not so great

mentally ill youth 1.

Study: Juvenile Detention Not a Great Place to Deal With Mental Health Issues

July 23, 2015

If you land in the hospital as an incarcerated teen, it’s more likely for mental health reasons—psychiatric illnesses, substance abuse, depression, or disruptive disorders—than for any other factor, says a new study.

Researchers from the Stanford University School of Medicine examined nearly 2 million hospitalizations in California of boys and girls between the ages of 11 and 18 over a 15-year period. They found that mental health diagnoses accounted for 63% of hospital stays by kids in the justice system, compared with 19% of stays by kids who weren’t incarcerated, according to their study published Tuesday in the Journal of Adolescent Health.

“Should we be getting them into treatment earlier, before they start getting caught up in the justice system?”

The study’s lead author, Dr. Arash Anoshiravani, said it seems likely that many locked-up kids developed mental health problems as a result of earlier stressful events during their childhoods, such as being abused or witnessing other acts of violence. “We are arresting kids who have mental health problems probably related to their experiences as children,” he said in a statement. “Is that the way we should be dealing with this, or should we be getting them into treatment earlier, before they start getting caught up in the justice system?”

Even if someone enters detention without a major mental health problem, she has a good chance of developing one once she’s there. The World Health Organization cites many factors in prison life as detrimental to mental stability, including overcrowding, physical or sexual violence, isolation, a lack of privacy, and inadequate health services. And the problem is obviously not just limited to juvenile offenders: Earlier this year, a study by the Urban Institute found that more than half of all inmates in jails and state prisons across the country have a mental illness of some kind.

In the California study, kids in detention and hospitalized were disproportionately black and from larger metropolitan counties like Los Angeles, Alameda, and San Diego. Among children and teens in the justice system, girls were more likely than boys to experience severe mental health problems, with 74% of their hospitalizations related to mental illness, compared with 57% of boys’ hospitalizations. (Boys, on the other hand, were five times more likely to be hospitalized for trauma.)

Earlier mental health interventions could lead to major savings, the researchers added: Detained youth in their study had longer hospital stays than kids outside the justice system, and a majority of them were publicly insured.

Samantha Michaels is an editorial fellow at Mother Jones. Previously, she worked for three years as a journalist in Myanmar and Indonesia.


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2 Responses to “not so great”

  1. 1 Frank Manning
    August 3, 2015 at 7:06 pm

    Great article, Dan. Spotlights a number of issues surrounding the inadequacy of our preventative mental health services, especially for poorer children.

    Here’s a big problem, though, I think, judging from the kids I’ve worked with in the reform school over the past decade or so. The boys and girls who wind up in the facility where I volunteer have been adjudicated of a crime, often a very serious crime, such as arson, aggravated assault, even murder or manslaughter. In most cases it’s not until they are locked up in juvenile detention or the reform school that their underlying mental health condition is uncovered. So now they are in the hands of the juvenile rehabilitation administration (JRA) or–if they are unlucky enough to live in states that emphasize punishment over treatment–the juvenile correctional service. Here in Washington our JRA is equipped and funded to deal with the kids’ mental health issues, with real psychologists and psychiatrists treating the kids with these problems. Juvenile correctional services are simply not equipped to treat mental illness in kids, inasmuch as their overarching mission is confinement and punishment. Sadly, many states regard the kids in their custody as criminals first then as children with mental health conditions.

    Now if the school districts or municipalities had adequate funding of mental health services for the children in their jurisdictions, we would have a very different picture from that painted by Samantha Michaels in her article. But the political will to provide funds for this is absent. And few politicians and school board members are open to suggestions for increasing such funding. That’s the big problem, I think.

    At the reform school where I volunteer they have specialized residential units (“cottages”) for boys and girls with diagnosed mental conditions such as bipolar illness, schizophrenia, and PTSD. The staff in these cottages have special training in dealing with mentally ill children. They are dedicated, caring professionals and do their best to help our kids. But by the time most of the kids arrive here the damage done by their untreated and undiagnosed condition is pretty bad, posing formidable challenges for the staff. I’ve learned a lot about mental illness in children from both the kids and the staffs. What I’ve learned reinforces my belief that school districts and localities need to spend substantially more on mental health services for children who are at risk of committing crimes of violence as a result of their illness. As usual these jurisdictions prefer to close the barn door after the horses get out–and then whip the horses for getting out.

    • 2 matt
      August 4, 2015 at 4:56 am

      “Now if the school districts or municipalities had adequate funding of mental health services for the children in their jurisdictions . . .”

      I agree with you, Frank, but there is only so much money available for social services, and there are obviously competing priorities, such as the below effort in your neighboring state, Oregon. That effort will impact very few and have very little impact on the betterment of society as a whole, and is thus a questionable use of tax dollars (IMHO). Opinions and priorities!

      “HERC approved the change back in January. Now transgender youth as young as 15 years old can get state-funded counseling, puberty suppressing drugs, and even gender reassignment surgery without parental consent.”


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