Mental Health Needs among Adolescents Committed to the Virginia Department of Juvenile Justice
McGarvey, Elizabeth Lloyd, Waite, Dennis, Developments in Mental Health Law
Mental health needs among juveniles who have contact with law enforcement agencies may vary somewhat across Virginia due to cultural and regional differences as well as the agency contact of origin. This article provides a prevalence report on the mental health problems and the trends in psychotropic medication use among adolescents who have been remanded to Virginia's Department of Juvenile Justice (DJJ) over the past eight years. Thus, it provides an overview of the mental health needs of adolescents committed to the DJJ.
YOUTH COMMITTED IN VIRGINIA
Using averages over an eight-year period, about 1,550 youth are committed to Virginia's juvenile correctional facilities in any year, of whom 89% are males and 11% are females. The race/ethnic distribution of youth has changed over the years. There were significantly fewer African-American youth (57%) committed to the system in 2000 than in 1993 (65%), compared to Caucasian youth who show the reverse trend. Caucasian youth comprised 40% of the total committed youth in the year 2000, compared to 32% in 1993. About 3% of committed youth were of other races or ethnic groups (e.g., Hispanic). The average age of the youth at commitment has been relatively stable, ranging from 15.6 years to 15.8 years over time.
Youth in DJJ have many difficulties, including family problems, low school achievement, and special education needs (for a comprehensive report, see McGarvey & Waite, 1999). About 30% of committed youth in any year have a parent with a history of incarceration. About 50% of youth score at least six years below their chronological age on language achievement scores. More than 40% of youth meet criteria for special education needs (i.e., Learning Disabled, Mentally Retarded, Educationally Disabled). About one-third of youth have a history of head injury, which increases their risk of having had traumatic brain injury.
ASSESSMENT OF PSYCHOLOGICAL FUNCTIONING
All youth committed to the custody of the Virginia Department of Juvenile Justice enter the system through the Reception and Diagnostic Center (RDC) located in Bon Air, Virginia. RDC is a self-contained facility with a main staff building where the offices of the Behavioral Services Unit (BSU) psychologists are located. Youth are housed in one of six living units and are transported back and forth to the main building for assessments during their initial period of incarceration.
At RDC, youth spend their first four weeks being evaluated for service needs and appropriate housing placement at one of the seven juvenile correctional facilities. During this time, each youth is assigned a caseworker who updates their social history and coordinates the assessment process. This includes a physical examination conducted by a physician and a nurse, a psychological assessment conducted by a psychologist, and an educational assessment conducted by an educational specialist. Staff psychologists conduct psychological evaluations on each youth using standard clinical methodology that involves both testing and the assessment of the youth in one-on-one sessions. Case files and history of prior psychological functioning, history of prior psychiatric illness and prior psychotropic medication use, are reviewed.
The findings show that attention deficit disorders, depression, anxiety and psychotic illnesses are present in the histories of many youth who are committed to Virginia's correctional facilities for juveniles. The following provides an overview of the prevalence of these disorders as indicated by the history of psychotropic medication use, diagnoses prior to incarceration and current DSM-IV assessment.
Attention-Deficit/Hyperactivity Disorder (ADHD)
In state fiscal year 2000, 36% of males and 30% of females committed to the juvenile correctional facilities in Virginia had a documented history of psychostimulant use (e.g., Ritalin) (Waite, 2000). …