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William Reardon: Some at-risk youths need residential care

This article ​was originally published on November 18, 2015 in the Providence Journal.

For more than a quarter-century, one primary principle has guided Boys Town New England in its mission to help children and families: Always do what is best for the child.

We firmly support the idea that all children should grow up in families that love and support them as they mature into healthy adults. We also agree that the vast majority of at-risk children and youth can find stability and receive the treatment they require while remaining with their own family or living with relatives, when their safety can be assured.

Last year, three out of every four youth who received treatment through Boys Town services received those services in their own homes. When services such as foster care or family-based interventions can provide effective assistance, those youth should receive help in that manner. However, there will always be a subset of troubled youth who need a higher level of care. Often, these high-needs children have been abused, neglected or abandoned. Many suffer from severe behavioral or mental health issues. Trauma has been their constant companion, and the result usually is extreme behavior problems, school failure and a sense of isolation and withdrawal.

It is unrealistic to expect foster parents to manage and/or change such behaviors, so foster care cannot be the only out-of-home option for these youth.

High-quality residential care is often the only answer for stabilizing these high-needs children, teaching them the skills they need for success and preparing them for placement in a permanent family. And although this type of care costs more in the short term, it results in long-term personal and economic benefits for youth, their families and society.

Tens of thousands of youth have experienced significant positive changes in their lives through high-quality residential care. With this care option, boys and girls with serious problems can get the treatment they need in a safe environment from caregivers who are properly trained to address even their most serious challenges. And anyone who works in juvenile justice, child welfare, mental health care and education knows a troubled child who could benefit from the intensive care provided by a high-quality residential care program.

Sadly, some decision makers and child welfare reformers want to do away with residential care, saying it traumatizes children by removing them from their own family, is expensive and does not produce positive outcomes. Unfortunately, these critics don’t differentiate between poor- and high-quality residential care, and ignore research (www. boystown.org/quality-care) that shows that good residential care is the best option for children whose treatment needs cannot be met through foster care and family-based programs.

This is why Boys Town and a number of other organizations have taken a leadership role in advocating high-quality residential care, both in New England and across the nation. We believe such care is the most effective way to treat high-needs children and gives them their best opportunity to achieve positive outcomes. We see those positive outcomes every day in the youth who receive compassionate, effective care in our family-style residential program at Boys Town New England.

We strongly disagree with critics who contend that eliminating high-quality residential care is the answer to cutting costs and reforming the child welfare system while still providing effective care for youth with the greatest needs. The experience of other countries like Australia and England provides grim examples of how children suffer when public policy goes too far in restricting effective treatment for them. As these countries dismantled their residential care systems, children began to experience more failed placements, were placed farther away from their family of origin and were increasingly involved in the juvenile justice system or became homeless.

High-quality residential care must be available for boys and girls who suffer from the most severe emotional, behavioral and mental health problems. Boys Town and its fellow advocates know the needs of these children firsthand and will continue to fight to ensure they receive the right care, in the right way, at the right time.