Providing an appropriate continuum of mental health services is imperative for the estimated one in five children and adolescents in the U.S. who have a mental health disorder.¹ The growing number of those served in residential treatment facilities (RTFs) can benefit from a system of care approach that facilitates coordination between residential and community-based providers, and engages youth and families as partners in care.

It is vital to understand how RTFs are serving this population, given pervasive questions about RTF overuse, lengths of stay, long-term effectiveness, and adoption of system of care principles.²

This issue brief describes the findings of a national survey of RTFs serving children and youth with serious behavioral health challenges. The survey, conducted by Mathematica Policy Research, explored the extent to which: 1) system of care principles are reflected in RTF policies and practices; and 2) RTFs are providing home- and community-based services and supports in addition to traditional offerings.

The findings are pertinent to stakeholders seeking evidence-based approaches to address the extensive behavioral health needs of children and youth, including: child behavioral health policymakers; purchasers of RTF services such as Medicaid; mental health and child welfare administrators; RTF providers; and child and family advocates.


¹ U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.