These Teenagers Needed Help, and What They Got Was a Nightmare

Sadie Sutton was first hospitalized for depression when she was 13. She grew up in the Bay Area and had access to all the medical professionals she might need but began to feel worthless and suicidal as she moved through adolescence. (Sutton is her middle name. She requested that I not disclose her last name to protect her family’s privacy).

At 15, after four hospitalizations and outpatient therapy at Stanford University, she was sent to an inpatient program at McLean Hospital, an affiliate of Harvard Medical School. There, she completed 14 weeks of dialectical behavior therapy (also known as D.B.T.), a science-backed approach that teaches people to regulate overwhelming emotions.

But afterward, her parents were afraid that living at home would threaten her recovery. They sent her to Chrysalis, a so-called therapeutic boarding school in Montana, part of what is known as the “troubled teen” industry, which also includes wilderness programs and other residential facilities that claim to treat everything from youthful misbehavior and drug problems to severe depression. They were told she’d receive more D.B.T. and other evidence-based care. Unfortunately, that wasn’t what she got. She said her stay there was “the worst year of my life.”

When even well-informed parents can’t distinguish between excellent and inappropriate care, our system is broken. As the United States faces a post-pandemic mental health emergency, we need immediate reform. As with medications, behavioral health treatments for teenagers must be required to be proved safe and effective before they can be sold.

At McLean, Ms. Sutton’s therapy was rigorous and emphasized autonomy: She worked collaboratively with the therapists, rather than simply being told what to do. She could call her parents anytime.

Ms. Sutton described the setting at Chrysalis — which was recently sued after a staff member was alleged to have sexually abused students — as “chaos.” “You had to ‘earn’ the privilege of talking to your parents” outside of therapy sessions, she said, which took months and even then was only a monitored, five-minute weekly call. At first, she just sobbed.