Boarding schools (also called academies) are generally advertised as  providing academic education beyond the survival skills a wilderness  therapy program might teach. Cases of Death and Abuse at Selected Residential Programs

In the eight closed cases we examined, ineffective management and  operating practices, in addition to untrained staff, contributed to the death  and abuse of youth enrolled in selected programs. The practice of physical restraint figured prominently in three of the  cases. The restraint used for these cases primarily involved one or more  staff members physically holding down a youth. On one occasion, while he was staying  with a host family and other patients, he attempted to escape from the  program. Deceptive Marketing and Questionable Practices in Selected Programs and Services

Posing as fictitious parents with fictitious troubled teenagers, we found  examples of deceptive marketing and questionable practices related to 10  private residential programs and 4 referral services. In addition, we identified examples of  questionable practices related to the health of youth enrolled in programs  and the method of convincing reluctant parents to enroll their children. A representative of the foundation explained that their “most  popular” method of fund-raising involved the friends and relatives of the  enrolled youth making tax-deductible donations to the foundation, which  in turn credited 90 percent of these “donations” specifically to pay for  tuition in a program the child was attending. Case 2: The program representative at a Montana boarding school told  our fictitious parent that they must submit an application form before their  child can be accepted to the school. However, after a separate undercover  call made to this school by one of our fictitious parents, the program  representative e-mailed us stating that our fictitious daughter had been  approved for admission into the program and subsequently sent an  acceptance letter. We did not fill out an application form for the school. Case 9: On its Web site, referral service “B” invites parents to call a toll- free number and states: “We will look at your special situation and help  you select the best school for your teen with individual attention.” Our  undercover investigators called this referral service pretending to be three  separate fictitious parents and described three separate fictitious children  to the agents who answered the phone. Despite these three different  scenarios, we found the referral service recommended the same  residential program all three times—a Missouri boot camp. Our  investigation into this referral service revealed that the owner of the  referral service is the husband of the boot camp owner. Appendix I: Private Residential Program Locations

In our examination of case studies for this testimony and our prior  testimony, we found that the victims of death and abuse came from across  the country and attended programs that were similarly located in  numerous states. Figure 2 illustrates the types of programs and  the states in which they are located, excluding boot camps.
Why GAO Did This Study

In October 2007, GAO testified before the Committee regarding allegations of abuse and death in private residential programs across the country such as wilderness therapy programs, boot camps, and boarding schools. GAO also examined selected closed cases where a youth died while enrolled in one of these private programs. Many cite positive outcomes associated with specific types of residential programs. However, due to continuing concerns about the safety and well-being of youth enrolled in private programs, the Committee requested that GAO (1) identify and examine the facts and circumstances surrounding additional closed cases where a teenager died, was abused, or both, while enrolled in a private program; and (2) identify cases of deceptive marketing or questionable practices in the private residential program industry. To develop case studies of death and abuse, GAO conducted numerous interviews and examined documents from eight closed cases from 1994 to 2006. GAO used covert testing along with other investigative techniques to identify, for selected cases, deceptive marketing or questionable practices. Specifically, posing as fictitious parents with fictitious troubled teenagers, GAO called 14 programs and related services. GAO did not attempt to evaluate the benefits of private residential programs and its results cannot be projected beyond the specific programs and services that GAO reviewed.

What GAO Found

In the eight closed cases GAO examined, ineffective management and operating practices, in addition to untrained staff, contributed to the death and abuse of youth enrolled in selected programs. The practice of physical restraint also figured prominently in three of the cases. The restraint used for these cases primarily involved one or more staff members physically holding down a youth. Posing as fictitious parents with fictitious troubled teenagers, GAO found examples of deceptive marketing and questionable practices in certain industry programs and services. For example, one Montana boarding school told GAO's fictitious parents that their child must apply using an application form before they are admitted. But after a separate call, a program representative e-mailed an acceptance letter for GAO's fictitious child even though an application was never submitted. In another example, the Web site for one referral service states: "We will look at your special situation and help you select the best school for your teen with individual attention." However, GAO called this service three times using three different scenarios related to different fictitious children, and each time the referral agent recommended a Missouri boot camp. Investigative work revealed that the owner of the referral service is married to the owner of the boot camp. GAO also called a program established as a 501(c)(3) charity that advocated a potentially fraudulent tax scheme. The scheme involves the friends and family of a child making tax-deductible "donations" to the charity, which are then credited to an account in the program the child is enrolled in. GAO referred this charity to the Internal Revenue Service for criminal investigation.