Psychiatric Residential Treatment Centers for Children and Adolescents: Modeling Variation in Facility Definition Type

A national picture of residential treatment centers (RTCs) for children is lacking and this situation may be complicated by differences between facilities in how RTCs are defined. This study uses data from a national survey of mental health facilities to supplement current knowledge about variation in the definition of RTCs nationwide. Descriptive analyses using 2012 National Mental Health Services Survey (N-MHSS) data were conducted on a standard definition of an RTC from the research literature and three different variations of it. Cohen’s h was calculated to assess whether differences in proportions were meaningful. While nearly two-thirds of RTCs that serve children define themselves following a standard definition in the research literature, nearly a quarter served adults, 9% did not require that residents have a diagnosis of serious emotional disturbance (SED), and a small proportion offered inpatient care in addition to residential care. Of the 9% of RTCs that did not require an SED diagnosis, the majority of these facilities were located in the West. This finding suggests that some of these RTCs may be wilderness programs, and it may also be an indicator of lack of RTC availability. Lack of consensus in the research literature and in the field regarding the definition of an RTC makes it difficult to compare different RTC study findings with each other. Development of a consensus definition of RTCs is a necessary first step to collecting comprehensive data and assessing the current state of this important component of the mental health delivery system.