Youth Residential Treatment in America
City Journal Audio
Manhattan Institute
4.7 • 657 Ratings
🗓️ 14 May 2026
⏱️ 45 minutes
🧾️ Download transcript
Summary
America's children are in crisis—and the system designed to help them is breaking down.
Christina Buttons, Naomi Schaefer Riley, Scott Dziengelski, and Carolyn Gorman explore one of the most urgent and overlooked issues in public health: the severe shortage of residential treatment beds for young people struggling with mental illness. What happens when children need intensive care and there's nowhere to send them?
We dig into the real story behind treatment facilities, cutting through the media sensationalism to show what quality mental health care for kids really looks like. Our discussion pulls no punches on how flawed legislation is making a fragile system even worse—and how the right reforms could make a difference.
Transcript
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| 0:00.0 | Hello and welcome to a special episode of the City Journal podcast. |
| 0:11.9 | I'm Carolyn Gorman Fellow at the Manhattan Institute. |
| 0:14.9 | And today we're bringing you a conversation about what I might call the real youth mental health crisis. |
| 0:21.6 | Across the country, there's a growing number of children and teens with severe mental |
| 0:27.7 | health and behavioral needs who have nowhere to go. And that's because youth residential |
| 0:34.4 | treatment beds over the past few decades have declined 94% across all states. |
| 0:42.6 | And nationally, we have a shortage of beds that's leaving these kids with the greatest needs underserved |
| 0:50.8 | and therefore abandoned in emergency departments, held in juvenile detention centers, |
| 0:57.4 | and left in unsafe home environments. |
| 1:01.5 | At the same time, we have sensationalized media attention and policy changes that are making |
| 1:07.1 | these bed shortages worse. |
| 1:09.7 | So to talk about what's going on, I'm joined by a few colleagues today, long-time |
| 1:15.4 | City Journal friend and contributor and recent City Journal podcast guest Naomi Schaefer Riley, |
| 1:21.6 | who's a senior fellow at the American Enterprise Institute, Scott Jengelsky, the president |
| 1:26.8 | and CEO of the National Association for |
| 1:28.9 | Behavioral Health Care and Adjunct Fellow at MI, and Christina Buttons, who's an investigative |
| 1:34.6 | reporter at City Journal. So, Scott, we hear pretty often about a youth mental health crisis, |
| 1:43.3 | but a lot of times when we're talking about that, |
| 1:46.0 | we're talking about kids with maybe high levels of normal distress. When we're talking about |
| 1:52.1 | youth residential care, first, sort of who are the kids that we're talking about and what is |
| 1:59.2 | residential treatment? Yeah. So when we're talking about this patient population, we're talking about and what is residential treatment? Yeah. So when we're talking about this patient |
| 2:03.1 | population, we're talking about generally speaking children that have serious emotional |
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