Ginger is right that public awareness must happen for the problem to be fixed.
Where she and I disagree is that she doesn't think any legislative solution will be an improvement.
I think we need consumer protection laws for mental health therapies.
I think we need an agency like the FDA, or an expansion of the FDA, to cover talk or behavioral therapies. For purposes of argument, figure we expand the FDA.
Just as, even with the FDA, people can still take various herbal and nutritional supplements, people would still be able to get any talk or behavioral therapy they wanted---so long as it's not demonstrably very dangerous.
What needs to be restricted is the practices that are very dangerous, and the claims made by various facilities. The FDA needs to be able to make therapists comply with standards for what therapies they claim to provide.
Specifically, if a therapist claims to provide a particular kind of proven therapy, like CBT, that therapist should have to have qualifications to provide that therapy or should have to post a disclaimer saying she doesn't have those qualifications.
If a facility or therapist claims to use certain therapies and deliver a certain percentage of results with them, then that facility or therapist had better be making truthful claims---just like the FDA verifies that when you buy a bottle of pills from the pharmacy, what it says on the label is what's really in the bottle.
If a facility or therapist provides unproven therapies exclusively or in addition to the proven ones, they should have to say so. They should have to say if they're unqualified to provide whatever it is. Consumers have a right to know what's in the bottle matches what's on the label.
If they make claims unverified by the FDA, the FDA should have the right to make them post a disclaimer---wherever and to whatever specifications the FDA decides---to protect the consumer.
Children should have consumer protections from ineffective or harmful treatments.
Right now, if your child clearly needs mental health help, then it's child neglect if you don't get them seen to the same as if the kid had an abcess. Child welfare may or may not catch it or pursue it, but they could make a case out of it if they chose.
Problem is, the mental health "help" you get them can be any old kind of snake oil gobbledegook you want.
With an expansion of the FDA, if a relative or a neighbor alleges that a parent is taking their child who clearly needs mental health help and sticking them in something ineffective or harmful---with clear, objective definitions of what works and what doesn't---then child welfare has a clean cut set of criteria for doing an investigation and has some basis to help them evaluate whether a particular child is being abused or neglected.
Another thing this would do is if another family member was seeking custody of the child, the use of harmful treatments if the child was fine, or the use of ineffective treatments or unqualified personnel if the child needed help, would give the other family member some grounds for bringing the case in front of a family court judge. Then the judge could decide in that kid's individual case how to rule in the custody case. He'd just have a lot more clear, objective information about the treatments happening to the kid if the FDA had authority to do normal consumer protection.
Personally, I think this would have the effect of shutting down these behavior mod facilities because they don't work.
Most of them would shut down through lack of demand if they had to provide the parents with prominent disclaimers written by the FDA saying that they don't work, and if the claims they could make to parents were heavily limited and enforced by the FDA.
The few that would still be able to fill beds in their facilities after the resulting industry shakeout would then be mostly shut down as neighbors and relatives of the kids looked at the disclaimers, looked at the parents, picked up the phone, and called child welfare authorities.
You guys point out that the behavior mod facilities comprise a huge industry. That's true. So did the medicine shows selling tonics like Lydia Pinkhams. So did the processed food industries when they didn't have to tell you what was really in the box or the can. When the FDA was created and got the power to make those folks tell the truth, the medicine show industry went away. Tonics like Lydia Pinkhams disappeared like the dinosaurs or, like Coca Cola, transformed into a relatively harmless soft drink that quit making health claims (and quit including cocaine).
I'm a fiscally conservative, socially libertarian Republican. I hate big government as a "solution" to social problems. I believe the private sector solves most problems much better for most consumers, more quickly, for a much better price.
But I'm not an anarchist.
I believe strong consumer protection laws are a necessary limit on a market economy.
I believe half the problem driving these behavior mod facilities is that the parents believe the claims Programs make.
Parents believe Programs because they are accustomed to the benefits of consumer protection laws in the other parts of their lives and naturally assume that the Programs they send their kids to are regulated in equivalent ways.
Our society moved away from Caveat Emptor a long time ago. People aren't used to thinking that way. There are some good reasons for choosing the present consumer protection system over straight laissez-faire capitalism.
The biggest public policy problem with the Programs, and with mental health care in general, is that we don't subject them to the same kinds of consumer protection laws we apply to most similarly important things.
If consumer protection laws enforced a certain level of truth in advertising and truth in labeling on the Programs, I believe Ginger's public awareness campaign would probably take care of the rest of the problem.
Julie
