Mental Health Issues in Juvenile Detention Centers

Critical Issues in Corrections

Diane L. Varner

March 6, 2009

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 Abstract

Juvenile detention centers across the nation have become an unnecessary

holding cell for juveniles that are waiting for mental health treatment. This has

become a serious national problem. Detention centers are not equipped to provide

proper care for mentally disordered juveniles. It takes proper education, training,

and preparation to work with mentally disordered juveniles. Juvenile justice

practitioners should not and cannot be expected to properly treat mentally

disordered juveniles. Treatment must come from a trained mental health

practitioner that involve the offender’s family and include appropriate community-

based mental health services, special education, and services that focus on

emotional and learning disabilities. Community based care programs are faced with

limitations and shortages. In order to achieve this, the reoccurring shortages of

resources and public funding to support the nation’s mental health system must be

addressed.

Mental Health Issues in Juvenile Detention Centers

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 There are a significant number of juveniles with mental health disorders that

enter juvenile justice systems throughout the United States. “It is well established

that the majority of youth in the juvenile justice system have mental health

disorders. Findings from a number of recently conducted studies are strikingly

consistent-approximately 70 percent of youth diagnosed in the juvenile justice

system meet criteria for a diagnosable mental disorder. Further, recent estimates

suggest that approximately 25 percent of youth experience disorders so severe that

their ability to function is significantly impaired.” (Lepler, Skowyra, & Coccozza,

P.5.).

So why are so many mentally disordered young people entering the juvenile

justice system rather than mental health facilities? This question has been asked

over and over again for years. “The lack of information about the mental health

needs of justice involved youth has hindered the juvenile justice system’s ability to

understand the needs of the youth in its care and develop appropriate responses.”

(Shufelt & Coccozza, P.1.).

Pam Clark is the President of the National Juvenile Detention Association. In

February 2008 she wrote an article titled Juvenile Justice Faces Mental Health

Issues. In her article she talks about this fifteen year girl who had been sent to a

detention center fourteen times in three years. The girl is violent, aggressive, and

less able to control herself every time she returned to the center. The young girl has

been in constant criminal mischief and goes into violent rages. She has been

diagnosed with borderline personality disorder. She needs proper mental health

services and without them she will keep reoffending. If she does she will eventually

be committed to the state department of corrections.

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 This is a very common story that is heard throughout the country. It has

become a very serious national problem. Juvenile detentions center across the

nation have become an unnecessary holding cell for juveniles that are waiting for

mental health treatment. These centers are not equipped to provide proper care for

mentally disordered juveniles. The facility staff lacks formal education, training, and

preparation to work with mentally disordered juveniles.

Post-Traumatic Stress Disorder occurs when a person is exposed to a

traumatic event or situation and the stress of the situation overwhelms their ability

to cope with the event or situation. PTSD can be caused from physical abuse, sexual

abuse, domestic violence, community violence, or disasters. “Studies report varying

rates of Post-Traumatic Stress Disorder (PTSD) among youth in the juvenile justice

system, with estimates ranging from a low of 3% to a high of 50%. One study found

that over 90% of juvenile detainees reported having experienced at least one

traumatic incident.” (Ford, Chapman, Hawke, & Albert, P.1.).

Juveniles exposed to traumatic events may experience a variety of

symptoms, such as, depression, anxiety, aggression, or conduct problems. Even

though trauma does not always cause these problems, traumatic stress can

interfere with a child’s ability to learn and think, and may interfere with healthy

physical, emotional, and intellectual development. “Further, traumatic stress among

children and youth is associated with increased utilization of health and mental

health services and increased risk of involvement with the child welfare and juvenile

justice systems.” (Ford, Chapman, Hawke, Albert, P.1.).

