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Ask the Mental Health Expert Archives 2001-2004

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Classifying Treatment Facilities

Q. How are residential treatment facilities for youth classified? I hear facilities are classified as Level I, Level II, Level III, and Level IV. What do these classifications mean?

A. To the best of my knowledge, the numbers you cite may mean somewhat different things, depending on whether the residential treatment facility (RTF) is part of a state-wide juvenile justice system, a private group home, or a hospital system. For example, in Florida, there are almost 5,000 juveniles who have been committed by a judge to a residential treatment facility. It is the judge who decides the level of commitment (essentially how long the sanction and treatment lasts and how secure the facility will be for that juvenile).

About 170 of those youth are locked up in Level 10 facilities. The others include:

a. About 2,500 in moderate-risk residential or Level 6 facilities that include boot camps, halfway houses, intensive vocational work programs, wilderness camps and youth development centers.
b. Around 1,700 in high-risk residential or Level 8 facilities like Dozier School, sex offender programs and intensive youth development centers.
c. The rest, about 500, are in low-risk residential or Level 4 facilities like family group homes and short-term wilderness programs.

On the other hand, the famous Boys Town Residential Treatment Center-which is part of the Boys Town National Research Hospital-describes itself as a level II treatment center. This is for "...more seriously troubled youth who require supervision, safety and therapy but do not require inpatient psychiatric care..." The Boy's Town facility provides round-the-clock supervision and locked/secure facilities.

In contrast, the Seneca Center (see http://www.senecacenter.org) in Alameda County, California, describes itself as a level 14 group home program, designed to provide the most intensive treatment and educational services available in a community-based setting for children aged 6-13. It seems clear that these numbers are not comparable across categories, but generally increase in magnitude as the degree of service intensity or security increase. You may want to check with the Department of Youth Services in your own state for more specific information.

April 2001

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