What happens to boys and girls with psychiatric illnesses who spend time in juvenile detention centers? Five years after being released many haven't gotten adequate treatment and are suffering the consequences: depression, addiction and more. The news has extensive implications for public health officials doing their best to address the mental health needs of children and young adults.
With relentless determination, researchers tracked down 1,829 youths five years after they were put in juvenile detention. Those young people were from an original pool of 2,000 children age 10 to 18 who were the subject of a landmark study published 10 years ago that found a shockingly high rate of psychiatric illness among boys and girls booked into juvenile detention centers.
How they've fared over the five years is the subject of a new study by researchers at Northwestern University Feinberg School of Medicine and published Monday in the Archives of General Psychiatry. The original study, one of the first of its kind, caused a significant overhaul of how detained youths are handled in centers, said the lead author of the study, Linda A. Teplin. Then, nearly two-thirds of males and 75 percent of females who entered juvenile detention centers had one or more diagnosable psychiatric disorders, such as depression, conduct disorder or addiction.
"The first article was sort of a call to action," Teplin, the Owen L. Coon Professor of Psychiatry and Behavioral Sciences, told TakePart. "Many detention centers now screen for mental disorders. But the problem is kids aren't in detention very long. It's not the optimal place to provide services. The better option is to link kids up with services once they get back to their communities."
The new study, also led by Teplin, shows those connections aren't happening. Teplin and her colleagues conducted interviews with the 1,829 youths following their detention. Five years after release, more than 45 percent of the males and nearly 30 percent of the females had one or more psychiatric disorders.
About 20 percent of the both the males and females had mood disorders, such as depression. But the most common problem was substance use disorders, particularly among males, with rates two to three times higher than females. And, although African-American males are locked up on drug charges at many times the rate of whites and Hispanics, they had lower rates of substance use disorders than the other groups. The finding, Teplin says, should contribute to the national discussion on the effectiveness of the "war on drugs" and whether that campaign disproportionately targets certain ethnic or racial groups.
Typically, she says, the kids who come into detention centers are from lower socioeconomic families who don't have the resources to steer their children into psychiatric treatment centers in lieu of detention, as more well-off families might do.
"A lot of these kids don't have to be in detention" if their parents could have intervened on their behalf, she says. "A lot of kids who could have been in detention are not in detention because their parents are savvy enough to be able to get services and because they can afford services."
Meanwhile, girls in detention appear to be faring better than boys because they have been a focus for intervention in the past decade, Teplin said. In recent years, programs have been created for girls to address pregnancy prevention programs, continuation of education and job training.
"There was an a recognition some years ago that the numbers of girls in detention was increasing and that girls are really different than boys and have special needs," she says. "The field was quite aggressive in developing terrific programs for girls in recognition of their gender-based needs. But I think we need to take a good look at the programs we have for boys."
But there's a limit on how much youth detention centers can accomplish, since most youth offenders don't stay in those centers for very long, Teplin said. The average stay is about two weeks. Some detention centers provide initial treatment but are unable to successfully transition youths into community-based treatment.
"It's very difficult. How do you link them up to services in the community when there aren't enough services in the community?" she says. Moreover, "some kids don't have parents involved in their lives or they have parents who are very poor."
It's up to local, state and federal healthcare programs to provide psychiatric services to youths upon discharge from detention centers, Teplin suggests, especially treatment for substance abuse. According to other studies, fewer than 10 percent of juveniles and adults with alcohol use problems receive treatment while incarcerated.
"The key is to link kids to community programs," she says. "That's not the responsibility of the Department of Justice but a responsibility of the healthcare system."
How can healthcare authorities do a better job helping mentally ill kids who are discharged from detention?
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Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.