Post-Traumatic Stress Disorder among juveniles involved in the juvenile

justice system widely varies. Studies have proven that many juveniles involved with

the juvenile justice system have experienced traumatic events and suffer from

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PTSD. Selected studies have proven that “more than one in three youth in the

California Youth Authority met full criteria for PTSD, and 20% met partial criteria for

PTSD. The incidence of PTSD among youth in the juvenile justice system is similar to

youth in the mental health and substance abuse systems, but up to eight times

higher than comparably aged youths in the general community population. Among

non-incarcerated youth seen in juvenile court clinics, one in nine met criteria for

PTSD. The prevalence of PTSD is higher among incarcerated female delinquents

(49%) than among incarcerated male delinquents (32%), and higher than among

youths in the community (<10%)”. (Ford, Chapman, Hawke, Albert, P.2.).

According to a legislative report that was obtained in July 2004:

“Two-thirds of juvenile detention facilities hold youths who are waiting for

community mental health treatment. Children as young as seven are incarcerated

while waiting for mental health services. Two-thirds of the juvenile detention

facilities that hold youths waiting for community mental health services report that

some of these youths have attempted suicide or attacked others. Juvenile detention

facilities spend $100 million each year to house youths who are waiting for

community mental health services.” (Clark, P.1.).

In 2006, The National Center for Mental Health and Juvenile Justice and the

Council of Juvenile Correctional Administrators conducted a multi-state mental

health prevalence study on juveniles involved with the juvenile justice system. The

goal of the study was to comprehensively examine the prevalence of mental health

and substance abuse among juveniles involved with the juvenile justice system.

“The data collected during the study clearly indicates that the majority (70.4%) of

youth in the juvenile justice system meet criteria for at least one mental health

disorder. In addition, the results of this study indicate that youth in contact with the

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juvenile justice system experience high rates of disorder across the various types of

mental disorders. Disruptive disorders (46.5%) such as conduct disorder are most

common, followed by substance use disorders (46.2%) such as alcohol abuse,

anxiety disorders (34.4%) like obsessive-compulsive disorder, and mood disorders

(18.3%) such as depression.” (Shufelt & Coccozza, P.1.).

The results of the study reveals that the majority of juveniles involved with

the juvenile justice system, from 65% to 70%, have at least one diagnosable mental

health disorder. Over 60% of the juveniles had qualified for three or more diagnoses.

The study revealed that girls (80%) are at a significantly higher rate than boys

(67%) for a being diagnosed with a mental health disorder. The study also revealed

that 60.8% of juveniles with a mental health diagnosis also met the criteria for a

substance use disorder. “This multi-state study confirms the high rate of disorder

found in earlier studies that often were limited to a particular site or level of care,

and provides further support for the critical need for improved mental health

services for justice involved youth.” (Shufelt & Coccozza, P.5.).

Studies have indicated that juveniles in community-based programs are more

likely to receive proper mental health services than those who are incarcerated.

These types of programs also allow the juvenile to remain in their home, school and

community. “Additionally, community-based programs have lowered recidivism rates

by 25%-some by as much as 80%.” ((www.physiciansforhumanrights.org.).

Community based care programs are faced with limitations and shortages.

This is why juvenile detention centers have become the care facilities for mentally

disordered juveniles. This is a very complex issue. “Juvenile justice practitioners

cannot and should not be expected to effectively treat mentally disordered children

and youths. Treatment must be provided by trained mental health professionals.”

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(Clark, P.2.). Proper funding and resources must be made available to support our

country’s mental health system. These changes must come from strong and

supportive legislators that are willing to fight for these much needed changes.

The major barrier that states and communities have is the lack of information

on how to fund mental health screenings, assessments, and treatment services for

juveniles involved with the juvenile justice system. In 2007, the National Center for

Mental Health and Juvenile Justice established the Blueprint for Change. The

Blueprint for Change is a comprehensive model for the identification and treatment

of juveniles with mental health disorders in contact with the juvenile justice system.

The document “offers a conceptual and practical framework for juvenile justice and

mental health systems to use when developing strategies and policies aimed at

improving mental health services for youth involved with the juvenile justice

system. Since its release in 2007, the Blueprint for Change has aided numerous

jurisdictions in their efforts to better address mental health issues within the

juvenile justice system, and has emerged as an important resource for systems

change.” (Leplar, Skowyra, & Cocozza, P.5.).

