Youth mental health has become a frequent topic of news coverage, often with an assumption that expanding treatment availability is necessary. However, not everything done in the name of youth mental health is for the benefit of young people. Patients can be harmed when the quality of care is poor, the root cause of their difficulties is unaddressed, or when abuse is disguised as medical help.
Young people deserve to have quality mental health support when they are struggling, instead of being placed into conditions that are likely to make things worse for them. In the following webpage, the National Youth Rights Association explains many flaws in youth mental health facilities, and the ways that they can negatively impact struggling youth who are forced to be placed in them.
Table of Contents
- Assumptions About Mental Health
- Involuntary Commitment
- Restraints and Seclusion
- Overuse of Drugs
- Failure to Obtain Informed Consent
- Abuse from Staff, Removal of Property and Cutting off Support
- Stories of Abuse in Mental Health Facilities
The National Youth Rights Association
If you’re interested in Youth Rights, consider volunteering with us. We are always looking for new members and would love to have you on board. If you have a personal story to share about experiencing harm in a youth mental health facility, or about a youth rights violation you’ve experienced, consider sending us an email at nyra@youthrights.org. We’d love to help get your story out to the world.
Assumptions About Mental Health
The very concept of mental health is defined in an extremely subjective way. For example, the World Health Organization says that “Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their community”. Despite using the same terminology as other branches of medicine, subjectivity is also a feature of the diagnostic system that psychiatry uses to justify treatment decisions. Some psychiatric diagnosises are based on assumptions about how far someone’s behavior deviates from what is expected, rather than objective medical tests, except to rule out the possibility of physical illness. For this reason, mental health diagnoses are easily weaponized for the purpose of institutionalizing people who resist oppressive authority figures.
Young people who are committed to a mental health facility are often there because their parents or other powerful adults, such as police officers or foster care workers, disapprove of their behavior. If these patients disagree that they have a medical problem, they may be ignored, punished, or have their objections taken as evidence that they are incompetent to make their own decisions.
Involuntary Commitment
In Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review, the authors explain that “involuntary treatment is simultaneously a common practice and almost the only exception to the principle that healthcare is voluntary and based on consent… thus becoming a morally complicated undertaking”.
Involuntary treatment is often claimed to be necessary when patients lack the mental capacity to make good decisions for themselves, or when they are at risk of harming themselves or others. Predictions of patients’ behavior can be influenced by prejudice, such as the belief that young people are prone to impulsivity and violence. Some adults may also portray young people’s behavior inaccurately or incompletely if they are trying to use involuntary commitment as a punishment.
A study of young people’s experiences of involuntary hospitalization found that many of them became distrustful of mental health professionals as a result. Their reasons “included perceptions of inpatient treatment as more punitive than therapeutic, staff as more judgmental than empathetic, and hospitalization overall failing to meet therapeutic needs”. The study also suggested that fear of being hospitalized can decrease willingness to disclose suicidal thoughts or other mental health problems.
Placement in a mental health facility can sometimes be more like getting arrested and jailed than receiving healthcare in a hospital. In the former scenario, the right of the accused to a fair trial is an important safeguard against unjust deprivation of freedom. This is why corrupt authorities might declare someone mentally ill to have them sequestered without having to honor their due process rights.
Young people already have limited rights in the court system, and they are likely to lose what little power they do have once they are inside a mental health facility. Some jurisdictions have “Mental Health Courts”, but these programs are often for adults only and are focused on those who have been accused of a crime in addition to receiving mental health treatment. Therefore, young people cannot generally access courts to resolve grievances against the mental health system.
Along with this, there are many instances where young people are involuntarily committed when they do not need it, leading to them being placed in a worse situation. The Washington Post documented cases in which schools invoked Florida’s Baker Act after children made statements about harming themselves or others. One involved a boy who, after being teased at school, said that he wanted to hurt himself. Police became involved and he was involuntarily taken for psychiatric evaluation. According to his family, he was handcuffed and taken to a psychiatric facility, where the 10-year-old refused to eat or shower and was housed with patients as old as 17. His family obtained an attorney and secured his release the following day. His father told the Post that the experience did not end when he was released: the child subsequently experienced nightmares for two years, became more anxious, and remained afraid that saying the wrong thing could cause authorities to detain him again.
