Magazine article Corrections Forum

The Psychiatric Crisis of Youth in Detention

Magazine article Corrections Forum

The Psychiatric Crisis of Youth in Detention

Article excerpt

More than 2.3 million juveniles are arrested every year, and about 600,000 of these are processed through juvenile detention centers and more than 100,000 are placed in secure juvenile correction facilities (Sickmund, 2004). More research has shown that the majority of youth in the juvenile justice system have mental health disorders.

Teplin et al. (2002) found that as many as 75% of juvenile offenders have one or more diagnosable psychiatric disorders. Most juvenile correctional facilities do not have the necessary resources to provide services to them. Mental health professionals who work in the juvenile justice system face many challenges; among them, negative attitudes towards delinquent youth, and the cooperation of various agencies (police, family courts, probation, social services, etc.). Short length of stay, minimum parental involvement, and lack of information about mental health history can also affect treatment. The juvenile detention facilities themselves are hampered by inadequate funding for services and programs, overcrowding, dilapidated facilities, and inadequately trained custodial and mental health staff. These factors are all associated with an increased risk of suicide, physical assaults and accidental injuries (National Juvenile Detention Association, 2000).

"As mental health services become more scarce, behavioral problems often come to the attention of juvenile courts. Often you see kids in the juvenile justice setting who would not otherwise have been there, due to lack of early mental health services intervention," says John Chapman, Psy.D., State of Connecticut, juvenile branch.

Rani A. Desai, PhD, MPH, associate professor of psychiatry and public health, Yale University School of Medicine, agrees that the prevalence of psychiatric disorders among youth in the juvenile justice system is primarily because of the shortage of mental health services in the community for kids. "We know that the majority of mental health services kids get are through the school system and schools are illequipped to provide them. Kids who are severely mentally ill will end up in the juvenile justice system," explains Desai.

The issue is complicated, notes Linda Teplin, PhD, Northwestern University, because many symptoms of mental disease are delinquent acts. When poor kids get in trouble, they may be arrested rather than referred to mental health treatment.

"We need to focus on providing treatment in the community so kids won't fall in the cracks and go untreated," says Teplin. "Children are one of the most underserved groups [for treatment of mental illness]."

Characterization of Mental Disorders

"Disruptive and antisocial behavior can be a feature of mental disorder in youth as well as adults. One of the major psychiatric diagnoses of childhood and adolescence is conduct disorder, characterized by antisocial acts; so it is no surprise that it is commonly found among delinquents. However, even when the diagnosis of conduct disorder is excluded, up to two thirds of delinquent youth are found to suffer with one or more psychiatric disorders," states Christopher Thomas, MD, professor, Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston. "Mental disorder can impair an individual's ability to handle confrontations with others in an acceptable manner and follow society's laws. Those suffering with mental illness may be more irritable or impulsive and have a lower frustration tolerance. The relationship is not one way, as involvement in crime and the justice system may result in stresses that can contribute to mental illness, such as drug and alcohol abuse, major depression or post-traumatic stress disorder."

Mood disorders, such as bipolar disorder, depression and anxiety, conduct disorders and substance abuse are the most common psychiatric disorders among youth in detention, according to Chapman. Very high rates of trauma and posttraumatic stress disorder (PTSD) are also prevalent. …

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