Even after publication of the Blueprint for Change one issue continues to

arise. Questions have repeatedly arisen on how to fund mental health services for

juveniles in the juvenile justice system and the resources that exist to pay for them.

The National Center for Mental Health and Juvenile Justice conducted a short survey

about the programs that were promising in the Blueprint for Change. The survey

provided information about the funding portfolio of seven programs that were

identified in the Blueprint for Change. The survey findings revealed that “the

majority of program funding is from the juvenile justice system and originates with

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state and local government.” (Leplar, Skowyra, & Cocozza, P.33.). Most programs

face numerous funding challenges and are not funded properly.

The problem is that state and local governments cannot provide the proper

funding and resources that are needed for juvenile justice systems. This is where

the Federal government needs to step in and make more funding and resources

available to states and local governments. Without this, change will not happen. The

United States has a crying need for mental health reform. “National efforts must be

made to increase prevention, early identification and intervention, assessment,

outpatient treatment, home-based services, wrap-around services, family support

groups, day treatment, residential treatment, crisis services and inpatient

hospitalization.” (www.physiciansforhumanrights.org.). Without proper mental

health reform mentally disordered juveniles will continue to be lost in the system

and labeled as juvenile offenders.

“According to a national study, juvenile facilities are not equipped to provide

necessary mental health services. Administrators reported that 27% of detention

centers had poor, or no mental health services, and 54% of the staff received poor,

very poor or no mental health training.” (www.physiciansforhumanrights.org.).

What can juvenile justice practitioners do to meet the needs of mentally

disordered juveniles? In the past five years, mental health screening has become a

standard procedure in many juvenile justice systems in the United States. A mental

health screening is usually a brief assessment carried out by a non-clinical staff

member. “One of the most important steps to respond to the mental health

treatment needs of youths in the juvenile justice system is to systematically identify

the mental health needs of youth as they become involved with the juvenile justice

system.” (www.ncmhij.com/pds/MHScreening.pdf.). In order to accomplish this, it is

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essential that mental health screening measures and procedures be in place when

the juvenile has first contact with the system. Mental health screenings help staff

identify juveniles with possible mental or emotional disorders. This is important

because juveniles could be at risk to harm others, themselves or suicide.

“There are dire consequences if mental services cannot be accessed in the

community. In 2003, over 12,000 families relinquished parental custody of their

children to the child welfare system in order to access mental health treatments

they could not afford. Parents are then denied authority to make medical,

educational and other important decisions about their children’s lives.” All young

people in the justice system have the right to the highest attainable standard of

mental health and related services. States’ over-reliance on incarceration as a

response to the development and mental health needs of children emphasizes a

need for change.” (www.physiciansforhumanrights.org.).

Bibliography

*Clark, Pam. Juvenile Justice Faces Mental Health Issues. February 2008.
http://www.aca.org.publications/pdf/CommentaryFeb8.pdf.

*Mental Health in the Juvenile Justice System.

http://www.physiciansforhumanrights.org.

*Ford, Julian D. Chapman, John F. Hawke, Josephine and Albert, David. Trauma
among Youth in the Juvenile Justice System: Critical Issues and New Directions. June
2007. http://www.ncmhjj.com.

*Schufelt, Jennie L. and Cocozza, Joseph J. Youth with Mental Disorders in the
Juvenile Justice System: Results from a Multi-State Prevalence Study. June 2006.
http://www.ncmhjj/pdfs/publications/PrevalenceRPB.pdf.

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*Lepler, Susan. Skowyra, Kathleen R. Cocozza, and Joseph J. Blueprint for Change:
Funding Mental Health Services for Youth in Contact with the Juvenile Justice
System. 2007. http://www.ncmhjj.com/pdfs/Blueprintfunding.pdf.

*Mental Health Screening within Juvenile Justice: The Next Frontier. 2006.
http://www.ncmhjj/pdfs/MHScreening.pdf.

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