Restraints and Seclusion
Restraints are devices such as belts, harnesses, or handcuffs used to immobilize patients. Seclusion refers to any scenario that a patient is left alone in a place where they are not allowed to leave.
Medical guidelines state that “applying physical restraint under urgent circumstances is rational, but it may be abused with the intention of punishment”. For example, a patient may be provoked by verbal abuse from staff, who then cite their angry reaction to justify restraining them. Restraining a patient should only be used as a last resort for administering medically necessary treatment, rather than for the convenience of staff.
A review of seclusion and restraint in adolescent mental health facilities found that “consumers reported overwhelmingly negative experiences and the revisiting of past trauma experiences due to seclusion and restraint practices”. Patients are at risk of being physically injured during the procedures, as well as “negative psychological effects, with consumers reporting intense anxiety and fear during restraint, re-traumatization and post-traumatic symptoms including nightmares and intrusive memories”.
Therefore, the use of coercive methods to manage an immediate difficulty results in later risks, such as increasing the probability of suicide or other mental health problems. Patients who experience psychological harm from restraint and seclusion can become dependent on the mental health system even after their original problem has been resolved. Excessive use of coercion in mental health settings also contributes to public perception that people with psychiatric diagnoses are dangerous, which can hinder their future employment, relationships, or encounters with law enforcement.
Overuse of Drugs
Chemical restraints are drugs that are used to control behavior rather than to treat an underlying condition, usually by sedating patients. Physical restraint is often used for administering these drugs. The psychological consequences of chemical restraint can be similar to those of physical restraint, because they both involve being overpowered by authority figures.
Aggressive marketing from pharmaceutical companies can lead to a preference for drug treatments, even if other kinds of interventions would be more helpful for the patient. Parents may also seek psychiatric drug prescriptions if that would relieve them of responsibility for providing care themselves. For example, antidepressants have the general effect of dulling emotions, which could be temporarily helpful for someone in a distressing situation. However, abusive parents or medical staff may use these drugs to suppress young people’s reactions to abuse while making themselves appear to be providing essential care.
Failure to Obtain Informed Consent
Informed consent is one of the core principles of medical ethics. It means that patients must be provided with information about the risks and benefits of treatment, and to make their own decisions on what kind of care to receive, if any. Adult patients are afforded a right to autonomy even in the most extreme scenarios, such as leaving a hospital when doctors believe they will die without treatment.
Most medical decisions for people under 18 are made by their parents, which can result in conflicts in a mental health setting. Parents who are using mental health treatment as a punishment might provide misleading information, such as portraying reactions to abuse as medical symptoms. When young people object to mental health care, their psychiatric diagnoses might make it harder for them to be perceived as competent, in addition to prejudice against young age itself. This can lead to diagnostic overshadowing, in which physical symptoms are misattributed to mental illness, resulting in denial of proper treatment. Parents or their insurance are generally paying the bill for treatment, which is another reason for young people being ignored by doctors. This is why youth medical autonomy is especially important in mental health.
Another way of denying informed consent to youth is failing to disclose the effects of drugs. Much research on the efficacy of psychiatric drugs focuses on short term outcomes, and often defines a good outcome as one that is desirable to adults, such as compliance with parents or school authorities. Psychiatric drug use increases the risk of many negative long term outcomes, including cardiovascular disease, sexual dysfunction, and cognitive impairment. The effects of drugs can also be misrepresented as symptoms of the illness that the drugs are needed to treat. Even if parents are informed of these risks, they may still consent to drugs against their child’s objections because they are unlikely to face consequences if the child is harmed.
Abuse from Staff, Removal of Property and Cutting off Support
A 2026 review found that it is common for mental health professionals to engage in abusive behaviors such as physical violence, verbal insults and threats, sexual harassment, theft and unauthorized use of patients’ money and other property, denying access to food or medical care, and privacy violations such as strip searches.
