“Abuse thrives in environments with minimal oversight. Many mental health facilities operate with little supervision, creating a breeding ground for these horrific acts to go undetected for years. Treating psychiatrists, hospital staff and profit-driven corporate managers are complicit in failing to act to protect.” – Jan Eastgate, President of CCHR International

CCHR Demands Increased Medicaid/Medicare Oversight, Accountability, and Criminal Prosecution in Response to National Scandal of Staff-Inflicted Sexual Abuse in Residential Behavioral and Psychiatric Hospitals.

By CCHR International
The Mental Health Industry Watchdog
March 14, 2025

• Rising Abuse: A 2023 study found that 5-45% of mental health inpatients experience sexual violence during their stay.
• Underreporting: In the UK, fewer than 5% of sexual abuse incidents in mental health facilities are reported to authorities, with similar concerns about the U.S.
• Vulnerable Patients: Many victims are juveniles or foster care children, often in for-profit facilities.
• Legal Action: Recent lawsuits highlight systemic abuse, including cases at Four Winds hospitals and Detroit Behavioral Institute.

CCHR is urgently calling for stronger regulatory protections and accountability to address the epidemic of sexual abuse allegations in psychiatric and behavioral facilities. This comes in the wake of CCHR’s report from February 2025, which revealed disturbing increases in reports of sexual abuse of patients by staff, especially in for-profit residential treatment psychiatric hospitals.

According to CCHR, research and reports from the UK indicate that a shocking 95% of such cases may never be reported to authorities, which the group believes could also reflect the situation in the U.S.[1] Furthermore, many of the victims in these facilities are vulnerable juveniles, with the Lawsuit Information Center warning that the problem is particularly severe in programs that “operate with minimal regulation or oversight from state authorities, creating an environment where abuse can go undetected for long periods.”[2]

“Abuse thrives in environments with minimal oversight,” said Jan Eastgate, President of CCHR International. “Many mental health facilities operate with little supervision, creating a breeding ground for these horrific acts to go undetected for years. Treating psychiatrists, hospital staff and profit-driven corporate managers are complicit in failing to act to protect.”

Recent studies confirm these claims, with a 2023 report revealing that 5 to 45% of inpatient mental health patients have experienced sexual violence during their admission.[3] Another study by the Joint Commission found that assault, rape, and sexual assault incidents in hospitals generally had risen 77% over two years, with nearly 43% of cases involving sexual assaults—28% of which were perpetrated by staff members.[4]

In response to this systemic abuse, CCHR is calling for immediate regulatory changes, including the revocation of government contracts for any facility found to have committed sexual abuse and criminal accountability for those responsible and a review of their Medicaid and Medicare reimbursements. For-profit psychiatric and behavioral hospitals should be held accountable as a condition of receiving government or private insurance reimbursements.

This call for reform comes after several high-profile cases. In Detroit, Fox 2 News reported on a lawsuit filed against the Detroit Behavioral Institute, alleging decades of sexual abuse against children. The mental health facility, owned by Acadia Healthcare, was suspended for five years in 2022, but CCHR believes this suspension should be permanent. DBI is accused of covering up “horrific” sexual abuse according to the lawsuit. The attorneys said they hope the lawsuit helps protect other children from abuse while in these centers.[5]

Similarly, in New York, 20 lawsuits were filed in December 2024 against Four Winds hospitals, accusing staff of sexual abuse ranging from groping to rape. The lawsuits allege that staff members had a pattern of using manipulation or threats to coerce patients into compliance, with some abuse occurring even after a staff member was arrested in 2017 for similar offenses.[6] That staff member, Dominic Sbordone, pled guilty and was sentenced to a mere six months in jail and 10 years’ probation.[7]

Medicaid Unwittingly Complicit in Patient Sexual Abuse and More

Some 70.7% of Acadia’s revenue in 2024 derived from Medicaid (56.5%) and Medicare (14.2%) representing $2,228,700,000 or of its total $3.15 billion. This was an increase from 69% of its revenue in 2023.

