How Utah became the leading place to send the nation's troubled teens

For years, Utah has been the epicenter of the nation’s so-called troubled-teen industry. 

Since 2015 some 20,000 kids have been sent to programs in Utah that cater to parents and state agencies desperate to find help for certain teenagers. Some are on juvenile probation. They may be struggling with drug misuse or suffering from eating disorders. Some are depressed or defiant. Some have cut themselves or attempted suicide.

And the businesses that have taken them in have profited from parents or state agencies paying hundreds of dollars per day for the promise that the child will be helped. The teens bring hundreds of millions of dollars into Utah’s economy every year, according to estimates from the University of Utah.

There are more kids sent to Utah for treatment than to any other state. Over six years, from 2015 to 2020, 34 percent of all teens who crossed state lines to enter a youth treatment facility went to Utah. 

How did the businesses in Utah become entrusted to help so many struggling young people? The answer is  a complex combination of history, culture and Utah’s rules and regulations. 

Utah’s squeaky-clean reputation

The seeds were planted in the 1960s when a Brigham Young University student named Larry Dean Olsen started leading wilderness outings with his classmates.

Leaders at BYU, which is owned by The Church of Jesus Christ of Latter-day Saints, noticed that students who went on the journeys seemed to do better in school and were more well-mannered at home. School officials developed a course that offered failing BYU students a chance at readmission if they learned survival skills and went on a monthlong backpacking trip through the Utah desert.

That was the foundation on which the lucrative wilderness therapy industry was born. 

Programs catering to parents promised that wayward teens living and hiking in Utah’s picturesque deserts and mountains would have a transformative experience that would change their lives for the better.

Republican state Sen. Mike McKell, who last year sponsored the first reform in more than a decade to the state’s oversight of the teen treatment industry, said that origin story at the private religious institution gave the industry “instant credibility” to parents in other states looking for solutions for their teenagers.

“Utah has a very clean look to it, a clean feel,” he said. “And we pride ourselves on strong family values. I think that all plays a part.”

A ‘pioneer’ in Provo Canyon School

By the 1970s, Utah’s youth-treatment programs had expanded beyond kids hiking through public lands. They included congregate care facilities. 

One program that started around that time remains among the most prominent: Provo Canyon School.

“You had kind of a pioneer in youth treatment programs with Provo Canyon School,” said Ken Stettler, a former regulator who used to run the Utah Office of Licensing, which oversees treatment programs throughout the state. “Anybody that’s involved with youth treatment nowadays can probably draw some tie back to Provo Canyon. And the fact that a goodly number of people that worked there broke off and started other treatment facilities.”

The men who founded Provo Canyon School in 1971 are a vivid example: Eugene Thorne, Robert Crist, and Jack Williams. They started  four facilities in Utah, most of which are still running. Other workers — including therapists and administrative staff — have opened programs, too.

“You had all these offshoots that started, and most of them were people that worked there,” said Stettler. “They were locals. They wanted to start their own program. They don’t want to go to some other state.”

The age for medical consent

Utah is considered a “parent’s rights state,” which means that parents get to make medical decisions on behalf of their children. So, if a child is in Utah for treatment, they aren’t able to leave the facility unless their parents agree to it.

That’s not what it’s like in other states. In California, for example, a child must consent to mental health treatment if they are 12 or older. In Washington state, that age is 13. 

Cheap land and an eager workforce

A lower cost of living in Utah compared to other states was another reason the teen-treatment industry has grown, according to Megan Stokes, the director of the National Association of Therapeutic Schools and Programs.

“There’s lots of land available,” she added. 

Stokes also said that Utah has an eager workforce, often college students who take lower-paying jobs to help care for kids — either because they are majoring in social work or feel called to help young people.

“That’s where you have the pool of talent,” she said.

About 30 percent of her organization’s members are from Utah, according to a review of their membership records.

Stettler, the former regulator, said that’s where Utah’s culture and deep connections to the LDS faith also come into play.

“People of that faith believe their role and responsibility on Earth is to help one another and to help others that need help,” he said. “So, the idea of working in a facility where you can help a kid turn their life around is appealing.”

Weak regulation

As the industry grew in Utah, serious problems set in — allegations of abuse, riots, deaths in wilderness programs, sexual assault, and lawsuits.

Historically, there’s been little state regulation of these programs. They are often allowed to keep operating despite findings that a facility violated state rules or that a worker harmed children.

Regulators haven’t closed a facility in the last five years. The closest was in 2019, when Red Rock Canyon School gave up its certification after a riot and media scrutiny showing increasing violence at the facility.

Today regulators are looking into these facilities more closely than ever after Utah legislators updated the law last year.

The law places limits on use of restraints, drugs, and isolation rooms in youth treatment programs. It requires facilities to document any instance in which staff use physical restraints and seclusion, and it mandates that they submit reports to state licensors. It also increases the number of inspections that regulators must conduct.

Amanda Slater was the director of the Office of Licensing for three years until she recently took another government job. She said the law has put regulators in facilities more often, which has helped them identify problems more quickly. Previously, regulators only visited a program once a year, and the inspection was scheduled.

“Most people would clean up their house before you show up, right?” she said. “So, you don’t always find the problems. If we’re aware of it, we take action. We are a lot more aware because we’re in there more frequently.”