VERNON, Texas -- Enclosed by an enormous chain-link fence with guard towers positioned at each corner, the Adolescent Forensic campus at the North Texas State Hospital appears imposing.
But during an exclusive visit this week, News 8 found the facility to resemble more of a school with dorms and activities than an actual jail environment. And staff at the facility, where Ethan Couch lived for months after driving drunk and killing four people, emphasize the mission here is about recovery and treatment.
"I want to underscore, we're not a corrections facility but a hospital," said Jim Smith, the hospital's superintendent.
Smith has spent much of his career working and now overseeing the larger mental health hospital, which includes two campuses split between Wichita Falls and Vernon.
The hospital focuses on adult patients as well.
But given the public outcry that erupted when Couch was sentenced to only probation and treatment nearly a year ago, News 8 was most interested in getting an inside look at just what type of treatment teen patients undergo.
"It's a lot of hard work. You really have to look at yourself in a way that most people aren't willing to," said Casey Little, the adolescent program supervisor.
No staff at the facility would comment directly on the Couch case, or any patient, because of privacy laws.
Little and Smith say the environment is meant to be intensive while also providing a platform for reform and personal responsibility.
"What would I say to persons who say, 'How in the world do they do any good?' What I would say is 'We're not treating the crime, we're treating the psychiatric disorder and co-occurring substance disorder,'" said Smith. "There are parts that very much underscore individual responsibility."
During his trial, Couch's defense team solicited testimony from a psychologist that the then-16-year-old was influenced by "affluenza" when he was driving drunk and killed four people in June of 2013.
During sentencing, juvenile Judge Jean Boyd expressed concern that Couch wouldn't receive proper treatment in a more traditional "jail" setting, although she said the affluent testimony didn't necessarily contribute to the decision.
The usual length of a stay for a teen patient in Vernon is six months. They live in dorm-style accommodations, attend classes, and even have access to a gymnasium and movie theater. Little said that some days the teens go through 15 to 16 hours of treatment and activities.
According to the hospital, typical costs per patient per day are about $260.
Couch's treatment cost more than $700 a day at one time, according to court testimony previously reported by our media partners at the Fort Worth Star-Telegram.
The state no longer keeps figures on how many patients discharged from the program re-offend.
Jeff Bearden, another director at the hospital, said he thought it was less than half. He said it's not uncommon for former patients to write letters of thanks years later when they have become productive members of society.
"Those letters really make a difference to our staff and show the good work that can happen," he said.
News 8 reached out to some of Couch's victims and his attorney, but they either didn't want to comment or didn't return inquiries.