Psychiatric Residential Treatment Facilities

Many PRTFs fail to provide mental health treatment. They are not effective or trauma-informed places. Instead, staff maintain control through strict rules and routines. Children and youth there are separated from their families and may be abused or neglected.

What are Psychiatric Residential Treatment Facilities?

Psychiatric Residential Treatment Facilities (PRTFs) are places children and adolescents are admitted to get mental health treatment.

The problems with PRTFs

Many PRTFs fail to provide mental health treatment. They are not effective or trauma-informed places. Instead, staff maintain control through strict rules and routines. Children and youth there are separated from their families and may be abused or neglected. This separation makes it harder to work through family issues. PRTFs are also expensive. They are not considered a best practice in treating mental health issues in youth. Yet, North Carolina has increased its reliance on PRTFs — at a rate of 119% since 2010.

News Reports in PRTFs

Local, state, and national media reports shine a spotlight on the violations and abuse in NC PRTFs and out-of-state PRTFs where NC sends our kids.

Learn more about PRTFs

Shadow of kind in chair on wall in front of an empty chair

Horrors of a broken system

Investigative reports and news articles reveal that children who are sent to PRTFs can experience significant trauma and often leave in worse shape than when they arrived. Horrific conditions, abuse, neglect, and inadequate staffing are the common themes in their stories. Meanwhile the for-profit companies running the facilities get rich warehousing children.

Empty bed in Piney Ridge PRTF

What the state knows about PRTFs

What really happens behind the locked doors of PRTFs? The state goes into these facilities to investigate complaints. Their reports corroborate the news reports. The state knows these facilities are mistreating and abusing kids. It’s in their own documents.

Watch these short DRNC videos to learn more about PRTFs

You are told your child needs to go to a PRTF to get mental health treatment. Maybe this is the first time for your child. Maybe this has happened before…maybe even many times before. You probably have questions. You deserve answers! Whether this is the first time your child (or the child for whom you are legally responsible) may go to a PRTF, or this has happened many times, we hope these videos will be helpful.

DRNC created this series of three short videos, in collaboration with experienced parents, to help you make an informed choice about this critical decision. We are offering these videos to give you tools you need to advocate for your child’s right to receive the care and treatment they need to heal and thrive in their community, and to advocate for their rights and safety if they are admitted to a PRTF.

profile of a girl sitting on the floor by her bed in a prtf. She looks towards a window, her face obscured by her hair. She is sad.

What DRNC is doing

DRNC launched #BringNCKidsHome in January 2021. Learn more about the campaign, read stories of survivors and join our campaign to help end abuse in PRTFs, and increase community-based supports and services so kids can live at home with their families. Tell NC it’s time to #BringNCKidsHome.

Kid holds his head with his hands in front of blue lockers at school

Learn about children's rights in PRTFs

It’s important to know the rights of children in PRTFs so you can advocate for these rights when you or a child for whom you are responsible is in a PRTF. Learn about these important rights so you can feel confidents advocating for them. Also, make sure your child knows their rights in the PRTF. With this information you and your child can recognize red flags.

A child looks through a keyhole in the door of a prtf room. Only the eye and a sliver of the face is visible.

NC’s Hidden Children

In our #BringNCKidsHome campaign, DRNC has been bringing you stories of traumatized NC kids who are bearing the brutal impact of NC’s over-reliance on institutional care in facilities called psychiatric residential treatment facilities (PRTFs)…

Behavioral healthcare for NC kids

NC Health News invited a panel of experts on April 21, 2022 to describe the challenges NC kids have accessing behavioral health services, especially when they have co-occuring developmental disabilities. The discussion featured  Joonu-Noel Andrews Coste, DRNC attorney; Clarissa Donnelly-DeRoven, NCHN rural health and Medicaid report; and Delia Bailey, parent advocate.

DRNC monitors in PRTFs

DRNC monitors in PRTFs to protect the rights of young people. We investigate abuse and neglect allegations, and represent youth in legal matters. One of our target goals for 2020 is to reduce NC’s reliance on PRTFs to treat our children and youth.

In January 2021, DRNC launched #BringNCKidsHome, a campaign to end abuse in PRTFs.

NDRN Member Organizations


Your rights in PRTFs at a glance

You have the right to:

  • Be treated with dignity and respect
  • Not be abused, neglected or exploited
  • Contact your parent or guardian at any reasonable time — not just on your scheduled “phone day”
  • Contact your advocate or attorney at any reasonable time
  • Make and receive private phone calls
  • Send and receive unopened mail
  • Be outside daily
  • Make visits and have people visit you
  • Participate in religious worship

For more detailed information about rights in PRTFs, go to this page: Children’s Rights in PRTFs

Other Resources

View all mental health resources for children and youth:

Contact information for State Legislators and NC DHHS Secretary: