Philadelphia set up a task force to investigate youth residential care after 17-year-old David Hess died at the hands of staff at a centre for troubled teens and youth campaigners spoke out about mistreatment.The result was a report released on November 26 by city authorities, which makes 19 recommendations, including the creation of alternatives to large faraway residential facilities.The task force said: “We must stay intently focused on bringing our children safely home. This means building a system of community-based providers within city boundaries with the mission of reunifying families and ensuring all of our young people exit our systems stronger than when they entered.”Other recommendations included:• Reducing the number of young people placed in institutions, across the child welfare, juvenile justice and behavioural health treatment systems, and supporting families before institutional placement becomes an option• An independent youth services ombudsman• Prioritising mental and behavioural health, trauma-based treatment and supports, family engagement, educational quality, and safety in local facilities• Local monitoring and oversight of education• Confronting racism and bias in the evaluation, placement and treatment of children“Over-institutionalising young people makes no sense,” councilwoman Helen Gym, who helped form the task force, was quoted as saying in The Philadelphia Inquirer. “It’s bad for children, it’s bad for communities, it doesn’t help their families in any way and it’s also bad for our bottom line.”The report said children in care should be placed closer to home to enable them to “maintain family relationships and achieve successful community reintegration”.It said: “Residential placement disconnects youth from their families, homes and communities. While family involvement is an expectation in all settings, what that means is not clear enough. “Distant or inaccessible placements too often prevent regular visitation and involvement in therapies, and families report that sometimes contact has been denied or limited based on a youth’s behaviour.“Research confirms that guardians should be involved throughout the entire process of placement to best support lasting youth outcomes.”The task force praised the young people who “bravely stepped forward to speak their truths” and said it hoped it had provided a “road map and a moral charge for youth residential placement reform”.