Acadia has also been implicated in multiple cases of sexual abuse in its facilities. For example, in 2023, a jury in New Mexico awarded $405 million in damages to a plaintiff who accused the company of child sexual abuse at one of its facilities.[8] In 2024, Acadia closed its Highland Ridge Hospital in Utah after state regulators investigated reports of dozens of rapes and assaults., with investigators and employees even referring to the facility as “The Rape Hospital” due to the frequency of sexual violence that was reported.[9]

Medicaid had already been defrauded. In May 2019, Acadia agreed to pay the federal government $17 million to settle allegations it defrauded Medicaid in West Virginia.[10]

The company’s practices have again been subject to Department of Justice and Securities and Exchange Commission investigations, which The New York Times has exposed in an in-depth series of articles in 2024.[11] Acadia now faces a fresh round of federal investigations into how the company admits patients and bills for their stay. In some states, the company was the subject of a grand jury investigation while the FBI and Health and Human Services are also investigating.[12] Yet, over 70% of its revenue is still paid by Medicaid and Medicare, prompting calls for further investigations.

A Global Problem in Psychiatric Hospitals

The problem is not confined to the United States. A 2024 investigation by The Independent and Sky News uncovered tens of thousands of sexual assaults and incidents at National Health Service (NHS)-run mental health hospitals in the UK. The investigation revealed that fewer than 5% of sexual incidents reported to hospitals were referred to the police, while over 19,000 incidents occurred between 2019 and 2023, including hundreds of reports of rape and serious assaults on women.[13]

A 2024 U.S. Senate investigation into residential mental health treatment centers further revealed severe abuse cases, including sexual violence, physical harm, and neglect, particularly against minors with developmental disabilities or those in foster care systems. These facilities often rely on public funding, raising significant concerns about the safety of children under the care of these institutions.[14]

Lawsuit Information Center reports, “Most concerningly, many of these minors—who often have developmental disabilities or are part of the foster care system—are placed in these facilities with public funding, including Medicaid and child welfare dollars. This raises serious questions about the use of taxpayer money to support facilities that fail to ensure the safety and well-being of children under their care.”

CCHR is calling for an overhaul of the system, including substantial fines for negligent facilities, criminal penalties for staff responsible for abuse and hospitals that failed to report the crime, and the creation of more accessible mechanisms for patients and families to report abuse without fear of retribution.

Patients and their families are urged to contact CCHR’s Abuse Case Hotline to report any incidents of abuse.

References:

[1] Rebecca Thomas and Sky News’s Rob Mulhern, “Mental health patients ‘raped and sexually assaulted’ as NHS abuse scandal revealed,” The Independent, 29 Jan. 2024, https://www.independent.co.uk/news/health/sexual-abuse-mental-health-uk-b2484163.html

[2] Ronald V. Miller, Jr., “Residential Treatment Facility Sex Abuse Lawsuits,” Lawsuit Information Center, 14 Nov. 2024, https://www.lawsuit-information-center.com/residential-treatment-facility-sex-abuse-lawsuits.html

[3] Holly Betterly, Meghan Musselman, and Renée Sorrentino, “Sexual assault in the inpatient psychiatric setting,” General Hospital Psychiatry, Vol. 82, May–June 2023, Pages 7-13, https://www.sciencedirect.com/science/article/abs/pii/S0163834323000270

[4] Gretchen Morgenson, “Lean staffing, lax hiring, training flaws: Why sexual assaults at hospitals are up
Allegations that go unreported and a lack of accountability for healthcare workers leave patients in the dark and increase the risk of abuse, research shows,” NBC News, 18 Nov. 2024, https://www.nbcnews.com/health/health-care/lean-staffing-lax-hiring-training-flaws-assaults-hospitals-are-rcna171055

[5] “Closed Detroit youth mental health facility accused of covering up ‘horrific’ sexual abuse in new lawsuit,” Fox 2 Detroit, 11 Mar. 2025, https://www.fox2detroit.com/news/closed-detroit-youth-mental-health-facility-accused-covering-up-horrific-sexual-abuse-new-lawsuit