Confiscation of cell phones is a particular issue for young people because it is often claimed that excessive use of phones and social media cause mental health problems. However, researcher Mike Males has demonstrated that family abuse is a much bigger predictor of psychiatric symptoms than social media, and that abused youth are more likely to go online to seek help. For that reason, mental health staff might take away camera phones to prevent young patients from recording abuse and contacting others who would try to rescue them from the facility.
A psychological-autopsy study examining adolescents’ social-media experiences found that for some girls who had spent time in inpatient psychiatric settings, social media was considered necessary for maintaining relationships with friends and family outside the facility. These teenagers were surrounded by other severely distressed patients and sometimes witnessed suicidal behavior among peers inside the institution. Researchers reported that communication with friends and family online helped them feel cared for and provided an emotional counterbalance to the distressing environment around them. The accounts show why mental health facilities restricting access to phones and social media can have particularly disastrous consequences for young people already experiencing serious mental-health difficulties. Online communication may be one of the few ways they can preserve relationships with the ordinary social world outside treatment.
Resistance to unreasonable demands can lead to unnecessary treatment because the criteria for various psychiatric disorders overlap heavily with reactions to abuse. Patients who dispute their diagnosis may be told that they are “in denial” of their mental illness or that they are “masking” their symptoms. These ideas are used to gaslight patients because there is no condition in which they can successfully argue that they don’t meet criteria for a psychiatric disorder. There is even a diagnosis called anosognosia meaning that a person doesn’t understand they have a mental illness, which can be abused to justify involuntary treatment.
Stories of Abuse in Mental Health Facilities
Chrissy, a survivor of the troubled teen industry, describes her experience with psychiatric drugging in a NYRA podcast. A psychiatrist interpreted her hand-washing habit that she developed in response to bullying as a symptom of Obsessive Compulsive Disorder. Her mother convinced the psychiatrist to prescribe drugs, and she was later sent to a troubled teen facility where she was verbally humiliated, threatened, and placed in solitary confinement. When another psychiatrist expressed concern for Chrissy, her mother went doctor-shopping for someone who would continue to prescribe drugs to control her. The effects of these drugs delayed the process of becoming an independent adult.
Nick Taber, in a video by Inner Compass Initiative, describes how the troubled teen industry uses the language of mental health to disguise systems of abuse and control. The facility he was sent to advertised to parents that spending time in the wilderness would be therapeutic for teenagers. In reality, the remote location made it difficult to escape from prison-like conditions. Some of the staff gained credibility with parents by having credentials in mental health professions, even though their actual job was more about controlling young people using sedative drugs and invasions of privacy. The only way to get out of these brutal conditions, according to Nick, was to be extremely compliant and pretend to be happy despite being abused by the authorities.
Dr. Jessica Taylor, a feminist critic of psychiatry, began to question assumptions about mental health while working with a 14 or 15 year old girl who had been raped. Taylor explains that instead of allowing the girl a safe place to process a traumatic event, she was non-consensually prescribed electroconvulsive therapy, a controversial procedure that induces seizures to supposedly erase bad memories. The treatment caused her to frequently feel ill, tired, and confused, which made her unable to concentrate or stay awake. Taylor goes on to explain how psychiatry has historically been used to marginalize people who challenge the status quo. A recent example is that “having a strong sense of justice” has been interpreted as a symptom of Autism Spectrum Disorder. This diagnosis is often given to youth who object to being oppressed by adults. Putting them in the same category as people who require a great deal of support increases the risk that they will be institutionalized for future noncompliance.
Emma Isabella Aluise was placed in a troubled teen facility that misled her parents by claiming to offer help for depression. A consultant for this facility reported to Emma’s parents that she was doing well, despite never meeting with her. When she rapidly gained weight due to medication, the staff blamed her for eating too much and placed restrictions on her diet, which caused further illness. Emma described her experience as “emotional abuse disguised as therapy” which she still struggles to cope with.
