitments: Billing Patients for Forced Psychiatric Care,” American Journal of Psychiatry, Volume 177, Number 12, 1 Dec. 2020, https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030319
[3] “Involuntary Civil Commitment: Fourteenth Amendment Due Process Protections,” Congressional Research Service, 24 May 2023, https://crsreports.congress.gov/product/pdf/R/R47571
[4] Melissa McCall, J.D., Legally reviewed by Aviana Cooper, Esq., “Involuntary Commitment: Patient and Public Rights,” FindLaw, 25 June 2023, https://www.findlaw.com/healthcare/patient-rights/involuntary-commitment-patient-and-public-rights.html
[5] Nathaniel P. Morris, M.D. and Robert A. Kleinman, M.D., “Involuntary Commitments: Billing Patients for Forced Psychiatric Care,” American Journal of Psychiatry, Volume 177, Number 12, 1 Dec. 2020, https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030319
[6] https://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/
[7] Chris Larson, “Senate Finance Committee Releases Excoriating Investigation of Abuse in At-Risk Youth Industry,” Behavioral Health Business, 12 June 2024, https://bhbusiness.com/2024/06/12/senate-finance-committee-releases-excoriating-investigation-of-abuse-in-at-risk-youth-industry/; Michael Fitzgerald and Sara Tiano, “Senate Investigation Slams Residential Treatment Centers for Children as ‘Warehouses of Neglect’,” The Imprint, 12 June 2024, https://imprintnews.org/top-stories/senate-investigation-slams-residential-treatment-centers-for-children-as-warehouses-of-neglect/250056
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