[6] Jonathan Bandler, “Lawsuits claim widespread sexual abuse of patients at Four Winds hospital in Lewisboro,” Rockland/Westchester Journal News, 11 Dec. 2024, https://www.yahoo.com/news/lawsuits-claim-widespread-sexual-abuse-222753828.html

[7] Irvin Jackson, “New York Psychiatric Hospital Chain Faces 20 Sexual Assault Lawsuits by Former Patients,” AboutLawsuits, 16 Dec. 2024, https://www.aboutlawsuits.com/new-york-psychiatric-hospital-chain-20-sexual-assault-lawsuits/

[8] “United States Attorney Announces $17 Million Healthcare Fraud Settlement,” Press Release, Attorney’s Office Southern District of West Virginia, 6 May 2019, https://www.justice.gov/usao-sdwv/pr/united-states-attorney-announces-17-million-healthcare-fraud-settlement; Morgan Gonzales “UHS Ordered to Pay $535M in Legal Case,” Behavioral Health Business, 1 Apr. 2024, https://bhbusiness.com/2024/04/01/uhs-to-pay-535m-in-sexual-assault-suit/

[9] https://www.cchrint.org/2025/02/28/new-un-report-exposes-psychiatric-abuses-end-forced-treatment/; Adam Herbets, “Utah psychiatric hospital to shut down after years of safety concerns exposed by FOX 13 Investigates,” Fox 13 News, Salt Lake City, 8 Apr. 2024, https://www.fox13now.com/news/fox-13-investigates/watch-the-fox-13-investigations-leading-up-to-shutdown-of-highland-ridge-hospital#google_vignette

[10] https://www.cchrint.org/2025/02/28/new-un-report-exposes-psychiatric-abuses-end-forced-treatment/, citing “United States Attorney Announces $17 Million Healthcare Fraud Settlement,” Attorney’s Office Southern District of West Virginia, 6 May 2019, https://www.justice.gov/usao-sdwv/pr/united-states-attorney-announces-17-million-healthcare-fraud-settlement

[11] https://www.cchrint.org/2024/10/04/cchr-demands-justice-for-victims-of-psychiatric-fraud-and-patient-sexual-abuse/; Jessica Silver-Greenberg and Katie Thomas, “Acadia Hospitals Reach $20 Million Settlement With Justice Dept.,” The New York Times, 26 Sept. 2024, https://www.nytimes.com/2024/09/26/health/acadia-doj-settlement-fbi.html; “Acadia Healthcare Company Inc. to Pay $19.85M to Settle Allegations Relating to Medically Unnecessary Inpatient Behavioral Health Services,” Dept. of Justice, 26 Sept. 2024, https://www.justice.gov/opa/pr/acadia-healthcare-company-inc-pay-1985m-settle-allegations-relating-medically-unnecessary; Jessica Silver-Greenberg and Katie Thomas, “Acadia Healthcare Says It Faces New Federal Investigations: Shares of the company, one of the largest chains of for-profit psychiatric hospitals, were down 25 percent at one point,” The New York Times, 27 Sept. 2024, https://www.nytimes.com/2024/09/27/business/acadia-federal-investigations.html

[12] https://www.cchrint.org/2024/10/04/cchr-demands-justice-for-victims-of-psychiatric-fraud-and-patient-sexual-abuse/; Jessica Silver-Greenberg and Katie Thomas, “Acadia Healthcare Says It Faces New Federal Investigations: Shares of the company, one of the largest chains of for-profit psychiatric hospitals, were down 25 percent at one point,” The New York Times, 27 Sept. 2024, https://www.nytimes.com/2024/09/27/business/acadia-federal-investigations.html

[13] Rebecca Thomas and Sky News’s Rob Mulhern, “Mental health patients ‘raped and sexually assaulted’ as NHS abuse scandal revealed,” The Independent, 29 Jan. 2024, https://www.independent.co.uk/news/health/sexual-abuse-mental-health-uk-b2484163.html

[14] Ronald V. Miller, Jr., “Residential Treatment Facility Sex Abuse Lawsuits,” Lawsuit Information Center, 14 Nov. 2024, https://www.lawsuit-information-center.com/residential-treatment-facility-sex-abuse-lawsuits.html