Better Care, Not No Care: Why Residential Treatment Remains Essential
Christina Buttons, Speaking Out to Help Change the Narrative about Teen Residential Treatment
Christina Buttons is an investigative reporter at the Manhattan Institute. Her work focuses on a range of social issues, including youth mental health treatment. Her data driven reporting offers a well researched counter to the oft reported “negative narratives” about residential treatment.
Many of us are familiar with the outcome data, including the Summit Achievement outcome data provided recently—and we see every day the life-saving value that quality residential programs provide. And more importantly, we’ve seen the faces behind the numbers—young people whose lives have been transformed through treatment, and families who have found hope after long seasons of struggle. And yet, despite the clear evidence of its value, residential treatment continues to face a wave of skepticism. The negative narrative persists, often overshadowing the fact that high-quality, ethical programs are doing vital work and changing lives every day.
A Crisis That Can’t Be Ignored
The nation is in the midst of an unprecedented youth mental health crisis. Suicides, psychiatric emergencies, and ER visits related to mental health have all risen sharply in recent years. Families across the country are struggling to find adequate support, while providers are overwhelmed with need.
At the same time, the very resources young people depend on are shrinking. Between 2010 and 2022, the number of youth residential treatment programs in the United States dropped by more than 60%, not because of reduced demand but due to growing policy resistance. [1] While reforms have been necessary in some cases, closing programs wholesale removes an essential lifeline for the very children and teens most at risk.
Misconceptions That Harm the Most Vulnerable
In Buttons’ most recent article, she highlights this troubling trend, underscoring the gap between ideology and evidence. One passage speaks volumes:
“What’s happening now across the U.S.—boarding children in ERs, placing them in shelters, sending them home without adequate support—isn’t a solution. It’s what happens when lawmakers act first and ask questions later. If ideology continues to override evidence, it’s the most vulnerable youth who will pay the price.”
This is not just a policy issue—it’s a matter of lives and futures. When residential programs are shuttered or dismissed outright, young people in crisis are left with inadequate alternatives. Emergency rooms, shelters, and temporary placements cannot provide the therapeutic structure, clinical support, and stability that these adolescents so desperately need.
The Path Forward: Reform, Not Elimination
The answer is not to eliminate residential care, but to strengthen it. We must continue holding programs accountable, improving transparency, and raising standards of care—while also protecting access to treatment for families who need it most. Better care, not no care, should always be the goal.
At Summit Achievement, we see every day the difference that high-quality treatment can make. Students rediscover their resilience, families rebuild trust, and futures that once seemed fragile are given new strength. These stories matter—and they remind us why preserving and improving residential treatment is so important.
A Call to Share the Truth
As professionals, we can play a role in reframing the conversation. When families are hesitant about treatment, or when skepticism about residential care surfaces, sharing resources like this article can be invaluable. Facts, context, and lived success stories counterbalance the narrative of fear and help families understand that compassionate, ethical, and effective treatment options do exist.
The goal must be better care—not no care. We invite you to read and share the article widely. Together, we can shift the focus back to what matters most: ensuring that young people in crisis receive the care and support they deserve.
Christina Buttons, Residential Treatment Programs Can Be A Lifeline But They are Under Attack
Here are additional investigative reports by Christina Buttons that are worth pursuing:
The Radical Movement to Divest from Youth Residential Treatment
[1] 1 Scott Dziengelski, “Deinstitutionalization Redux: The Decline in Residential Mental Health Treatment for Youth,” Manhattan Institute, May 16, 2024.