Tracy, you were clear, to me, that you were talking about adolescents.  The current situation in terms of caring for such teens who may fit the diagnosis of psychopath seems woefully and dangerously deficient. It must be very hard for parents to come to a realization that their child lacks the capacity for empathy and recognizes no limits when he is blocked, even minimally, from carrying out his intentions.  I admire the professional sturdiness you have developed to speak honestly about reality to these families.

My thought is that we need to create a vision of what would be effective.  It doesn't exist now.
But envisioning it will give direction and purpose to actions. 

We certainly know what doesn't work.  We know the financial situation that makes even what doesn't work out of reach.

But if we start with a clear image of what can work or has a good chance of working, then we as a community can build toward it.

I suppose, first, we have to make clear what "working" means.  Depending on the severity of the teen's mental and emotional constitution, that can vary from full recovery through to a lifetime of severe containment.

On the vision list for the third option I would include that it be a place supplying:

1.    Safety for child, parents and all in the proximity of both.
2.    Strong holding environment, physical and emotional,  that offers education and alternatives to   current behaviors.
3,    Regular mindfulness practices (which could be helpful for those not lost in psychopathology)
4.    Opportunity to use intelligence, creativity and talents in meaningful ways while restricted from access to greater community.
5.    A natural environment with opportunity to get close to nature.

This is what I'd like to see in the now non existent third option secure residential setting,
staffed by a wide range of highly qualified professionals.

Personally, I always wonder why the public and the politicians balk at the high cost of things.  No matter how high the cost, prevention turns out to be much cheaper than the expensive devastation caused by lack of prevention.