Tough Love was the setting for another teenager's death while belated debate over the largely unregulated, unaccountable residential treatment industry for teenagers proceeded.

The Philadelphia Inquirer reported:

Omega Leach, the Philadelphia teen killed in June after the city sent him to a Tennessee treatment center, died of strangulation after a fight with a staff member there, according to the Tennessee medical examiner.
The death has been ruled a homicide, the autopsy report says.
Bruce P. Levy found that Leach had "multiple hemorrhages" of his neck muscles from a clash June 2 with two staffers at the Chad Youth Enhancement Center outside Nashville. ...

What is that on my hands? And yours.

              

"Tough love" is a poorly defined article of faith from the addiction-treatment community, where maps of the path to recovery often fail to resemble one another.

When reports surfaced that some paths for troubled young people led to unrehabilitative pain and sometimes death, groups including the National Association of Therapeutic Schools and Programs called it all “the noisy complaints of a few individuals.”

They were and are brutally wrong.

The U.S. Government Accountability Office investigated and "found thousands of allegations of abuse, some of which involved death, at residential treatment programs across the country and in American-owned and American-operated facilities abroad between the years 1990 and 2007," and a lack of appropriate regulatory oversight. In its report, the GAO wrote:

For example, during 2005 alone, 33 states reported 1,619 staff members involved in incidents of abuse in residential programs. GAO could not identify a more concrete number of allegations because it could not locate a single Web site, federal agency, or other entity that collects comprehensive nationwide data. and emotional problems. This testimony concerns programs across the country referring to themselves as wilderness therapy

Although the GAO focused on 10 deaths during "wilderness therapy" residential treatment, the full report (pdf) makes it clear that lack of appropriate oversight is characteristic of the entire industry. Residential drug rehabilitation treatment for young people is, "with the exception of financial services" simply "not regulated by the federal government" and by state government in a number of states effectively regulated only for programs that accept public funds.

The result is a sweeping lack of accountability which conceals great harm and many varieties of treatment failure.

We can do far better for our addicted young people and their families.

It is a matter of collective national shame that we have not done better.